title: Prevalence and clinical implication of microbleeds in dementia with lewy bodies in comparison with microbleeds in Alzheimer's disease.
abstract: BACKGROUND
  Cerebral microbleeds (MBs) have been well investigated in Alzheimer's disease (AD), but not very extensively in non-AD dementias or in dementia with Lewy bodies (DLB).
  
  
  OBJECTIVE
  To elucidate the clinical significance of MBs in DLB.
  
  
  METHODS
  We compared the prevalence, locations and risk factors for MBs in 59 DLB and 81 AD patients. We visually counted MBs in each of the cortical and subjacent areas (frontal, temporal, parietal and occipital), the basal ganglia and the thalamus, and the brainstem and the cerebellar hemispheres on 1.5-tesla T2*-weighted gradient-recalled-echo MRI images. White matter lesions were semiquantified in fluid-attenuated inversion recovery images according to the Fazekas rating scale.
  
  
  RESULTS
  While the prevalence of MBs was comparable, MBs tended to be more abundant in DLB than in AD in all brain areas with the exception of the occipital lobes. The number of MBs was positively associated with the severity of white matter lesions but not with other vascular risk factors in either AD or DLB. The presence of MBs could be associated with cognitive impairment at onset. MB-positive DLB patients showed less impairment on (123)I-metaiodobenzylguanidine myocardial scintigraphy (MIBG scintigraphy) images, supporting the notion of an inverse relationship between vascular lesions and Lewy body pathology.
  
  
  CONCLUSIONS
  It was suggested that an intricate association between Lewy body pathology, AD-type pathologies and vascular lesions seems to be related to the initial symptoms and results of MIBG scintigraphy in DLB.
authors.affiliation: Division of Neurology, Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Fukui
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Oowan
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Ryuta
authors.initials: R
authors.lastname: Kinno
keywords: 123I-metaiodobenzylguanidine myocardial scintigraphy; Alzheimer's disease; Dementia with Lewy bodies; Initial symptoms; Microbleeds; Periventricular hyperintensities; White matter hyperintensities