Department of Neurology, National Yang Ming University, Taipei, Taiwan.
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.
Transl Stroke Res. 2020 Feb;11(1):29-38. doi: 10.1007/s12975-019-00704-z. Epub 2019 Apr 29.
Cerebral small vessel diseases (CSVD), such as white matter hyperintensities (WMH), have been acknowledged as a cause of brain atrophy. However, the relationship between brain volumes and cerebral microbleeds (CMBs) has not yet been determined. We aimed to evaluate whether the presence and topography of CMBs are associated with altered volumes of gray matter (GMV) and white matter (WMV). Non-stroke and non-demented subjects were prospectively recruited from the I-Lan Longitudinal Aging Study. High-resolution 3-T MRI was performed to quantify total and regional WMV and GMV, including Alzheimer's disease-susceptible areas. CMBs were assessed with susceptibility-weighted imaging. Six hundred and fifty-nine subjects (62.1 ± 8.3 years, 290 (44%) men) were included. Thirty-two (4.9%) subjects had strictly lobar CMBs (SL-CMBs) and 51 (7.7%) had deep or infratentorial CMBs (DI-CMBs). We observed an association between CMBs and WMV, independent of age, sex, and vascular risk factors; the direction of association depended on the location of the CMBs. The SL-CMB group had an increased total, frontal, and occipital WMV compared with the no-CMB group, which remained significant after adjusting for other CSVDs (WMH volumes and lacune numbers). In contrast, the DI-CMB group had a decreased occipital WMV compared to the no-CMB group. However, this significance disappeared after taking other CSVDs into consideration. Our results showed no relationship between CMBs and GMV. In conclusion, the increased WMV in non-stroke, non-demented subjects with SL-CMBs observed here provides insight into the early pathogenesis of SL-CMBs. This may be a result of increased water content or amyloid accumulation.
脑小血管病（CSVD），如脑白质高信号（WMH），已被认为是脑萎缩的原因。然而，脑容量与脑微出血（CMBs）之间的关系尚未确定。我们旨在评估 CMBs 的存在和分布是否与灰质（GMV）和白质（WMV）体积的改变有关。非卒中和非痴呆的受试者前瞻性地从宜兰纵向老龄化研究中招募。进行高分辨率 3-T MRI 以量化总和区域性 WMV 和 GMV，包括阿尔茨海默病易感区域。使用磁敏感加权成像评估 CMBs。纳入 659 名受试者（62.1±8.3 岁，290 名（44%）男性）。32 名（4.9%）受试者有严格的皮质下 CMBs（SL-CMBs），51 名（7.7%）有深部或幕下 CMBs（DI-CMBs）。我们观察到 CMBs 与 WMV 之间存在关联，独立于年龄、性别和血管危险因素；关联的方向取决于 CMBs 的位置。与无 CMBs 组相比，SL-CMB 组的总、额和枕部 WMV 增加，调整其他 CSVD（WMH 体积和腔隙数量）后仍然显著。相比之下，与无 CMBs 组相比，DI-CMB 组的枕部 WMV 减少。然而，在考虑其他 CSVDs 后，这种显著性消失了。我们的结果表明 CMBs 与 GMV 之间没有关系。总之，这里观察到非卒中和非痴呆的 SL-CMBs 患者的 WMV 增加提供了对 SL-CMBs 早期发病机制的深入了解。这可能是由于含水量增加或淀粉样蛋白积累所致。
