Gyanwali Bibek, Shaik Muhammad Amin, Tan Chuen Seng, Vrooman Henri, Venketasubramanian Narayanaswamy, Chen Christopher, Hilal Saima
Memory Aging and Cognition Centre, National University Health System, Singapore.
Department of Pharmacology, National University of Singapore, Singapore.
Aging (Albany NY). 2019 Nov 25;11(22):10581-10596. doi: 10.18632/aging.102478.
Cerebral microbleeds (CMBs) in the lobar and deep locations are associated with two distinct pathologies: cerebral amyloid angiopathy and hypertensive arteriopathy. However, the role of mixed-location CMBs in neurodegeneration remains unexplored. We investigated the associations between strictly lobar, strictly deep and mixed-location CMBs with markers of neurodegeneration. This study recruited 477 patients from a memory clinic who underwent 3T MRI scans. CMBs were categorized into strictly lobar, strictly deep and mixed-location. Cortical thickness, white matter volume and subcortical structural volumes were quantified using Free-Surfer. Linear regression models were performed to assess the association between CMBs and cerebral atrophy, and the mean difference (β) and 95% confidence intervals (CIs) were reported. In the regression analyses, mixed-location CMBs were associated with smaller cortical thickness of limbic region [β= -0.01; 95% CI= -0.02, -0.00, p=0.007) as well as with smaller accumbens volume [β= -0.01; 95% CI= -0.02, -0.00, p=0.004) and presubiculum region of hippocampus [β= -0.01; 95% CI= -0.02, -0.00, p=0.002). Strictly lobar CMBs were associated with smaller total white matter volume [β= -0.03; 95% CI= -0.04, -0.01, p<0.001] and with region specific white matter volumes. The underlying mechanism requires further research and may involve shared mechanisms of vascular dysfunction and neurodegeneration.
脑叶和深部位置的脑微出血（CMBs）与两种不同的病理状况相关：脑淀粉样血管病和高血压性动脉病。然而，混合型CMBs在神经退行性变中的作用仍未得到探索。我们研究了严格局限于脑叶、严格深部以及混合型CMBs与神经退行性变标志物之间的关联。本研究从一家记忆诊所招募了477名接受3T磁共振成像（MRI）扫描的患者。CMBs被分为严格局限于脑叶、严格深部和混合型。使用Free-Surfer软件对皮质厚度、白质体积和皮质下结构体积进行量化。采用线性回归模型评估CMBs与脑萎缩之间的关联，并报告平均差异（β）和95%置信区间（CIs）。在回归分析中，混合型CMBs与边缘叶皮质厚度减小相关[β = -0.01；95% CI = -0.02，-0.00，p = 0.007]，同时与伏隔核体积减小[β = -0.01；95% CI = -0.02，-0.00，p = 0.004]以及海马旁回前区体积减小相关[β = -0.01；95% CI = -0.02，-0.00，p = 0.002]。严格局限于脑叶的CMBs与总白质体积减小相关[β = -0.03；95% CI = -0.04，-0.01，p < 0.001]以及与特定区域的白质体积相关。其潜在机制需要进一步研究，可能涉及血管功能障碍和神经退行性变的共同机制。
