Cerebral microbleeds and neuropsychiatric symptoms in an elderly Asian cohort.
OBJECTIVE
Neuropsychiatric symptoms (NPS) are commonly found in patients with cerebral small vessel disease such as white matter hyperintensities and lacunar infarcts. However, the association between cerebral microbleeds (CMBs) and NPS has not been examined. Hence the present study sought to investigate the relation between CMBs and NPS in an elderly population.


METHODS
This is a cross-sectional study of elderly Asians living in the community, who were assessed on a comprehensive neuropsychological battery and underwent clinical examinations as well as brain MRI scans. The 12-item neuropsychiatric inventory (NPI) was administered to a reliable informant. Total scores for individual symptoms and for NPI global performance were calculated and compared across three groups: no CMB, presence of 1 CMB and presence of multiple CMBs, controlling for demographics, vascular risk factors and other MRI markers.


RESULTS
A total of 802 participants were included in the analysis. Participants with multiple CMBs had higher NPI total score compared to those with no CMB (1.06 vs 2.66, p=0.03). On individual symptom scores, higher score on depression (0.16 vs 0.53, p=0.02) and disinhibition (0.01 vs 0.14, p=0.04) was found in those elderly with multiple CMBs, independent of demographic and vascular risk factors, history of stroke, and other small vessel and large vessel disease markers.


CONCLUSIONS
The presence of multiple CMBs is associated with high global neuropsychiatric disorder burden, in particular symptoms of depression and disinhibition. Future studies are recommended to investigate the importance of CMBs in the pathogenesis and longitudinal progression of neuropsychiatric disorders in the general elderly population.
Department of Pharmacology, National University of Singapore, Singapore, Singapore.|Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
Xin
X
Xu
Department of Pharmacology, National University of Singapore, Singapore, Singapore.|Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
Qun Lin
QL
Chan
Department of Pharmacology, National University of Singapore, Singapore, Singapore.|Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
Saima
S
Hilal
Department of Pharmacology, National University of Singapore, Singapore, Singapore.|Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
Win King
WK
Goh
Departments of Epidemiology & Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Mohammad Kamran
MK
Ikram
Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.|Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Tien Yin
TY
Wong
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Ching-Yu
CY
Cheng
Department of Pharmacology, National University of Singapore, Singapore, Singapore.|Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
Christopher Li-Hsian
CL
Chen
Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.|Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.
Narayanaswamy
N
Venketasubramanian
D000368:Aged; D044466:Asian People / Q000523:psychology*; D016022:Case-Control Studies; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales