Cerebral Microbleeds in the Aging Population

项目摘要/摘要 脑微出血(CMBS)是随着年龄增长而出现的一种常见脑血管病变。即使CMBS 已被证实是脑出血的危险因素，但几乎没有数据来指导临床医生和患者 关于偶然发现的CMBS未来出血的风险。这导致了临床上的两难选择 需要抗血栓药物来预防脑或心脏缺血，但也有 CMB使他们容易出血。特别是，以前对CMBS的研究并不是基于人群或 还不包括淀粉样蛋白和tau正电子发射断层扫描(PET)。这笔赠款的主要目的是 在以人群为基础的环境中用多模式确定CMBS患者的临床结果 神经成像。在确定CMBS的患病率和发病率后，我们将确定未来的风险 利用Rochester的结果数据研究CMBS患者的脑内出血 流行病学项目。赠款的次要目标是确定病理生理学和 CMBS的病理基础。我们将确定哪些神经成像生物标记物(淀粉样PET、tau PET、白色- 物质高强度、腔隙卒中)与CMBS的位置相关，并预测其发展 CMBS。最后，我们将通过生前磁力检查来识别患有CMBS的个体。 磁共振成像。通过对CMB区域的取样，确定CMBS的病理背景。 我们将利用现有的以人口为基础的和预期的梅奥老年诊所研究(MCSA)队列。 MCSA样本的基于总体的性质非常适合开发和推广 这些发现是因为它捕捉到了偶然检测到的CMBS。该提案的优点之一是告知 大量老年CMBS患者的临床决策。这个项目将作为一个 首席调查员职业发展奖。在项目期间，PI将接受亲身实践 在神经影像分析和量化以及神经病理学方面拥有丰富的经验和专业知识。在……里面 此外，PI将接受在老龄化和CMBS方面经验丰富的调查人员的指导，并参加课程 关于领导力的发展。

PROJECT SUMMARY/ABSTRACT Cerebral microbleeds (CMBs) are a common cerebrovascular pathology found with aging. Even though CMBs are a proven risk factor for intracerebral hemorrhage, there is little data to guide clinicians and patients regarding the risk of future hemorrhage with incidentally identified CMBs. This leads to clinical dilemmas for individuals who require antithrombotic medications to prevent cerebral or cardiac ischemia but also have a CMB predisposing them to hemorrhage. In particular, prior studies of CMBs have not been population-based or have not included amyloid- and tau-positron emission tomography (PET). The primary objective of this grant is to determine the clinical outcome of individuals with CMBs in a population-based setting with multimodal neuroimaging. After determining the prevalence and incidence of CMBs, we will determine the risk of future intracerebral hemorrhage among individuals with CMBs by harnessing outcome data from the Rochester Epidemiology Project. The secondary objective of the grant is to determine the pathophysiologic and pathologic basis for CMBs. We will determine which neuroimaging biomarkers (amyloid PET, tau PET, white- matter hyperintensity, lacunar stroke) are associated with CMBs by location and predict the development of CMBs. Lastly, we will identify individuals with CMBs, who come to autopsy, by antemortem magnetic resonance imaging. By sampling the region of CMB, we will determine the pathologic background of CMBs. We will capitalize on the existing population-based and prospective Mayo Clinic Study of Aging (MCSA) cohort. The population-based nature of the MCSA sample is ideally suited for the development and generalizability of the findings because it captures incidentally detected CMBs. One of the strengths of the proposal is to inform clinical decision-making for the large number of elderly individuals with CMBs. This project will serve as a career development award for the Principal Investigator. During the project, the PI will receive hands-on experience and develop expertise in neuroimaging analysis and quantification, and neuropathology. In addition, the PI will receive mentorship from experienced investigators in aging and CMBs, and take courses on leadership development.