Khaledian Homayoon, Rad Ali Julaee, Barjisi Pardis, Saberian Parsa, Mozafar Mehrdad, Ghahramani Sahar, Sadeghi Mohammad, Mayeli Mahsa, Alavi Seyed Mohammad Amin, Berenjian Soorin, Karami Shaghayegh, Andalibian Mohadeseh
Borderless Research, Advancement and Innovation in Neuroscience Network (BRAINet), Tehran, Iran.
Department of Neurosurgery, Faculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
Aging Clin Exp Res. 2025 May 13;37(1):148. doi: 10.1007/s40520-025-02988-8.
To investigate the associations between cerebral microhemorrhages (CMH) and cognitive decline across the Alzheimer's dementia continuum.
Using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, we studied 619 participants, categorized into 221 cognitively normal (CN) participants, 281 patients with mild cognitive impairment (MCI), and 117 patients with Alzheimer's disease (AD). CMH prevalence and distribution were determined using T2-weighted magnetic resonance imaging (MRI), focusing on the frontal, occipital, and parietal subcortical regions of interest (ROIs).Clinical dementia rating scale sum of boxes (CDR-SB) and mini-mental state examination (MMSE) were used for diagnosis and composite cognitive scores regarding visuospatial abilities, language, memory, and executive functions were used as outcome variables. Age, gender, and APOE ε4 positivity status were used as covariates.
The AD group displayed significantly elevated tau and P-tau levels compared to MCI and CN groups (p < 0.001). APOE ε4 positivity was 67.5% in the AD group, surpassing the 50.2% in MCI and 29% in CN individuals (p < 0.001). Cognitive assessments revealed that the AD group's CDR-SB score and MMSE both significantly differed from these scores in the MCI and CN groups (p < 0.001). Overall, CMH prevalence was 27.7%, with a predominant distribution in the frontal subcortical ROIs. MCI subjects with CMH showed notably diminished ADNI Visuospatial Composite Scores compared to those without CMH. Age significantly predicted CMH in CN and MCI (p < 0.05). In AD participants, APOE ε4 heterozygotes (p = 0.02) and homozygotes (p = 0.01) hadincreased CMH likelihood.
CMHs are significantly associated with cognitive decline in patients with MCI. This association is more prominent in regard to the decline in visuospatial abilities.
研究脑微出血（CMH）与阿尔茨海默病连续体中认知衰退之间的关联。
利用阿尔茨海默病神经影像倡议（ADNI）数据库，我们研究了619名参与者，分为221名认知正常（CN）参与者、281名轻度认知障碍（MCI）患者和117名阿尔茨海默病（AD）患者。使用T2加权磁共振成像（MRI）确定CMH的患病率和分布，重点关注额叶、枕叶和顶叶皮质下感兴趣区域（ROI）。临床痴呆评定量表框和（CDR-SB）和简易精神状态检查表（MMSE）用于诊断，视空间能力、语言、记忆和执行功能的综合认知评分用作结果变量。年龄、性别和APOE ε4阳性状态用作协变量。
与MCI和CN组相比，AD组的tau和P-tau水平显著升高（p<0.001）。AD组中APOE ε4阳性率为67.5%，超过MCI组的50.2%和CN个体的29%（p<0.001）。认知评估显示，AD组的CDR-SB评分和MMSE均与MCI和CN组的这些评分有显著差异（p<0.001）。总体而言，CMH患病率为27.7%，主要分布在额叶皮质下ROI。与没有CMH的MCI受试者相比，有CMH的MCI受试者的ADNI视空间综合评分明显降低。年龄在CN和MCI中显著预测CMH（p<0.05）。在AD参与者中，APOE ε4杂合子（p=0.02）和纯合子（p=0.01）发生CMH的可能性增加。
CMH与MCI患者的认知衰退显著相关。这种关联在视空间能力衰退方面更为突出。
