Department of Psychiatry, Heisei Hospital, Yatsushiro, Kumamoto, Japan.
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
J Alzheimers Dis. 2019;71(1):273-280. doi: 10.3233/JAD-190272.
Although cerebral microbleeds (CMBs) are commonly observed in patients with Alzheimer's disease (AD), their clinical relevance for AD remains unclear.
We investigated the significance of CMBs in AD by examining the relationship between CMBs and cerebral blood flow (CBF) in patients with AD.
Thirty-four patients (aged 77.9±7.6 years; 17 men) with probable AD and multiple (≥8) CMBs were selected from 394 consecutive patients. For each lobe of the brain, the correlation between the number of CMBs observed on susceptibility-weighted images and the decrease in CBF observed on single-photon emission computed tomography was assessed.
The number of microbleeds was significantly correlated with the severity of decrease in the occipital lobe (Spearman's r = 0.531, p < 0.001) and temporal lobe (r = 0.437, p < 0.001) but not in the frontal lobe (r = 0.201, p = 0.101) and parietal lobe (r = 0.178, p = 0.146). These results were unchanged in the partial correlational analysis after controlling the effect of other small vessel disease such as lacunars and white matter hyperintensities.
Multiple CMBs are associated with cerebral hypoperfusion in AD. The effects of CMBs on CBF differed according to brain location, possibly reflecting different distributions of the underlying cerebral amyloid angiopathy and AD-related histopathology, such as neurofibrillary tangles.
尽管脑微出血（CMBs）在阿尔茨海默病（AD）患者中很常见，但它们与 AD 的临床相关性尚不清楚。
通过检查 AD 患者 CMBs 与脑血流（CBF）之间的关系，研究 CMBs 在 AD 中的意义。
从 394 例连续患者中选择 34 例（年龄 77.9±7.6 岁；17 名男性）可能患有 AD 且存在多处（≥8 处）CMBs 的患者。评估每个脑叶的 CMBs 数量与单光子发射计算机断层扫描观察到的 CBF 下降之间的相关性。
微出血数量与枕叶（Spearman r=0.531，p<0.001）和颞叶（r=0.437，p<0.001）严重程度降低显著相关，但与额叶（r=0.201，p=0.101）和顶叶（r=0.178，p=0.146）无关。在控制腔隙和白质高信号等其他小血管疾病的影响后，在部分相关分析中，这些结果仍然不变。
多发性 CMBs 与 AD 中的脑灌注不足有关。CMBs 对 CBF 的影响因脑区而异，可能反映了潜在的脑淀粉样血管病和 AD 相关组织病理学（如神经纤维缠结）的不同分布。
