Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Neuroradiology Department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
J Neurol. 2020 May;267(5):1491-1498. doi: 10.1007/s00415-020-09736-0. Epub 2020 Feb 4.
Microbleeds are associated with the development of dementia in older people and are common in Alzheimer's disease (AD). Their prevalence and clinical importance in dementia with Lewy bodies (DLB) is unclear. The objective of this study was to compare the rates of microbleeds in DLB with those in AD and healthy older people, and investigate associations between microbleeds and amyloid deposition, vascular risk and disease severity in DLB.
DLB (n = 30), AD (n = 18) and control (n = 20) participants underwent clinical assessment at baseline and 1 year in this longitudinal observational study. 3T MRI (including T2* susceptibility weighted imaging) and florbetapir PET were carried out at baseline. Microbleeds were rated visually and a standardised uptake value ratio (SUVR) was calculated from florbetapir PET scans.
40% of DLB subjects had microbleeds compared with 50% of AD and 15% of controls. Compared to DLB without microbleeds, those with microbleeds had higher systolic BP (156 ± 26 v. 135 ± 19 mmHg; p = 0.03), but did not have greater levels of vascular disease or amyloid deposition (SUVR 1.25 ± 0.24 v. 1.25 ± 0.22; p = 0.33). There was evidence of less severe dementia in DLB participants with microbleeds, but these differences may have been driven by a shorter disease duration in those with microbleeds.
The presence of microbleeds in DLB is associated with higher blood pressure, but not with other measures of vascular disease or amyloid deposition. The relationship between microbleeds and clinical presentation remains unclear.
微出血与老年人痴呆的发展有关，在阿尔茨海默病（AD）中很常见。在路易体痴呆（DLB）中，其患病率和临床重要性尚不清楚。本研究的目的是比较 DLB 中微出血的发生率与 AD 和健康老年人的发生率，并探讨 DLB 中微出血与淀粉样蛋白沉积、血管风险和疾病严重程度之间的关系。
在这项纵向观察研究中，30 名 DLB（n=30）、18 名 AD（n=18）和 20 名对照组（n=20）参与者在基线和 1 年后进行了临床评估。在基线时进行了 3T MRI（包括 T2*磁敏感加权成像）和氟比拉肽 PET 检查。通过视觉评估微出血，并从氟比拉肽 PET 扫描中计算标准化摄取值比（SUVR）。
与 50%的 AD 和 15%的对照组相比，40%的 DLB 患者有微出血。与无微出血的 DLB 患者相比，有微出血的患者收缩压更高（156±26 v. 135±19 mmHg；p=0.03），但血管疾病或淀粉样蛋白沉积水平没有更高（SUVR 1.25±0.24 v. 1.25±0.22；p=0.33）。有微出血的 DLB 患者的痴呆程度较轻，但这些差异可能是由于有微出血的患者的疾病持续时间较短所致。
DLB 中微出血的存在与更高的血压有关，但与其他血管疾病或淀粉样蛋白沉积的测量无关。微出血与临床表现之间的关系仍不清楚。
