Lobar Distribution of Cerebral Microbleeds
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands. Archives of neurology
(Impact Factor: 7.42).
05/2011; 68(5):656-9. DOI: 10.1001/archneurol.2011.93
To investigate the distribution of lobar microbleeds over the different lobes, taking into account lobar volume and clustering effects of multiple microbleeds.
Population-based, cross-sectional analysis.
The Rotterdam Scan Study.
A total of 198 persons (age range, 61-95 years) with lobar microbleeds.
Distribution of microbleeds over different lobes.
We found that lobar cerebral microbleeds occurred significantly more often in the temporal lobe, a region known to be more affected in cerebral amyloid angiopathy.
This study corroborates the presumed association of lobar microbleeds with cerebral amyloid angiopathy.
Available from: Sergi Martinez-Ramirez
- "Associations of mixed MBs resembled the profile of strictly deep MBs. In a subsequent study based on the same population, lobar MBs were seen to occur significantly more often in the temporal lobe , one of the regions severely affected by CAA. There still exists another line of investigation providing support to the link between lobar MB and CAA, and it consists of the study of CAA patients with both MRI and Pittsburgh compound B (PiB)-positron emission tomography (PET) imaging. "
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ABSTRACT: Cerebral microbleeds (MBs) are small chronic brain hemorrhages which are likely caused by structural abnormalities of the small vessels of the brain. Owing to the paramagnetic properties of blood degradation products, MBs can be detected in vivo by using specific magnetic resonance imaging (MRI) sequences. Over the last decades, the implementation of these MRI sequences in both epidemiological and clinical studies has revealed MBs as a common finding in many different populations, including healthy individuals. Also, the topographic distribution of these MBs has been shown to be potentially associated with specific underlying vasculopathies. However, the clinical and prognostic significance of these small hemorrhages is still a matter of debate as well as a focus of extensive research. In this article, we aim to review the current knowledge on the pathophysiology and clinical implications of MBs, with special emphasis on the links between lobar MBs, cerebral amyloid angiopathy, and Alzheimer’s disease.
Available from: PubMed Central
- "Furthermore, these microbleeds might also be related to different pathogenesis. Most studies believed that strictly lobar microbleeds might be related to cerebral amyloid angiopathy31, 32, which refers to the deposition of β-amyloid. On the other hand, similarly to silent brain infarctions, deep and infratentorial microbleeds were proven to be caused by hypertensive arteriolosclerosis33, 34. "
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Leukoaraiosis, microbleeds, and silent brain infarctions are phenotypes of small vessel disease. Leukoaraiosis is the most prevalent, and advanced periventricular leukoaraiosis is regarded as a strong predictor of cognitive dysfunction. Microbleeds and silent brain infarctions sometimes coexist with leukoaraiosis. This study aims to analyze the effects of microbleeds and silent brain infarctions on cognitive function of patients with advanced periventricular leukoaraiosis.
227 patients with advanced periventricular leukoaraiosis were divided into control, MB, SBI, and MB&SBI groups. The presence and locations of microbleeds and silent brain infarctions were evaluated. Mini-Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test and Verbal Fluency Test were performed. Chi-square test and ANOVA to compare the characteristics of four groups, multiple linear regressions to identify the risk factors for cognitive dysfunction.
The scores in all four tests were lower in the MB and MB&SBI groups while only the scores in Clock Drawing Test and Verbal Fluency Test were lower in the SBI group than in the control group. Age and the presence of microbleeds were independent risk factors for the lower scores in all four tests, whereas the presence of silent brain infarctions was the only independent risk factor for the lower scores in Clock Drawing Test and Verbal Fluency Test. Lobar microbleeds had the most significant effect on cognitive function.
Microbleeds and silent brain infarctions were associated differently with cognitive impairment of patients with advanced periventricular leukoaraiosis. The effect of lobar microbleeds was the most significant.
Available from: W.J. Niessen
- "This is indirect evidence that deep or infratentorial microbleeds result from arteriolosclerotic angiopathy, whereas strictly lobar microbleeds are caused by cerebral amyloid angiopathy. This is also corroborated by our finding that spatial distribution of lobar microbleeds in our population follows the known topographic distribution of amyloid angiopathy . "
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ABSTRACT: Neuroimaging plays an important role in etiologic research on neurological diseases in the elderly. The Rotterdam Scan Study was initiated as part of the ongoing Rotterdam Study with the aim to unravel causes of neurological disease by performing neuroimaging in a population-based longitudinal setting. In 1995 and 1999 random subsets of the Rotterdam Study underwent neuroimaging, whereas from 2005 onwards MRI has been implemented into the core protocol of the Rotterdam Study. In this paper, we discuss the background and rationale of the Rotterdam Scan Study. We also describe the imaging protocol and post-processing techniques, and highlight the main findings to date. Finally, we make recommendations for future research, which will also be the main focus of investigation in the Rotterdam Scan Study.
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