title: Distributional impact of brain microbleeds on global cognitive function in adults without neurological disorder.
abstract: OBJECTIVE
  Brain microbleeds (MBs) are considered to be associated with cognitive decline and can be pathologically and topographically classified as cerebral amyloid angiopathy-related (located in lobar regions) and hypertensive microangiopathy-related (located in deep regions). We examined whether different effects on global cognitive function might be seen with different distributions of MBs.
  
  
  METHODS
  A total of 1279 adults without neurological disorders were studied prospectively. Subjects were divided into 4 groups: without-MBs group; lobar group; deep group; and with in both areas (diffuse group). The Mini-Mental State Examination was administered to determine global cognitive functions, with scores<27 regarded as subnormal.
  
  
  RESULTS
  MBs were detected in 98 subjects (8%): 36 subjects (3%) classified as lobar group, 48 subjects (4%) as deep group, and 14 subjects (1%) as diffuse group. Subnormal scores were found in 76 subjects (5.9%), associated with age, education, hypertension, severe white matter hyperintensities, and distribution and number of MBs. In the final model of logistic regression analysis, the deep group (OR, 2.79; 95% CI, 1.14-6.79) was associated with subnormal scores, whereas the lobar group (OR, 0.77; 95% CI, 0.17-3.44) was not. Trend for the diffuse group did not reach the level of significance (OR, 5.01; 95% CI, 0.88-28.41). These trends were also seen in analysis using another cut-off point for subnormal score. Scores for total Mini-Mental State Examination and attention and calculation were significantly lower in the deep group and the diffuse groups compared with the without-MBs group.
  
  
  CONCLUSIONS
  This Japanese cross-sectional study demonstrated that MB-related global cognitive dysfunction seems to occur based on hypertensive pathogenesis rather than on cerebral amyloid angiopathy.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan. yakushij@cc.saga-u.ac.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yakushiji
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noguchi
authors.forename: Megumi
authors.initials: M
authors.lastname: Hara
authors.forename: Masashi
authors.initials: M
authors.lastname: Nishihara
authors.forename: Makoto
authors.initials: M
authors.lastname: Eriguchi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nanri
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishiyama
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Hirotsu
authors.forename: Junko
authors.initials: J
authors.lastname: Nakajima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Hideo
authors.initials: H
authors.lastname: Hara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology / Q000523:psychology; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D016657:Cerebral Amyloid Angiopathy / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D002543:Cerebral Hemorrhage / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology*; D003072:Cognition Disorders / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases; D009483:Neuropsychological Tests; D011446:Prospective Studies