J Clin Neurol.  2020 Jan;16(1):83-89. 10.3988/jcn.2020.16.1.83.

Coexistence of Cerebral Microbleeds and Amyloid Pathology in Patients with Cognitive Complaints

Affiliations
  • 1Department of Neurology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. ahyun@catholic.ac.kr
  • 2Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
  • 4Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
We investigated the prevalence of amyloid positivity and cerebral microbleeds (CMBs) in subjects with cognitive complaints with the aim of identifying differences in clinical parameters and cognitive function according to the pattern of coexistence.
METHODS
We retrospectively enrolled 200 subjects with memory impairment and applied both standardized ¹â¸F-florbetaben PET and brain MRI, including susceptibility-weighted imaging. The amyloid burden was visually classified as positive or negative, and the number and location of CMBs were also analyzed visually. Descriptive analysis was performed for the prevalence of amyloid positivity and CMBs. The relationship between the coexisting pattern of those two findings and clinical parameters including the results of neuropsychiatric tests was analyzed.
RESULTS
Positive amyloid PET scans were exhibited by 102 (51.5%) of the 200 patients, and 51 (25.5%) of them had CMBs, which were mostly located in lobar areas in the patients with positive amyloid scans. The patients with CMBs were older and had a higher burden of white-matter hyperintensities than the patients without CMBs. The patients with CMBs also performed worse in confrontation naming and frontal/executive function. When classified by topographical region, parietal CMBs (odds ratio=3.739, p=0.024) were significantly associated with amyloid positivity.
CONCLUSIONS
The prevalence of CMBs was higher in patients with cognitive decline than in the general population. CMBs play distinctive roles in affecting clinical parameters and neuropsychological profiles according to the coexistence of amyloid pathology.

Keyword

cerebral microbleeds; Alzheimer disease; cognitive dysfunction; dementia

MeSH Terms

Alzheimer Disease
Amyloid*
Brain
Cognition
Dementia
Humans
Magnetic Resonance Imaging
Memory
Parietal Lobe
Pathology*
Positron-Emission Tomography
Prevalence
Retrospective Studies
Amyloid
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