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

Abstract

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.

Risk factors of radiotherapy‐induced cerebral microbleeds and serial analysis of their size compared with white matter changes: A 7T MRI study in 113 adult patients with brain tumors

“…When related to neurocognitive measures, CMB burden was associated with impairments in multiple domains of cognitive function, suggesting that CMBs may serve as a potential marker of cognitive impairment . Although this relationship has yet to be shown for patients who received treatment for a brain tumor during adulthood, similar forms of vascular injury have been related to the cognitive decline experienced by healthy aging adults, stroke patients, and patients with neurodegenerative disorders …”

“…9 Although this relationship has yet to be shown for patients who received treatment for a brain tumor during adulthood, similar forms of vascular injury have been related to the cognitive decline experienced by healthy aging adults, stroke patients, and patients with neurodegenerative disorders. 10 While the outcomes of prior studies provide valuable insights into the potential clinical relevance of RT-induced CMBs and the impact that clinical and treatment parameters may have on their development, these prior studies have predominately used lower-field magnetic resonance imaging (MRI) systems and less sensitive imaging data that results in reduced visualization of CMBs, 11 thereby warranting further investigation with more advanced methods. Little published research exists characterizing CMBs, their prevalence, and risk factors in brain tumor patients treated with RT during adulthood.…”

“…. With each additional year following treatment, the data showed~10% increase in CMB burden (rate ratio: 1 10,. confidence interval [CI] [1.04, 1.16]).…”

Automated quantification of small vessel disease brain changes on MRI predicts cognitive and functional decline

“…Due to unavailable susceptibility weighted MRI sequences we could not include cerebral microbleeds in our analyses, although they are regarded as part of the typical SVD neuroimaging features 1 and have been identified as risk factors for cognitive dysfunction. 7 Another limitation of our study is a possible attrition bias in follow-up neuropsychological data (subjects with more severe decline more likely to drop out). Linear mixed models were used as the statistical approach to allow for incomplete observations and utilize all available data.…”

“…The neuroimaging features of SVD include small subcortical infarcts, lacunes, white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), microbleeds and brain atrophy, 1 which have been variably associated with cognitive performance. [2][3][4][5][6][7] Recently, SVD has been considered as a dynamic 'whole-brain' disease due to the diffuse nature, common microvascular pathologies and varying progression of its lesion types. 8 A multifactorial approach, taking comprehensive imaging data into consideration with clinical follow-up, may be optimal in characterizing the course of SVD.…”