Division of Geriatrics and Geneva Memory Center, Geneva University Hospitals, Geneva, Switzerland.
IMIS Team and IRIS Plateform, ICube Laboratory, UMR 7357, French National Centre for Scientific Research (CNRS), Strasbourg, France.
Int J Geriatr Psychiatry. 2021 Jun;36(6):851-857. doi: 10.1002/gps.5485. Epub 2020 Dec 26.
To determine the prevalence, localization and associations of cerebral microbleeds (CMB) in dementia with Lewy bodies (DLB) with its core clinical symptoms and cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD). We hypothesize DLB patients with CMB have increased amyloid burden compared to those without CMB, which could also translate into clinical differences.
Retrospective cross-sectional analysis from the AlphaLewyMA study (https://clinicaltrials.gov/ct2/show/NCT01876459). Patients underwent a standardized protocol of brain MRI including 3D T1, 3D FLAIR and T2* sequences, and CSF analysis of AD biomarkers. CMB and white matter hyperintensities (WMHs) were visually assessed in prodromal and mild demented (DLB, N = 91) and AD (AD, N = 67) patients.
CMB prevalence did not differ among DLB and AD (24.2% vs. 37.3%; p = 0.081). CMB were mainly distributed in lobar topographies in both DLB (74%) and AD (89%). CMB in DLB was not associated with global cognitive performance, executive functioning, speed of information processing, or AD CSF biomarkers. Similarly, there was no difference regarding specific clinical symptoms: fluctuations, psychotic phenomena, sleep behavior disorder and Parkinsonism between DLB patients with and without CMB. AD patients with CMB had increased burden of WMH compared to those without (2.1 ± 0.86 vs. 1.4 ± 0.89; p = 0.005), according to Fazekas scale, whereas no significant difference was observed in DLB patients (1.68 ± 0.95 vs. 1.42 ± 0.91; p = 0.25).
CMB were equally prevalent with similar topographic distribution in both DLB and AD patients. CMB was not associated with CSF AD biomarkers or core clinical symptoms in DLB.
确定路易体痴呆（DLB）患者中脑微出血（CMB）的患病率、定位和与阿尔茨海默病（AD）核心临床症状和脑脊液（CSF）生物标志物的关联。我们假设与无 CMB 的 DLB 患者相比，有 CMB 的 DLB 患者的淀粉样蛋白负担增加，这也可能转化为临床差异。
回顾性横断面分析来自 AlphaLewyMA 研究（https://clinicaltrials.gov/ct2/show/NCT01876459）。患者接受了包括 3D T1、3D FLAIR 和 T2* 序列在内的脑 MRI 标准方案以及 AD 生物标志物的 CSF 分析。在前驱期和轻度痴呆（DLB，N=91）和 AD（AD，N=67）患者中，通过视觉评估 CMB 和白质高信号（WMHs）。
DLB 和 AD 之间的 CMB 患病率没有差异（24.2% vs. 37.3%；p=0.081）。CMB 主要分布在 DLB（74%）和 AD（89%）的脑叶解剖结构中。DLB 中的 CMB 与整体认知表现、执行功能、信息处理速度或 AD CSF 生物标志物无关。同样，DLB 患者中 CMB 与无 CMB 患者之间在特定的临床症状方面也没有差异：波动、精神病现象、睡眠行为障碍和帕金森病。与无 CMB 的患者相比，AD 患者的 CMB 导致 WM 负担增加（2.1±0.86 与 1.4±0.89；p=0.005），根据 Fazekas 量表，而在 DLB 患者中未观察到显著差异（1.68±0.95 与 1.42±0.91；p=0.25）。
CMB 在 DLB 和 AD 患者中的患病率相同，且具有相似的拓扑分布。CMB 与 DLB 中的 CSF AD 生物标志物或核心临床症状无关。
