Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study
Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study
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DOI：
10.1016/j.jns.2016.07.018
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发表时间：
2016-09-15
影响因子：
4.4
通讯作者：
Pantoni, Leonardo
中科院分区：
文献类型：
--
作者：
Valenti, Raffaella;Del Bene, Alessandra;Pantoni, Leonardo
背景和目的：脑微出血(CMBS)是小血管疾病(SVD)的神经影像表现。我们在一组有轻度认知障碍(MCI)的SVD患者中调查了：1)微出血解剖学评定量表(MARS)的可靠性；2)CMBS的负荷和位置及其与认知功能的关系，独立于其他临床和神经影像特征。方法：患者接受临床、神经心理学(4个认知领域)和MRI评估。结果：152例GRE序列患者(男性占57.2%，平均年龄+/-SD：75.5±/-6.7岁)中，41例(27%)至少有一个CMB。评分员对CMBS数量和位置的一致性从好到非常好[多评分员Fleiss kappa(95%CI)：0.70-0.95]。腔隙性脑梗塞和某些临床变量(如高血压和体力活动)与特定区域的CMBS相关。MARS与注意/执行域和流利域相关。讨论：MARS是评估SVD合并MCI患者CMBS的可靠工具。其中近三分之一的患者至少有一例CMB。总的CMBS负荷与注意力/执行功能和流利性领域受损、腔隙梗死以及一些潜在的可改变的危险因素有关。(C)2016爱思唯尔B.V.保留所有权利。
Background and objectives: Cerebral microbleeds (CMBs) are a neuroimaging expression of small vessel disease (SVD). We investigated in a cohort of SVD patients with mild cognitive impairment (MCI): 1) the reliability of the Microbleed Anatomical Rating Scale (MARS); 2) the burden and location of CMBs and their association with cognitive performances, independent of other clinical and neuroimaging features.Methods: Patients underwent clinical, neuropsychological (4 cognitive domains), and MRI assessments. CMBs were assessed by three raters.Results: Out of the 152 patients (57.2% males; mean age +/- SD: 75.5 +/- 6.7 years) with gradient-echo (GRE) sequences, 41 (27%) had at least one CMB. Inter-rater agreement for number and location of CMBs ranged from good to very good [multi-rater Fleiss kappa (95%CI): 0.70-0.95]. Lacunar infarcts and some clinical variables (e.g., hypertension and physical activity) were associated with CMBs in specific regions. Total number of CMBs and of those in deep and lobar regions were associated with attention/executive and fluency domains.Discussion: MARS is a reliable instrument to assess CMBs in SVD patients with MCI. Nearly one third of these patients had at least one CMB. Total CMBs burden was associated with attention/executive functions and fluency domains impairment, lacunar infarcts, and with some potentially modifiable risk factors. (C) 2016 Elsevier B.V. All rights reserved.