Cerebral microbleeds are associated with worse cognitive function The Rotterdam Scan Study
Cerebral microbleeds are associated with worse cognitive function The Rotterdam Scan Study
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DOI：
10.1212/wnl.0b013e3182452928
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发表时间：
2012-01-01
期刊：
影响因子：
9.9
通讯作者：
Vernooij, M. W.
中科院分区：
文献类型：
--
作者：
Poels, M. M. F.;Ikram, M. A.;Vernooij, M. W.
目的：脑微出血常见于老年人群，可能反映潜在的血管疾病，但其在认知功能中的作用尚不清楚。方法：我们调查了3979名无痴呆患者（平均年龄60.3岁）脑微出血与多个认知领域表现之间的关系。采用简易精神状态检查（MMSE）评分和神经心理测试评估整体认知和以下认知领域：记忆、信息处理速度、执行功能和运动速度。我们使用微出血数作为连续变量，并区分无微出血、1微出血、2-4微出血和>= 5微出血。使用线性回归模型估计微出血与不同认知领域的关联。对血管危险因素、脑萎缩和其他脑血管疾病的影像学指标进行了额外的调整。我们根据微出血的位置进行分层分析。结果：微出血越多，MMSE评分越低，在信息处理速度和运动速度测试中的表现越差。当对每个类别进行分析时，出现5个或更多的微出血与除记忆外所有认知领域的较差表现相关。这些关联在严重的大叶微出血患者中最为明显，而在进一步调整后，深度或幕下微出血患者的关联消失。结论：大量微出血的存在，特别是在严格意义上的大叶位置，与认知功能测试的较差表现有关，即使在调整了血管危险因素和其他小血管疾病的成像标记之后也是如此。这些结果表明微出血相关的血管病变在认知障碍中具有独立的作用。神经病学(R) 2012；78:326 - 333
Objective: Cerebral microbleeds are frequently found in the general elderly population and may reflect underlying vascular disease, but their role in cognitive function is unknown.Methods: We investigated the association between cerebral microbleeds and performance in multiple cognitive domains in 3,979 persons without dementia (mean age, 60.3 years). Mini-Mental State Examination (MMSE) score and neuropsychological tests were used to assess global cognition and the following cognitive domains: memory, information processing speed, executive function, and motor speed. We used number of microbleeds as continuous variable, and additionally distinguished between persons with no microbleeds, 1 microbleed, 2-4 microbleeds, and >= 5 microbleeds. The association of microbleeds with different cognitive domains was estimated using linear regression models. Additional adjustments were made for vascular risk factors, brain atrophy, and other imaging markers of cerebral small vessel disease. We stratified analyses by location of microbleeds.Results: A higher number of microbleeds was associated with lower MMSE score and worse performance on tests of information processing speed and motor speed. When analyzed per category, presence of 5 or more microbleeds was associated with worse performance in all cognitive domains, except memory. These associations were most robust in participants with strictly lobar microbleeds, whereas after additional adjustments associations disappeared for deep or infratentorial microbleeds.Conclusions: Presence of numerous microbleeds, especially in a strictly lobar location, is associated with worse performance on tests measuring cognitive function, even after adjustments for vascular risk factors and other imaging markers of small vessel disease. These results suggest an independent role for microbleed-associated vasculopathy in cognitive impairment. Neurology (R) 2012;78:326-333