Oral Carriage of Harboring the Gene Relates to an Increased Incidence of Cerebral Microbleeds.

BACKGROUND AND PURPOSE

Cerebral microbleeds (CMB) are associated with stroke and cognitive impairment. We previously reported a high prevalence of CMB in people with expressing Cnm, a collagen-binding protein in the oral cavity. is a major pathogen responsible for dental caries. Repeated challenge with harboring the gene encoding Cnm induced cerebral bleeding in stroke-prone spontaneously hypertensive rats. The purpose of this longitudinal study is to examine the relationship of -positive to the development of CMB.

METHODS

We retrospectively investigated patients with stroke receiving oral microbiological examination and head 3T magnetic resonance imaging evaluations twice in the period 2014 to 2019, allowing >180-day interval. Patients with -positive were compared with those without. Quasi-Poisson regression models were used to explore associations between -positive and the increase in number of CMB between the 2 magnetic resonance imaging scans.

RESULTS

A total of 111 patients were identified; 21 (19%) with -positive and 90 (81%) without. Clinical history, including blood pressure and the use of antithrombotic agents, were comparable between the 2 groups. New CMB were more commonly observed in patients with -positive (52% versus 23%; =0.008). The incidence of CMB was significantly higher in the group with -positive , especially in deep areas, (incidence rate ratios [95% CI], 5.1 [1.9-13.6] for CMB in any brain region; 15.0 [5.4-42.0] for deep CMB), which persisted after adjusting for age, sex, hypertension, and renal impairment (4.7 [1.8-11.9] for CMB in any brain region; 13.9 [4.3-44.5] for deep CMB).

CONCLUSIONS

This study demonstrates that -positive is associated with an increased incidence of CMB. Treatment for -positive infection may be a novel microbiota-based therapeutic approach for stroke and cognitive impairment.