Cerebral microbleeds and neuropsychiatric symptoms in an elderly Asian cohort

Xu, Xiaoyan; Chan, Qun Lin; Hilal, Saima; Goh, Win King; Ikram, M. Kamran; Wong, Tien Yin; Cheng, Ching‐Yu; Chen, Christopher; Venketasubramanian, Narayanaswamy

doi:10.1136/jnnp-2016-313271

Cited by 28 publications

(33 citation statements)

References 29 publications

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“…Collectively, these studies were composed of 7,328 patients with CMBs evaluation (study sample size range: 335–3,742), 1,319 (18.0%) of which had CMBs on initial MRI scans. Notably, patients received SWI (3.0 T) showed higher prevalence of CMBs (33.4–34.9%) than those received T2*-GRE (1.5 T) (10.4–17.3%) ( 3 , 4 , 13 , 15 , 16 ). About half of the patients with CMBs had exactly 1 CMB ( 15 , 16 ).…”

Section: Resultsmentioning

confidence: 98%

“…Six studies (all published) met our predetermined criteria; however, two studies were from a same cohort ( 13 , 14 ). Finally, five studies were pooled in a meta-analysis (Figure 1 ) ( 3 , 4 , 13 , 15 , 16 ). Characteristics of the included studies are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…After excluding van Sloten et al’s study, pooled analysis of the rest four cross-sectional studies ( 4 , 13 , 15 , 16 ), including 5,379 patients (982 with CMBs), demonstrated OR for the presence of CMBs and depression to be 1.230 (95% CI 1.017–1.489; p = 0.033) with no evidence of statistical heterogeneity ( I 2 = 0.0%, p = 0.543) (Figure 4 ). Pooled analysis of Asian cohorts that used 3.0 T MRI ( 13 , 15 ), including 1,137 patients (392 with CMBs), demonstrated OR for the presence of CMBs and depression to be 1.443 (95% CI 1.052–1.980; p = 0.023). However, no significant association was found in the Western cohorts that used 1.5 T MRI (OR = 1.102, 95% CI 0.906–1.342; p = 0.332) ( 3 , 4 , 16 ).…”

Section: Resultsmentioning

confidence: 99%

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Association Between Cerebral Microbleeds and Depression in the General Elderly Population: A Meta-Analysis

Wang

Liu

et al. 2018

Front. Psychiatry

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BackgroundIt remains unclear whether cerebral microbleeds (CMBs) are associated with depression in the general elderly population. We thus performed a meta-analysis to evaluate the relationship between depression and CMBs.MethodsA systematic literature search was conducted in EBSCO, PubMed, and Web of Science for relevant studies that assessed the relationship between depression and the prevalence of CMBs.ResultsFive eligible studies including 7,328 patients were pooled in meta-analysis. The prevalence of CMBs was 18.0%. The prevalence of depression was 11.1%. The pooled analysis demonstrated odds ratio for CMBs and depression to be 1.187 (95% confidence interval 1.005–1.403; p = 0.043) with no evidence of statistical heterogeneity (I2 = 0.0%, p = 0.621).ConclusionOur meta-analysis of available published data indicated an increased prevalence of depression in the subjects with pre-existing CMBs. This finding supports the vascular depression hypothesis. Further studies are needed to investigate the role of CMBs in the pathogenesis and progression of depression, which might provide a potential target for the prevention and treatment.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Association Between Cerebral Microbleeds and Depression in the General Elderly Population: A Meta-Analysis

Wang

Liu

et al. 2018

Front. Psychiatry

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“…As for the limitations, sample sizes, measure scales and measurement bias of the included studies mainly limit our meta-analysis. First, as for sample sizes, some studies [ 6 , 16 , 26 , 29 , 32 , 36 ] involving a relatively large number of participants with CMBs were included, while others were dozens of participants. So, it was likely to cause selection bias due to different sample sizes.…”

Section: Discussionmentioning

confidence: 99%

The significant effects of cerebral microbleeds on cognitive dysfunction: An updated meta-analysis

Yuan

Yang

et al. 2017

PLoS ONE

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ObjectiveAccumulated data suggests that cerebral microbleeds (CMBs) play an important role in the decline of cognitive function, but the results remain inconsistent. In the current study, we aimed to investigate the association between CMBs and cognitive function, as well as the various effects of CMBs on different domains of cognition.MethodsWe searched through the databases of PubMed, Embase, Cochrane Library, and ScienceDirect. After a consistency test, the publication bias was evaluated and a sensitivity analysis was performed with combined odds ratios (OR) and standardized mean difference (SMD) of CMBs.ResultsA meta-analysis of 25 studies with 9343 participants total was conducted. Patients with CMBs had higher incidence of cognitive impairment (OR:3.5410; 95% confidence interval [CI] [2.2979, 5.4567], p<0.05) and lower scores of cognitive functions (SMD: -0.2700 [-0.4267, -0.1133], p<0.05 in Mini-Mental State Examination [MMSE] group and -0.4869 [-0.8902, -0.0818], p<0.05 in Montreal Cognitive Assessment [MoCA] group). Our results also indicated that patients with CMBs had obvious decline in cognitive functions, for instance, orientation (SMD: -0.9565 [-1.7260, -0.1869], p<0.05), attention and calculation (SMD: -1.1518 [-1.9553, -0.3484], p<0.05) and delayed recall (SMD: -0.5527 [-1.1043, -0.0011], p = 0.05).ConclusionsOur data suggested that CMBs might be an important risk factor for cognitive dysfunction, especially in the domains of orientation, attention and calculation and delayed recall functions. Prospective cohort studies with further investigations will be needed in larger samples.

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“…Xu et al 5 emphasise the importance of cerebral microbleeds, a common manifestation of small vessel disease, in the emergence of neuropsychiatric dysfunction, particularly depression and disinhibition. Moullaali et al 6 describe the factors which contribute to intraventricular haemorrhage, a complication of larger expanding haemorrhages.…”

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confidence: 99%