Impact of Cerebral Microbleeds on Lower and Upper Extremities Function in Cerebral Small Vessel Disease

Abstract

Background and Purpose: White matter hyperintensities (WMHs) , lacunars and brain atrophy have been demonstrated to be positively related to gait disorder. However, cerebral microbleeds (CMBs) as a manifestation of cerebral small vessel disease (CSVD) is still under-estimated. Therefore, we investigated the correlations between CMB and upper and lower extremity motor performance.Method: A cross-sectional study of middle-aged to older adults was conducted for this study. CSVD burden was measured with magnetic resonance imaging (MRI) and CMB locations and numbers were analyzed. We evaluated gait and balance using the 4-m walkway, Tinetti, Timed-Up-and-Go (TUG) and Short Physical Performance Battery (SPPB) tests. The upper extremity function was measured by 10 repeated pronation-supination time, 10 repeated finger tapping time, and 10 repeated opening and closing of the hands.Result: A total of 224 participants were included in this study, with a mean age of 60.6±10.5 years. The prevalence of CMB was 33.5% and most of them were lobar. Multiple linear regression analysis showed that CMB was associated with lower gait velocity, wider stride width, longer TUG test time, and poor performance on Tinetti and SPPB tests independently of other coexisting CSVD markers and risk factors. These relationships appeared to be explained by CMBs in the frontal, temporal, basal ganglia and infratentorial regions. The motor function of upper extremity also had independent correlation with CMBs especially in frontal, parietal, temporal, and basal ganglia.Conclusion: We found that CMBs were associated with both gait and upper extremity disturbances. The presence of CMB seems to be another major driving force for CSVD on gait and upper extremity impairment in healthy elderly subjects.

Relationship between glycemic variability and cognitive function in lacune patients with type 2 diabetes

“…Cognitive function disorder ( n = 37) and normal cognitive function ( n = 107) patients were classified according to whether or not cognitive dysfunction occurred. The inclusion criteria were as follows: (1) Patients compatible with T2DM diagnostics criteria established by the ‘China Diabetes Prevention and Treatment Guideline (2017 Edition)”[ 11 ]; (2) patients who met the “Diagnostic Criteria of Lacunes” in the 2021 “Chinese Common Cerebrovascular Disease Medical Specialist Common Recognition” guidelines[ 12 ]; (3) routine blood tests performed on admission, and baseline data such as blood lipids and blood sugar levels were complete; and (4) head magnetic resonance imaging (MRI) was recorded on admission. The exclusion criteria were as follows: (1) Other intracranial diseases such as intracranial infection, massive cerebral infarction, cerebral hemorrhage, and tumor, trauma; (2) taking medications that may affect cognitive function; (3) combined with severe infectious and metabolic diseases; (4) combined with structural or functional damage of vital organs; (5) age < 18 years; and (6) no informed consent was signed.…”

Elevated Pulse Pressure Is a Risk Factor for Cerebral Microbleeds. A Single Center Case-Control Study

“…Our results show that most CMBs amongst the cases were frequently noted in the cortical and subcortical regions, and this may explain the primary clinical observation of limb disorder. Indeed, Hou et al [49] recently confirmed that CMBs are associated with lower gait velocity, wider stride width, longer Time-up-and-Go (TUG) test times, and other upper and lower extremity dysfunctions amongst patients with CMBs.…”

Correlation of imaging markers of cerebral small vessel disease with left ventricular disease: A review

“…CSVD is a type of lesion in which micro and small arteries, their distal branches, capillaries, microvessels, and small veins [1] are the main responsible vessels in the brain. This category also includes some hereditary CSVD, such as autosomal dominant disease combined with subcortical infarcts and leukoencephalopathy (CADASIL) and autosomal recessive disease combined with subcortical infarcts and leukoencephalopathy (CARASIL).…”

“…Cerebral small vessel disease (CSVD) is a common manifestation of cerebrovascular disease that can seriously jeopardize one's health due to its insidious onset, mild clinical symptoms, and ease of neglect [1] . Early diagnosis can significantly reduce the mortality and disability of related cerebrovascular events.…”