Yakushiji Yusuke, Noguchi Tomoyuki, Charidimou Andreas, Eriguchi Makoto, Nishihara Masashi, Hara Megumi, Nanri Yusuke, Horikawa Etsuo, Nishiyama Masanori, Werring David J, Hara Hideo
Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan; Stroke Research Group, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Department of Radiology, Saga University Faculty of Medicine, Saga, Japan.
J Stroke Cerebrovasc Dis. 2015 Feb;24(2):431-9. doi: 10.1016/j.jstrokecerebrovasdis.2014.09.015. Epub 2014 Dec 13.
We previously showed that global cognitive function was associated with deep or infratentorial (D/I) cerebral microbleeds (CMBs) in a Japanese healthy cohort. We continually recruited participates and performed further investigation to focus on the impact of different distributions of D/I CMBs on gradient-echo magnetic resonance imaging on global cognitive function.
A total of 1392 subjects including subjects without CMBs (n = 1335), with D/I CMBs limited to the basal ganglia (BG; BG group, n = 33), thalamus (thalamus group, n = 14), and infratentorial area (infratentorial group, n = 10) were included in analyses. Subjects with strictly lobar CMBs (n = 43) were excluded, but subjects in the BG, thalamus, and infratentorial groups could also have lobar CMBs. The mini-mental state examination (MMSE) was administered to determine global cognitive function; scores less than 27 or more than 1.5 standard deviations (SDs) below the age-education-related mean were regarded as impaired.
In the multivariable logistic regression analyses, hypertension and severe white matter hyperintensities were associated with the BG group and the thalamus group. In multivariable logistic regression analysis of the association between D/I CMBs classification and impaired MMSE score, only the BG group consistently displayed associations with both MMSE score less than 27 (odds ratio [OR], 5.96; 95% confidence interval [CI], 2.08-17.09) and MMSE score more than 1.5 SDs below the age-education-related mean (OR, 3.34; 95% CI, 1.24-8.99). In the BG group, adjusted mean scores of total MMSE and "attention and calculation" were lower compared with subjects without CMBs.
In our study of D/I CMBs, only BG CMBs have strong association with global cognitive function. This association was independent of CMBs in other location.
我们之前在一个日本健康队列中发现，整体认知功能与深部或幕下（D/I）脑微出血（CMB）有关。我们持续招募参与者并进行进一步研究，以聚焦D/I CMB在梯度回波磁共振成像上的不同分布对整体认知功能的影响。
总共1392名受试者纳入分析，包括无CMB的受试者（n = 1335）、D/I CMB局限于基底节区（BG；基底节组，n = 33）、丘脑（丘脑组，n = 14）和幕下区域（幕下组，n = 10）的受试者。严格局限于脑叶的CMB受试者（n = 43）被排除，但基底节、丘脑和幕下组的受试者也可能有脑叶CMB。采用简易精神状态检查表（MMSE）评估整体认知功能；得分低于27分或低于年龄-教育相关均值1.5个标准差（SD）以上被视为认知功能受损。
在多变量逻辑回归分析中，高血压和严重的白质高信号与基底节组和丘脑组相关。在对D/I CMB分类与MMSE评分受损之间关联的多变量逻辑回归分析中，只有基底节组始终显示出与MMSE得分低于27分（比值比[OR]，5.96；95%置信区间[CI]，2.08 - 17.09）以及MMSE得分低于年龄-教育相关均值1.5个SD以上（OR，3.34；95% CI，1.24 - 8.99）均有关联。在基底节组中，总MMSE和“注意力及计算能力”的校正平均分低于无CMB的受试者。
在我们对D/I CMB的研究中，只有基底节CMB与整体认知功能有强关联。这种关联独立于其他部位的CMB。
