title: Prevalence of small cerebral bleeds in patients with progressive supranuclear palsy: a neuropathological study with 7.0-Tesla magnetic resonance imaging correlates.
abstract: BACKGROUND
  Progressive supranuclear palsy (PSP) is a degenerative disease affecting mainly the brain stem, basal ganglia and cerebellum. Associated cerebrovascular lesions, mainly small cerebral bleeds, are frequently observed in some neurodegenerative diseases such as Alzheimer dementia and rare in others such as frontotemporal lobar degeneration. The present post-mortem study investigates the prevalence and distribution of small cerebral bleeds in PSP brains.
  
  
  METHODS
  Nineteen brains of PSP patients were compared to 12 age-matched controls. The prevalence and distribution of mini-bleeds were investigated on a coronal section of a cerebral hemisphere at the level of the mamillary bodies and on a horizontal section through the pons and cerebellum. In addition, out of these series T2*-weighted gradient-echo 7.0-Tesla magnetic resonance imaging (MRI) of 3 coronal sections of a cerebral hemisphere and of a brain stem and cerebellum was performed in 14 PSP and 11 control brains.
  
  
  RESULTS
  Although the total number of mini-bleeds was the same on neuropathological examination of both groups, they prevailed around the dentate nucleus of the cerebellum (p = 0.05) and in the tegmentum pontis (p = 0.05) of the PSP brains. On MRI the small bleeds were also more frequent around the dentate nucleus of the cerebellum (p = 0.02) and in the pons (p = 0.04) of PSP brains.
  
  
  CONCLUSIONS
  In PSP brains, mini-bleeds only prevail in the regions affected by the neurodegenerative process, similarly to what happens in frontotemporal lobar degeneration. They should be considered as the result of increased angiogenesis and microglial activation, leading to associated disturbances of the blood-brain barrier in the most affected regions of PSP. They are not indicative of cerebrovascular disease.
authors.affiliation: J. De Reuck, MD, PhD, Leopold II laan 96, BE-9000 Ghent, Belgium, phone: +32 9 221 8844; fax: +32 9 3324971, e-mail: dereuck.j@gmail.com.
authors.forename: Jacques
authors.initials: J
authors.lastname: De Reuck
authors.forename: Dominique
authors.initials: D
authors.lastname: Caparros-Lefebvre
authors.forename: Vincent
authors.initials: V
authors.lastname: Deramecourt
authors.forename: Luc
authors.initials: L
authors.lastname: Defebvre
authors.forename: Florent
authors.initials: F
authors.lastname: Auger
authors.forename: Nicolas
authors.initials: N
authors.lastname: Durieux
authors.forename: Regis
authors.initials: R
authors.lastname: Bordet
authors.forename: Florence
authors.initials: F
authors.lastname: Pasquier
authors.forename: Claude-Alain
authors.initials: CA
authors.lastname: Maurage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013494:Supranuclear Palsy, Progressive / Q000453:epidemiology* / Q000473:pathology*