Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Neurobiol Aging. 2013 Sep;34(9):2225-30. doi: 10.1016/j.neurobiolaging.2013.03.021. Epub 2013 Apr 24.
Cerebral small vessel disease (SVD), including white matter lesions (WML) and lacunar infarcts, is related to objective cognitive impairment but also to subjective cognitive failures (SCF). SCF have reported to be an early predictor of dementia. Cerebral microbleeds (MB) are another manifestation of SVD and have been related to cognitive impairment, but the role of MB in SCF has never been studied. We therefore investigated whether MB are related to SCF among non-demented elderly individuals with SVD, independent of coexisting WML and lacunar infarcts. The RUN DMC study is a prospective cohort study among 503 older persons with cerebral SVD between 50 and 85 years of age. All participants underwent FLAIR and T2* scanning. SCF, subjective memory failures (SMF), and subjective executive failures (SEF) were assessed. The relation between SCF and the presence, number and location of MB was assessed by linear regression analyses adjusted for age, sex, education, depressive symptoms, cognitive function, total brain volume, normalized hippocampal volume, territorial infarcts, WML, and lacunar infarcts. MB were present in 11%. We found a relation between the presence, total number and lobar located MB, and SCF, SMF, and SEF and the reported progression of these failures, especially in participants with good objective cognitive function. In conclusion, MB are related to SCF independent of co-existing WML and lacunar infarcts, especially in those with good objective cognitive performance. These results suggest that MB are associated with the earliest manifestations of cognitive impairment. MB may help us to understand the role of the ever-expanding spectrum of SVD in cognitive impairment.
脑小血管病（SVD）包括白质病变（WML）和腔隙性梗死，与客观认知障碍有关，但也与主观认知失败（SCF）有关。SCF 已被报道为痴呆的早期预测指标。脑微出血（MB）是 SVD 的另一种表现形式，与认知障碍有关，但 MB 在 SCF 中的作用从未被研究过。因此，我们研究了在无痴呆的 SVD 老年患者中，MB 是否与非痴呆的 SVD 老年患者的 SCF 有关，而不考虑同时存在的 WML 和腔隙性梗死。RUN DMC 研究是一项针对 503 名年龄在 50 至 85 岁之间的脑 SVD 患者的前瞻性队列研究。所有参与者均接受了 FLAIR 和 T2*扫描。通过线性回归分析评估了 SCF、主观记忆失败（SMF）和主观执行失败（SEF）与 MB 的存在、数量和位置之间的关系，并进行了调整，包括年龄、性别、教育、抑郁症状、认知功能、总脑容量、正常化海马容量、区域性梗死、WML 和腔隙性梗死。MB 存在于 11%的患者中。我们发现 MB 的存在、总数和叶位与 SCF、SMF 和 SEF 之间存在关系，以及这些失败的报告进展，特别是在客观认知功能良好的参与者中。总之，MB 与 SCF 有关，独立于同时存在的 WML 和腔隙性梗死，尤其是在客观认知功能良好的患者中。这些结果表明，MB 与认知障碍的最早表现有关。MB 可能有助于我们理解不断扩大的 SVD 谱在认知障碍中的作用。
