Department of Medicine - The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Department of Aged Care, The Royal Melbourne Hospital, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.
Neurobiol Aging. 2024 Feb;134:74-83. doi: 10.1016/j.neurobiolaging.2023.11.006. Epub 2023 Nov 19.
Cerebral microbleeds (CMB) are often associated with vascular risk factors and/or cerebral amyloid angiopathy and are frequently identified in people with dementia. The present study therefore aimed to estimate the pooled prevalence and associations of CMB in Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), using meta-analytic methods. Sixty-five MRI studies were included after a systematic search on major electronic databases. We found that the prevalence of CMB was comparable across the three dementia subtypes (31-36%) and was highly influenced by the MRI techniques used. CMB in AD were associated with a history of hypertension and amyloid-β burden. In contrast, CMB in DLB, despite being predominantly lobar, were associated with hypertension, but not amyloid-β burden. These findings suggest that the underlying pathophysiology of CMB in DLB might differ from that of AD. There was substantially larger number of AD studies identified and more studies evaluating CMB in Lewy body dementias are warranted.
脑微出血 (CMB) 常与血管危险因素和/或脑淀粉样血管病相关,并在痴呆患者中经常被发现。因此,本研究旨在使用荟萃分析方法估计阿尔茨海默病 (AD)、路易体痴呆 (DLB) 和帕金森病痴呆 (PDD) 中 CMB 的患病率和相关性。在主要电子数据库上进行系统搜索后,纳入了 65 项 MRI 研究。我们发现,三种痴呆亚型的 CMB 患病率相当(31-36%),且受 MRI 技术的影响很大。AD 中的 CMB 与高血压和淀粉样蛋白-β负担有关。相比之下,DLB 中的 CMB 虽然主要是脑叶性的,但与高血压有关,而与淀粉样蛋白-β负担无关。这些发现表明,DLB 中 CMB 的潜在病理生理学可能与 AD 不同。AD 的研究数量明显更多,需要更多研究来评估路易体痴呆症中的 CMB。