Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease
Background and aim Whether cerebral microbleeds cause cognitive impairment remains uncertain. We analyzed whether cerebral microbleeds are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease, and whether this association is independent of other neuroimagi...
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| Veröffentlicht in: | International journal of stroke 2022-04, Vol.17 (4), p.415-424 |
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| creator | Nannoni, Stefania Ohlmeier, Laura Brown, Robin B Morris, Robin G MacKinnon, Andrew D Markus, Hugh S |
| description | Background and aim
Whether cerebral microbleeds cause cognitive impairment remains uncertain. We analyzed whether cerebral microbleeds are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease, and whether this association is independent of other neuroimaging markers of cerebral small vessel disease.
Methods
We analyzed consecutive patients with MRI-confirmed lacunar stroke included in DNA-Lacunar-2 multicenter study. Cerebral microbleeds were graded using the Brain Observer Microbleed Rating Scale (BOMBS). Neuropsychological assessment was performed using the Brief Memory and Executive Test (BMET). We analyzed the association between cerebral microbleeds, BMET, and the following subdomains: executive function/processing speed and orientation/memory. We also searched for an independent association between cerebral microbleeds and vascular cognitive impairment, defined as BMET ≤ 13.
Results
Out of 688 included patients, cerebral microbleeds were detected in 192 (27.9%). After adjusting for white matter hyperintensities severity, lacune count, and other confounders, both the presence and the number of cerebral microbleeds were significantly associated with impaired cognitive performance [β = −13.0; 95% CI = (−25.3, −0.6) and β = −13.1; 95% CI = (−19.8, −6.4), respectively]. On analysis of specific cognitive domains, associations were present for executive function/processing speed [β = −5.8; 95% CI = (−9.3, −2.2) and β = −4.3; 95% CI = (−6.2, −2.4), respectively] but not for orientation/memory [β = −0.4; 95% CI = (−4.0, 3.2) and β = −2.1; 95% CI = (−4.0, 0.1), respectively]. We also found an independent association between the presence and the number of cerebral microbleeds and vascular cognitive impairment [adjusted OR = 1.48; 95% CI = (1.01, 2.18) and OR = 1.43; 95% CI = (1.15, 1.79), respectively].
Conclusion
In a large cohort of symptomatic cerebral small vessel disease patients, after controlling for other neuroimaging markers of cerebral small vessel disease severity, cerebral microbleeds were associated with cognitive dysfunction. Executive function and processing speed were predominantly impaired. This might suggest a causal role of cerebral microbleeds in determining vascular cognitive impairment. |
| doi_str_mv | 10.1177/17474930211012837 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2515687199</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_17474930211012837</sage_id><sourcerecordid>2515687199</sourcerecordid><originalsourceid>FETCH-LOGICAL-c383t-3d40064e5955ebedb746d86cc5584ba7dc96430c9860cdcdae1ed5e989f9b7013</originalsourceid><addsrcrecordid>eNp9kEtLAzEUhYMotlZ_gBvJ0k1r0iSTyVKKLyi40Y2bIZPcqSnzcm6m0n_vlNZuBFf3cvjOgXMIueZsxrnWd1xLLY1gc84Zn6dCn5DxTptKI83p8RdsRC4Q14xJpUVyTkZCpFozrsfkY9Gs6hDDBmioWusibQrqoIO8syWtguuavATwSENNWxsD1BHpd4ifFLdVG5tq0BzFypYl3QAilNQHBItwSc4KWyJcHe6EvD8-vC2ep8vXp5fF_XLqRCriVHjJWCJBGaUgB59rmfg0cU6pVOZWe2cSKZgzacKcd94CB6_ApKYw-VBCTMjtPrftmq8eMGZVQAdlaWtoeszmiqsk1dyYAeV7dKiF2EGRtV2obLfNOMt2k2Z_Jh08N4f4Pq_AHx2_Gw7AbA-gXUG2bvquHur-k_gDfF9_lg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2515687199</pqid></control><display><type>article</type><title>Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease</title><source>Access via SAGE</source><source>MEDLINE</source><creator>Nannoni, Stefania ; Ohlmeier, Laura ; Brown, Robin B ; Morris, Robin G ; MacKinnon, Andrew D ; Markus, Hugh S</creator><creatorcontrib>Nannoni, Stefania ; Ohlmeier, Laura ; Brown, Robin B ; Morris, Robin G ; MacKinnon, Andrew D ; Markus, Hugh S ; DNA Lacunar 2 investigators ; for the DNA Lacunar 2 investigators</creatorcontrib><description>Background and aim
Whether cerebral microbleeds cause cognitive impairment remains uncertain. We analyzed whether cerebral microbleeds are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease, and whether this association is independent of other neuroimaging markers of cerebral small vessel disease.
Methods
We analyzed consecutive patients with MRI-confirmed lacunar stroke included in DNA-Lacunar-2 multicenter study. Cerebral microbleeds were graded using the Brain Observer Microbleed Rating Scale (BOMBS). Neuropsychological assessment was performed using the Brief Memory and Executive Test (BMET). We analyzed the association between cerebral microbleeds, BMET, and the following subdomains: executive function/processing speed and orientation/memory. We also searched for an independent association between cerebral microbleeds and vascular cognitive impairment, defined as BMET ≤ 13.
Results
Out of 688 included patients, cerebral microbleeds were detected in 192 (27.9%). After adjusting for white matter hyperintensities severity, lacune count, and other confounders, both the presence and the number of cerebral microbleeds were significantly associated with impaired cognitive performance [β = −13.0; 95% CI = (−25.3, −0.6) and β = −13.1; 95% CI = (−19.8, −6.4), respectively]. On analysis of specific cognitive domains, associations were present for executive function/processing speed [β = −5.8; 95% CI = (−9.3, −2.2) and β = −4.3; 95% CI = (−6.2, −2.4), respectively] but not for orientation/memory [β = −0.4; 95% CI = (−4.0, 3.2) and β = −2.1; 95% CI = (−4.0, 0.1), respectively]. We also found an independent association between the presence and the number of cerebral microbleeds and vascular cognitive impairment [adjusted OR = 1.48; 95% CI = (1.01, 2.18) and OR = 1.43; 95% CI = (1.15, 1.79), respectively].
Conclusion
In a large cohort of symptomatic cerebral small vessel disease patients, after controlling for other neuroimaging markers of cerebral small vessel disease severity, cerebral microbleeds were associated with cognitive dysfunction. Executive function and processing speed were predominantly impaired. This might suggest a causal role of cerebral microbleeds in determining vascular cognitive impairment.</description><identifier>ISSN: 1747-4930</identifier><identifier>EISSN: 1747-4949</identifier><identifier>DOI: 10.1177/17474930211012837</identifier><identifier>PMID: 33877017</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Cerebral Hemorrhage - complications ; Cerebral Hemorrhage - diagnostic imaging ; Cerebral Hemorrhage - psychology ; Cerebral Small Vessel Diseases - complications ; Cerebral Small Vessel Diseases - diagnostic imaging ; Cognition ; Cognition Disorders - complications ; Cognition Disorders - etiology ; Cognitive Dysfunction - complications ; Cognitive Dysfunction - etiology ; Humans ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Stroke - complications</subject><ispartof>International journal of stroke, 2022-04, Vol.17 (4), p.415-424</ispartof><rights>2021 World Stroke Organization</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-3d40064e5955ebedb746d86cc5584ba7dc96430c9860cdcdae1ed5e989f9b7013</citedby><cites>FETCH-LOGICAL-c383t-3d40064e5955ebedb746d86cc5584ba7dc96430c9860cdcdae1ed5e989f9b7013</cites><orcidid>0000-0002-1825-1874 ; 0000-0002-9794-5996</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/17474930211012837$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/17474930211012837$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33877017$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nannoni, Stefania</creatorcontrib><creatorcontrib>Ohlmeier, Laura</creatorcontrib><creatorcontrib>Brown, Robin B</creatorcontrib><creatorcontrib>Morris, Robin G</creatorcontrib><creatorcontrib>MacKinnon, Andrew D</creatorcontrib><creatorcontrib>Markus, Hugh S</creatorcontrib><creatorcontrib>DNA Lacunar 2 investigators</creatorcontrib><creatorcontrib>for the DNA Lacunar 2 investigators</creatorcontrib><title>Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease</title><title>International journal of stroke</title><addtitle>Int J Stroke</addtitle><description>Background and aim
Whether cerebral microbleeds cause cognitive impairment remains uncertain. We analyzed whether cerebral microbleeds are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease, and whether this association is independent of other neuroimaging markers of cerebral small vessel disease.
Methods
We analyzed consecutive patients with MRI-confirmed lacunar stroke included in DNA-Lacunar-2 multicenter study. Cerebral microbleeds were graded using the Brain Observer Microbleed Rating Scale (BOMBS). Neuropsychological assessment was performed using the Brief Memory and Executive Test (BMET). We analyzed the association between cerebral microbleeds, BMET, and the following subdomains: executive function/processing speed and orientation/memory. We also searched for an independent association between cerebral microbleeds and vascular cognitive impairment, defined as BMET ≤ 13.
Results
Out of 688 included patients, cerebral microbleeds were detected in 192 (27.9%). After adjusting for white matter hyperintensities severity, lacune count, and other confounders, both the presence and the number of cerebral microbleeds were significantly associated with impaired cognitive performance [β = −13.0; 95% CI = (−25.3, −0.6) and β = −13.1; 95% CI = (−19.8, −6.4), respectively]. On analysis of specific cognitive domains, associations were present for executive function/processing speed [β = −5.8; 95% CI = (−9.3, −2.2) and β = −4.3; 95% CI = (−6.2, −2.4), respectively] but not for orientation/memory [β = −0.4; 95% CI = (−4.0, 3.2) and β = −2.1; 95% CI = (−4.0, 0.1), respectively]. We also found an independent association between the presence and the number of cerebral microbleeds and vascular cognitive impairment [adjusted OR = 1.48; 95% CI = (1.01, 2.18) and OR = 1.43; 95% CI = (1.15, 1.79), respectively].
Conclusion
In a large cohort of symptomatic cerebral small vessel disease patients, after controlling for other neuroimaging markers of cerebral small vessel disease severity, cerebral microbleeds were associated with cognitive dysfunction. Executive function and processing speed were predominantly impaired. This might suggest a causal role of cerebral microbleeds in determining vascular cognitive impairment.</description><subject>Cerebral Hemorrhage - complications</subject><subject>Cerebral Hemorrhage - diagnostic imaging</subject><subject>Cerebral Hemorrhage - psychology</subject><subject>Cerebral Small Vessel Diseases - complications</subject><subject>Cerebral Small Vessel Diseases - diagnostic imaging</subject><subject>Cognition</subject><subject>Cognition Disorders - complications</subject><subject>Cognition Disorders - etiology</subject><subject>Cognitive Dysfunction - complications</subject><subject>Cognitive Dysfunction - etiology</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Neuropsychological Tests</subject><subject>Stroke - complications</subject><issn>1747-4930</issn><issn>1747-4949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEUhYMotlZ_gBvJ0k1r0iSTyVKKLyi40Y2bIZPcqSnzcm6m0n_vlNZuBFf3cvjOgXMIueZsxrnWd1xLLY1gc84Zn6dCn5DxTptKI83p8RdsRC4Q14xJpUVyTkZCpFozrsfkY9Gs6hDDBmioWusibQrqoIO8syWtguuavATwSENNWxsD1BHpd4ifFLdVG5tq0BzFypYl3QAilNQHBItwSc4KWyJcHe6EvD8-vC2ep8vXp5fF_XLqRCriVHjJWCJBGaUgB59rmfg0cU6pVOZWe2cSKZgzacKcd94CB6_ApKYw-VBCTMjtPrftmq8eMGZVQAdlaWtoeszmiqsk1dyYAeV7dKiF2EGRtV2obLfNOMt2k2Z_Jh08N4f4Pq_AHx2_Gw7AbA-gXUG2bvquHur-k_gDfF9_lg</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Nannoni, Stefania</creator><creator>Ohlmeier, Laura</creator><creator>Brown, Robin B</creator><creator>Morris, Robin G</creator><creator>MacKinnon, Andrew D</creator><creator>Markus, Hugh S</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1825-1874</orcidid><orcidid>https://orcid.org/0000-0002-9794-5996</orcidid></search><sort><creationdate>202204</creationdate><title>Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease</title><author>Nannoni, Stefania ; Ohlmeier, Laura ; Brown, Robin B ; Morris, Robin G ; MacKinnon, Andrew D ; Markus, Hugh S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-3d40064e5955ebedb746d86cc5584ba7dc96430c9860cdcdae1ed5e989f9b7013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cerebral Hemorrhage - complications</topic><topic>Cerebral Hemorrhage - diagnostic imaging</topic><topic>Cerebral Hemorrhage - psychology</topic><topic>Cerebral Small Vessel Diseases - complications</topic><topic>Cerebral Small Vessel Diseases - diagnostic imaging</topic><topic>Cognition</topic><topic>Cognition Disorders - complications</topic><topic>Cognition Disorders - etiology</topic><topic>Cognitive Dysfunction - complications</topic><topic>Cognitive Dysfunction - etiology</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Neuropsychological Tests</topic><topic>Stroke - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nannoni, Stefania</creatorcontrib><creatorcontrib>Ohlmeier, Laura</creatorcontrib><creatorcontrib>Brown, Robin B</creatorcontrib><creatorcontrib>Morris, Robin G</creatorcontrib><creatorcontrib>MacKinnon, Andrew D</creatorcontrib><creatorcontrib>Markus, Hugh S</creatorcontrib><creatorcontrib>DNA Lacunar 2 investigators</creatorcontrib><creatorcontrib>for the DNA Lacunar 2 investigators</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of stroke</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nannoni, Stefania</au><au>Ohlmeier, Laura</au><au>Brown, Robin B</au><au>Morris, Robin G</au><au>MacKinnon, Andrew D</au><au>Markus, Hugh S</au><aucorp>DNA Lacunar 2 investigators</aucorp><aucorp>for the DNA Lacunar 2 investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease</atitle><jtitle>International journal of stroke</jtitle><addtitle>Int J Stroke</addtitle><date>2022-04</date><risdate>2022</risdate><volume>17</volume><issue>4</issue><spage>415</spage><epage>424</epage><pages>415-424</pages><issn>1747-4930</issn><eissn>1747-4949</eissn><abstract>Background and aim
Whether cerebral microbleeds cause cognitive impairment remains uncertain. We analyzed whether cerebral microbleeds are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease, and whether this association is independent of other neuroimaging markers of cerebral small vessel disease.
Methods
We analyzed consecutive patients with MRI-confirmed lacunar stroke included in DNA-Lacunar-2 multicenter study. Cerebral microbleeds were graded using the Brain Observer Microbleed Rating Scale (BOMBS). Neuropsychological assessment was performed using the Brief Memory and Executive Test (BMET). We analyzed the association between cerebral microbleeds, BMET, and the following subdomains: executive function/processing speed and orientation/memory. We also searched for an independent association between cerebral microbleeds and vascular cognitive impairment, defined as BMET ≤ 13.
Results
Out of 688 included patients, cerebral microbleeds were detected in 192 (27.9%). After adjusting for white matter hyperintensities severity, lacune count, and other confounders, both the presence and the number of cerebral microbleeds were significantly associated with impaired cognitive performance [β = −13.0; 95% CI = (−25.3, −0.6) and β = −13.1; 95% CI = (−19.8, −6.4), respectively]. On analysis of specific cognitive domains, associations were present for executive function/processing speed [β = −5.8; 95% CI = (−9.3, −2.2) and β = −4.3; 95% CI = (−6.2, −2.4), respectively] but not for orientation/memory [β = −0.4; 95% CI = (−4.0, 3.2) and β = −2.1; 95% CI = (−4.0, 0.1), respectively]. We also found an independent association between the presence and the number of cerebral microbleeds and vascular cognitive impairment [adjusted OR = 1.48; 95% CI = (1.01, 2.18) and OR = 1.43; 95% CI = (1.15, 1.79), respectively].
Conclusion
In a large cohort of symptomatic cerebral small vessel disease patients, after controlling for other neuroimaging markers of cerebral small vessel disease severity, cerebral microbleeds were associated with cognitive dysfunction. Executive function and processing speed were predominantly impaired. This might suggest a causal role of cerebral microbleeds in determining vascular cognitive impairment.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>33877017</pmid><doi>10.1177/17474930211012837</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1825-1874</orcidid><orcidid>https://orcid.org/0000-0002-9794-5996</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cerebral Hemorrhage - complications Cerebral Hemorrhage - diagnostic imaging Cerebral Hemorrhage - psychology Cerebral Small Vessel Diseases - complications Cerebral Small Vessel Diseases - diagnostic imaging Cognition Cognition Disorders - complications Cognition Disorders - etiology Cognitive Dysfunction - complications Cognitive Dysfunction - etiology Humans Magnetic Resonance Imaging Neuropsychological Tests Stroke - complications |
| title | Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease |
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