Meike Willemijn Vernooij MD, Presenter: Nothing to Disclose

Marielle M. F. Poels, Abstract Co-Author: Nothing to Disclose

Mohammad Arfan Ikram, Abstract Co-Author: Nothing to Disclose

Gabriel P. Krestin MD, PhD, Abstract Co-Author: Consultant, General Electric Company Research grant, General Electric Company Research grant, Bayer AG Research grant, Siemens AG

Monique M. B. Breteler MD, PhD, Abstract Co-Author: Nothing to Disclose

Aad Van Der Lugt MD, PhD, Abstract Co-Author: Nothing to Disclose

Vascular pathology has been shown to play a prominent role in impaired cognitive function. Cerebral microbleeds are frequently found on MRI in the general elderly population and may reflect underlying vascular disease, in particular cerebral amyloid angiopathy (CAA) and hypertensive arteriolosclerosis. Their role in cognitive function in the general elderly population, however, is unknown.  

In 3,979 non-demented persons (mean age, 60.3 years) from the population-based Rotterdam Scan Study, brain MRI was performed which included a 3D T2* GRE MRI sequence for microbleed detection. Cognitive function was assessed by performance on neuropsychological tests in the following cognitive domains: memory, executive function, information processing speed, global cognition and motor speed. We used linear regression models to estimate the association of microbleeds with these different cognitive domains. Separate categories were made for 1 microbleed, 2-5 microbleeds, and >5 microbleeds. We stratified analyses for location of microbleeds and APOE ε4 allele status. Additional adjustments were made for vascular risk factors, brain atrophy and other markers of small vessel disease (white matter lesions and lacunar infarcts). 

Presence of more than 5 microbleeds was associated with worse performance in all cognitive domains, except memory. These associations were most marked in participants with strictly lobar microbleeds, whereas associations were much weaker or absent for deep or infratentorial microbleeds. After adjustment for brain atrophy, vascular risk factors or other markers of small vessel disease the associations attenuated only marginally. 

Presence of multiple microbleeds, especially in a strictly lobar location, is associated with worse performance on tests measuring cognitive function, even after adjustments for vascular risk factors and other markers of small vessel disease. These results suggest an independent role for microbleeds in cognitive impairment. 

Our results strongly support the notion that microbleeds may be the “missing link” in the interaction between CAA and hypertensive arteriolosclerosis in the pathogenesis of dementia. 

Vernooij, M, Poels, M, Ikram, M, Krestin, G, Breteler, M, Van Der Lugt, A, Cerebral Microbleeds are Associated with Worse Cognitive Function in the General Population.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012420.html