Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
Neuroimage Clin. 2019;22:101749. doi: 10.1016/j.nicl.2019.101749. Epub 2019 Mar 6.
Cerebral microbleeds (CMBs) are considered to be risk factors for cognitive dysfunction. The specific pathology and clinical manifestations of CMBs are different based on their locations. We investigated the association between CMBs at different locations and cognitive dysfunction and explored the potential underlying pathways in a rural Han Chinese population.
We used baseline data from 562 community-dwelling adults (55-65 years old) in the Taizhou Imaging Study between 2013 and 2015. All individuals underwent multimodal brain magnetic resonance imaging (MRI) and 444 subjects completed neuropsychological tests: the Mini-Mental Status Examination and the Montreal Cognitive Assessment. Multinomial logistic regression was used to estimate the association between CMBs and cognitive dysfunction. The volume of brain regions and white matter microstructure were analyzed using Freesurfer and tract-based spatial statistics, respectively.
CMBs were detected in 104 individuals (18.5%) in our study. Multinomial logistic regression found deep/mixed CMBs were associated with global cognitive dysfunction (OR 3.52; 95% CI 1.21 to 10.26), whereas lobar CMBs (OR 1.76; 95% CI 0.56 to 5.53) were not. Quantification of multimodal brain MRI showed that deep/mixed CMBs were accompanied by decreased thalamic volume and loss of fractional anisotropy of bilateral anterior thalamic radiations.
Deep/mixed CMBs were associated with cognitive dysfunction in this Chinese cross-sectional study. Disruption of thalamocortical connectivity might be a potential pathway underlying this relationship.
脑微出血（CMB）被认为是认知功能障碍的危险因素。CMB 的具体病理学和临床表现因其位置而异而有所不同。我们研究了不同部位的 CMB 与认知功能障碍之间的关系，并在一个农村汉族人群中探讨了潜在的潜在途径。
我们使用了 2013 年至 2015 年台州影像学研究中 562 名居住在社区的成年人（55-65 岁）的基线数据。所有患者均接受了多模态脑磁共振成像（MRI）检查，444 名患者完成了神经心理学测试：简易精神状态检查和蒙特利尔认知评估。使用多项逻辑回归来估计 CMB 与认知功能障碍之间的关联。使用 Freesurfer 分析脑区容积，使用基于束的空间统计分析白质微观结构。
在我们的研究中，104 名患者（18.5%）检测到 CMB。多项逻辑回归发现深部/混合 CMB 与整体认知功能障碍相关（OR 3.52；95%CI 1.21-10.26），而脑叶 CMB 则没有（OR 1.76；95%CI 0.56-5.53）。多模态脑 MRI 定量分析显示，深部/混合 CMB 伴有丘脑体积减少和双侧前丘脑辐射各向异性分数丧失。
在这项中国横断面研究中，深部/混合 CMB 与认知功能障碍相关。丘脑皮质连接的中断可能是这种关系的潜在途径。
