title: Chronic obstructive pulmonary disease and cerebral microbleeds. The Rotterdam Study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a common, complex multisystem disease in the elderly with multiple comorbidities that significantly impact morbidity and mortality. Although cerebral small-vessel disease is an important cause of cognitive decline and age-related disability, it is a poorly investigated potential systemic manifestation of patients with COPD.
  
  
  OBJECTIVE
  To examine whether COPD relates to the development and location of cerebral microbleeds, a novel marker of cerebral small-vessel disease.
  
  
  METHODS
  Cross-sectional and longitudinal analyses were part of the Rotterdam Study, a prospective population-based cohort study in subjects aged greater than or equal to 55 years. Diagnosis of COPD was confirmed by spirometry. Cerebral microbleeds were detected using high-resolution magnetic resonance imaging (MRI).
  
  
  RESULTS
  Subjects with COPD (n = 165) had a higher prevalence of cerebral microbleeds compared with subjects with normal lung function (n = 645) independent of age, sex, smoking status, atherosclerotic macroangiopathy, antithrombotic use, total cholesterol, triglycerides, and serum creatinin (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.15-2.47; P = 0.007). Regarding the specific microbleed location, subjects with COPD had a significantly higher prevalence of microbleeds in deep or infratentorial locations (OR, 3.3; 95% CI, 1.97-5.53; P < 0.001), which increased with severity of airflow limitation and are suggestive of hypertensive or arteriolosclerotic microangiopathy. Furthermore, in longitudinal analysis restricted to subjects without microbleed at baseline, COPD was an independent predictor of incident cerebral microbleeds in deep or infratentorial locations (OR, 7.1; 95% CI, 2.1-24.5; P = 0.002).
  
  
  CONCLUSIONS
  Our findings are compatible with COPD causing an increased risk of the development of cerebral microbleeds in deep or infratentorial locations.
authors.affiliation: 1 Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.forename: Sirwan K L
authors.initials: SK
authors.lastname: Darweesh
authors.forename: Saloua
authors.initials: S
authors.lastname: Akoudad
authors.forename: Daan W
authors.initials: DW
authors.lastname: Loth
authors.forename: Guy F
authors.initials: GF
authors.lastname: Joos
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology