title: Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study.
abstract: OBJECTIVE
  Cerebral microbleeds (CMBs) are a neuroimaging expression of small vessel disease (SVD). We investigated in a cohort of SVD patients with mild cognitive impairment (MCI): 1) the reliability of the Microbleed Anatomical Rating Scale (MARS); 2) the burden and location of CMBs and their association with cognitive performances, independent of other clinical and neuroimaging features.
  
  
  METHODS
  Patients underwent clinical, neuropsychological (4 cognitive domains), and MRI assessments. CMBs were assessed by three raters.
  
  
  RESULTS
  Out of the 152 patients (57.2% males; mean age±SD: 75.5±6.7years) with gradient-echo (GRE) sequences, 41 (27%) had at least one CMB. Inter-rater agreement for number and location of CMBs ranged from good to very good [multi-rater Fleiss kappa (95%CI): 0.70-0.95]. Lacunar infarcts and some clinical variables (e.g., hypertension and physical activity) were associated with CMBs in specific regions. Total number of CMBs and of those in deep and lobar regions were associated with attention/executive and fluency domains.
  
  
  CONCLUSIONS
  MARS is a reliable instrument to assess CMBs in SVD patients with MCI. Nearly one third of these patients had at least one CMB. Total CMBs burden was associated with attention/executive functions and fluency domains impairment, lacunar infarcts, and with some potentially modifiable risk factors.
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Valenti
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Del Bene
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Poggesi
authors.affiliation: 'Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ginestroni
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Salvadori
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pracucci
authors.affiliation: Division of Neurology, Azienda ULSS 15 "Alta Padovana", Camposampiero Hospital, Padua, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ciolli
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Marini
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Nannucci
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pasi
authors.affiliation: Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pescini
authors.affiliation: Department of Electrical, Electronic, and Information Engineering 'Guglielmo Marconi', University of Bologna, Cesena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Diciotti
authors.affiliation: Department of Neurosciences, University of Pisa, Pisa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Orlandi
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
authors.forename: Mirco
authors.initials: M
authors.lastname: Cosottini
authors.affiliation: Department of Neurosciences, University of Pisa, Pisa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Chiti
authors.affiliation: 'Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Mascalchi
authors.affiliation: Department of Neurosciences, University of Pisa, Pisa, Italy.
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bonuccelli
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy. Electronic address: leonardo.pantoni@unifi.it.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059345:Cerebral Small Vessel Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D060825:Cognitive Dysfunction / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007558:Italy; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
keywords: Cerebral microbleeds; Clinical features; Cognition; Inter-rater agreement; Mars; Small vessel disease