title: Diagnostic Significance of Cortical Superficial Siderosis for Alzheimer Disease in Patients with Cognitive Impairment.
abstract: OBJECTIVE
  Because the diagnostic significance of cortical superficial siderosis for Alzheimer disease and the association between cortical superficial siderosis and the topographic distribution of cerebral microbleeds have been unclear, we investigated the association between cortical superficial siderosis and clinicoradiologic characteristics of patients with cognitive impairment.
  
  
  METHODS
  We studied 347 patients (217 women, 130 men; mean age, 74 ± 9 years) who visited our memory clinic and underwent MR imaging (3T SWI). We analyzed the association between cortical superficial siderosis and the topographic distribution of cerebral microbleeds plus clinical characteristics including types of dementia. We used multivariate logistic regression analysis to determine the diagnostic significance of cortical superficial siderosis for Alzheimer disease.
  
  
  RESULTS
  Twelve patients (3.5%) manifested cortical superficial siderosis. They were older (P = .026) and had strictly lobar cerebral microbleeds significantly more often than did patients without cortical superficial siderosis (50.0% versus 19.4%, P = .02); the occurrence of strictly deep and mixed cerebral microbleeds, however, did not differ in the 2 groups. Alzheimer disease was diagnosed in 162 (46.7%) patients. Of these, 8 patients (4.9%) had cortical superficial siderosis. In the multivariate logistic regression analysis for the diagnosis of Alzheimer disease, lacunar infarcts were negatively and independently associated with Alzheimer disease (P = .007).
  
  
  CONCLUSIONS
  Although cortical superficial siderosis was associated with a strictly lobar cerebral microbleed location, it was not independently associated with Alzheimer disease in a memory clinic setting. Additional studies are required to investigate the temporal changes of these cerebral amyloid angiopathy-related MR imaging findings.
authors.affiliation: From the Departments of Neurology (Y.I., M.N., M.U., M.W., Y.A.) yinoue@fc.kuh.kumamoto-u.ac.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: From the Departments of Neurology (Y.I., M.N., M.U., M.W., Y.A.).
authors.forename: M
authors.initials: M
authors.lastname: Nakajima
authors.affiliation: Diagnostic Radiology (H.U., T.H., M.K., D.U., Y.Y.).
authors.forename: H
authors.initials: H
authors.lastname: Uetani
authors.affiliation: Diagnostic Radiology (H.U., T.H., M.K., D.U., Y.Y.).
authors.forename: T
authors.identifier: http://orcid.org/0000-0003-1480-2197
authors.initials: T
authors.lastname: Hirai
authors.affiliation: From the Departments of Neurology (Y.I., M.N., M.U., M.W., Y.A.).
authors.forename: M
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Diagnostic Radiology (H.U., T.H., M.K., D.U., Y.Y.).
authors.forename: M
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Diagnostic Radiology (H.U., T.H., M.K., D.U., Y.Y.).
authors.forename: D
authors.initials: D
authors.lastname: Utsunomiya
authors.affiliation: From the Departments of Neurology (Y.I., M.N., M.U., M.W., Y.A.).
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Psychiatry and Neuropathobiology (M.H., M.I.), Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Psychiatry and Neuropathobiology (M.H., M.I.), Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Diagnostic Radiology (H.U., T.H., M.K., D.U., Y.Y.).
authors.forename: Y
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: From the Departments of Neurology (Y.I., M.N., M.U., M.W., Y.A.).
authors.forename: Y
authors.initials: Y
authors.lastname: Ando
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000150:complications*; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged