title: Basal ganglia cerebral microbleeds and global cognitive function: the Kashima Scan Study.
abstract: BACKGROUND
  We previously showed that global cognitive function was associated with deep or infratentorial (D/I) cerebral microbleeds (CMBs) in a Japanese healthy cohort. We continually recruited participates and performed further investigation to focus on the impact of different distributions of D/I CMBs on gradient-echo magnetic resonance imaging on global cognitive function.
  
  
  METHODS
  A total of 1392 subjects including subjects without CMBs (n = 1335), with D/I CMBs limited to the basal ganglia (BG; BG group, n = 33), thalamus (thalamus group, n = 14), and infratentorial area (infratentorial group, n = 10) were included in analyses. Subjects with strictly lobar CMBs (n = 43) were excluded, but subjects in the BG, thalamus, and infratentorial groups could also have lobar CMBs. The mini-mental state examination (MMSE) was administered to determine global cognitive function; scores less than 27 or more than 1.5 standard deviations (SDs) below the age-education-related mean were regarded as impaired.
  
  
  RESULTS
  In the multivariable logistic regression analyses, hypertension and severe white matter hyperintensities were associated with the BG group and the thalamus group. In multivariable logistic regression analysis of the association between D/I CMBs classification and impaired MMSE score, only the BG group consistently displayed associations with both MMSE score less than 27 (odds ratio [OR], 5.96; 95% confidence interval [CI], 2.08-17.09) and MMSE score more than 1.5 SDs below the age-education-related mean (OR, 3.34; 95% CI, 1.24-8.99). In the BG group, adjusted mean scores of total MMSE and "attention and calculation" were lower compared with subjects without CMBs.
  
  
  CONCLUSIONS
  In our study of D/I CMBs, only BG CMBs have strong association with global cognitive function. This association was independent of CMBs in other location.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan; Stroke Research Group, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, United Kingdom. Electronic address: yakushij@cc.saga-u.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yakushiji
authors.affiliation: Department of Radiology, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noguchi
authors.affiliation: Stroke Research Group, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: Andreas
authors.initials: A
authors.lastname: Charidimou
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Eriguchi
authors.affiliation: Department of Radiology, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Nishihara
authors.affiliation: Department of Preventive Medicine, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Hara
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nanri
authors.affiliation: Center for Comprehensive Community Medicine, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Horikawa
authors.affiliation: Department of Internal Medicine, Yuai-Kai Oda Hospital, Kashima, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishiyama
authors.affiliation: Stroke Research Group, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: David J
authors.initials: DJ
authors.lastname: Werring
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Hara
mesh_terms: D000368:Aged; D001479:Basal Ganglia / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000473:pathology / Q000523:psychology*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors
keywords: Cerebral microbleeds; basal ganglia; cognitive dysfunction; magnetic resonance imaging; small vessel disease