Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment.
Different distributions of cerebral microbleeds (CMBs) are associated with distinct pathological mechanisms. Lobar CMBs are thought to be related to cerebral amyloid angiopathy, whereas deep or infratentorial CMBs are related to hypertensive vasculopathy. The present study aimed to evaluate the effects of CMBs and their locations on a variety of cognitive domains.



Study subjects were selected from the community-based I-Lan Longitudinal Aging Study. We assessed cognitive domains, including verbal memory, language, visuospatial executive function, and verbal executive function. CMBs were evaluated using 3T susceptibility-weighted magnetic resonance imaging.



We studied 959 subjects (mean±SD, 62.5±8.6 years; 425 [44.3%] men). CMBs were found in 14.2% of the population. We classified subjects with CMBs into 2 different groups based on the locations of their CMBs: (1) deep or infratentorial (85 subjects, 8.8% of population) and (2) strictly lobar (49, 5.1%). Multivariate linear analysis showed that strictly lobar CMBs were significantly associated with deficits in global cognitive function (Mini-Mental State Examination) and visuospatial executive function, as determined by the copy test of the Taylor complex figure test and the clock drawing test. We adjusted our results for age, sex, years of education, cardiovascular risk factors, and other markers of cerebral small vessel disease, lacunes, and white matter hyperintensity. Deep or infratentorial CMBs were not associated with changes in cognitive function in our population.



Strictly lobar, but not deep or infratentorial, CMBs are associated with changes in cognitive function, especially in visuospatial executive functions. Cerebral amyloid angiopathy may be the underlying pathology associated with CMB-related cognitive impairment.
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Chih-Ping
CP
Chung
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Kun-Hsien
KH
Chou
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Wei-Ta
WT
Chen
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Li-Kuo
LK
Liu
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Wei-Ju
WJ
Lee
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Liang-Kung
LK
Chen
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).
Ching-Po
CP
Lin
From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.). pnwang@vghtpe.gov.tw.
Pei-Ning
PN
Wang
D000368:Aged; D000375:Aging / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000523:psychology; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000523:psychology; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors
aging; cerebral microbleeds; cognitive function; executive function