Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
J Alzheimers Dis. 2021;81(1):113-122. doi: 10.3233/JAD-201536.
The relationship between cerebral microbleeds (CMBs) on hemosiderin-sensitive MRI sequences and cerebral amyloid angiopathy (CAA) remains unclear in population-based participants or in individuals with dementia.
To determine whether CMBs on antemortem MRI correlate with CAA.
We reviewed 54 consecutive participants with antemortem T2*GRE-MRI sequences and subsequent autopsy. CMBs were quantified on MRIs closest to death. Autopsy CAA burden was quantified in each region including leptomeningeal/cortical and capillary CAA. By a clustering approach, we examined the relationship among CAA variables and performed principal component analysis (PCA) for dimension reduction to produce two scores from these 15 interrelated predictors. Hurdle models assessed relationships between principal components and lobar CMBs.
MRI-based CMBs appeared in 20/54 (37%). 10 participants had ≥2 lobar-only CMBs. The first two components of the PCA analysis of the CAA variables explained 74% variability. The first rotated component (RPC1) consisted of leptomeningeal and cortical CAA and the second rotated component of capillary CAA (RPC2). Both the leptomeningeal and cortical component and the capillary component correlated with lobar-only CMBs. The capillary CAA component outperformed the leptomeningeal and cortical CAA component in predicting lobar CMBs. Both capillary and the leptomeningeal/cortical components correlated with number of lobar CMBs.
Capillary and leptomeningeal/cortical scores correlated with lobar CMBs on MRI but lobar CMBs were more closely associated with the capillary component. The capillary component correlated with APOEɛ4, highlighting lobar CMBs as one aspect of CAA phenotypic diversity. More CMBs also increase the probability of underlying CAA.
在基于人群的参与者或痴呆患者中，磁共振成像（MRI）序列上的脑微出血（CMBs）与脑淀粉样血管病（CAA）之间的关系尚不清楚。
确定MRI 上的 CMBs 是否与 CAA 相关。
我们回顾了 54 例连续接受 MRI 检查的患者，这些患者生前进行了 T2*GRE-MRI 序列检查，并随后进行了尸检。在与死亡时间最接近的 MRI 上对 CMBs 进行定量分析。对包括软脑膜/皮质和毛细血管 CAA 在内的每个区域的 CAA 负担进行定量分析。通过聚类方法，我们检查了 CAA 变量之间的关系，并对这些 15 个相互关联的预测因子进行主成分分析（PCA）以进行降维，从而从这些预测因子中产生两个得分。障碍模型评估了主要成分与脑叶 CMBs 之间的关系。
MRI 上的 CMBs 出现在 20/54 例（37%）患者中。10 例患者存在≥2 个脑叶仅有 CMBs。CAA 变量的 PCA 分析的前两个成分解释了 74%的变异性。第一旋转成分（RPC1）由软脑膜和皮质 CAA 组成，第二旋转成分由毛细血管 CAA（RPC2）组成。软脑膜和皮质成分以及毛细血管成分均与脑叶仅有 CMBs 相关。毛细血管 CAA 成分在预测脑叶 CMBs 方面优于软脑膜和皮质 CAA 成分。毛细血管和软脑膜/皮质成分均与脑叶 CMBs 的数量相关。
毛细血管和软脑膜/皮质评分与 MRI 上的脑叶 CMBs 相关，但脑叶 CMBs 与毛细血管成分的相关性更强。毛细血管成分与 APOEɛ4 相关，突出了脑叶 CMBs 是 CAA 表型多样性的一个方面。更多的 CMBs 也增加了潜在 CAA 的可能性。
