title: Cerebral microbleeds in early Alzheimer's disease.
abstract: We hypothesize that cerebral microbleeds (CMB) in patients with different neuropsychological profiles (amnestic or non-amnestic) and MRI features of vascular damage could provide important information on the underlying pathological process in early Alzheimer's disease. The study was performed at two trial sites. We studied 136 outpatients with cognitive decline. MRI was performed using a magnetic field of 1.5 and 3 T. Neuropsychological assessment included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Addenbrooke's Cognitive Examination (ACE-R), Cambridge Cognitive Examination battery (CAMCOG) (Part 3), Clock Drawing Test, fluency test and the visual memory test (SCT). CSF was examined for standard parameters such as tau, phosphorylated tau, amyloid-β 1-40 and 42 and Qalbumin, in accordance with established protocols and genotype. In 61 patients (45 %), at least 1 CMB was found. Most of the CMBs were described in the amnestic profile (67 %). In 86 % of the cases, multiple CMB were observed. The ratio of Aβ1-40/42 in non-amnestic patients with CMB was significantly lower (mean 0.6) than in patients without CMB (mean 1.2). A notable difference in the albumin ratio as an indicator of the BBB was observed between groups with and without CMB. In the CMP-positive group, the E2 genotype was observed more frequently, and the E4 genotype less frequently, than in the CMB-negative group. Based on the cerebrospinal fluid-serum albumin ratio, we were able to show that patients with CMB present several features of BBB dysfunction. According to logistic regression, the predictive factors for CMB in patients with cognitive decline were age, WMHs score and albumin ratio. We found a significant reduction in the Aβ-amyloid ratio in the non-amnestic profile group with CMB (particularly in the cortical region) in comparison to those without CMB. While this is an interesting finding, its significance needs to be assessed in a prospective follow-up.
authors.affiliation: Russian Medical Academy of Postgraduate Education, Moscow, Russia.|Clinical Hospital of S.P. Botkin, Moscow, Russia.
authors.forename: T
authors.initials: T
authors.lastname: Poliakova
authors.affiliation: Russian Medical Academy of Postgraduate Education, Moscow, Russia.
authors.forename: O
authors.initials: O
authors.lastname: Levin
authors.affiliation: Clinical Hospital of S.P. Botkin, Moscow, Russia.
authors.forename: A
authors.initials: A
authors.lastname: Arablinskiy
authors.affiliation: Russian Medical Academy of Postgraduate Education, Moscow, Russia.
authors.forename: E
authors.initials: E
authors.lastname: Vasenina
authors.affiliation: Department of Neurology, National Reference Center for Neurodegenerative Diseases, University Medical School, Georg-August-Universität Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany. epicjd@med.uni-goettingen.de.
authors.forename: I
authors.initials: I
authors.lastname: Zerr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000150:complications* / Q000000981:diagnostic imaging; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D001057:Apolipoproteins E / Q000235:genetics; D002543:Cerebral Hemorrhage / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D001057:Apolipoproteins E; D010446:Peptide Fragments; C000605559:amyloid beta-protein (11-42); D016875:tau Proteins
keywords: Alzheimer disease; Blood–brain barrier damage; Cerebral microbleeds; Magnetic resonance imaging; Mild cognitive impairment; White matter lesions