Distributional Impact of Brain Microbleeds on Global Cognitive Function in Adults Without Neurological Disorder

医学 脑淀粉样血管病 高强度 认知 逻辑回归 微血管病 小型精神状态检查 白质 冲程(发动机) 内科学 认知功能衰退 神经系统检查 磁共振成像 认知障碍 精神科 痴呆 糖尿病 内分泌学 放射科 疾病 工程类 机械工程
作者
Yusuke Yakushiji,Tomoyuki Noguchi,Megumi Hara,Masashi Nishihara,Makoto Eriguchi,Yusuke Nanri,Masanori Nishiyama,Tatsumi Hirotsu,Junko Nakajima,Yasuo Kuroda,Hideo Hara
出处
期刊:Stroke [Lippincott Williams & Wilkins]
卷期号:43 (7): 1800-1805 被引量:67
标识
DOI:10.1161/strokeaha.111.647065
摘要

Brain microbleeds (MBs) are considered to be associated with cognitive decline and can be pathologically and topographically classified as cerebral amyloid angiopathy-related (located in lobar regions) and hypertensive microangiopathy-related (located in deep regions). We examined whether different effects on global cognitive function might be seen with different distributions of MBs.A total of 1279 adults without neurological disorders were studied prospectively. Subjects were divided into 4 groups: without-MBs group; lobar group; deep group; and with in both areas (diffuse group). The Mini-Mental State Examination was administered to determine global cognitive functions, with scores<27 regarded as subnormal.MBs were detected in 98 subjects (8%): 36 subjects (3%) classified as lobar group, 48 subjects (4%) as deep group, and 14 subjects (1%) as diffuse group. Subnormal scores were found in 76 subjects (5.9%), associated with age, education, hypertension, severe white matter hyperintensities, and distribution and number of MBs. In the final model of logistic regression analysis, the deep group (OR, 2.79; 95% CI, 1.14-6.79) was associated with subnormal scores, whereas the lobar group (OR, 0.77; 95% CI, 0.17-3.44) was not. Trend for the diffuse group did not reach the level of significance (OR, 5.01; 95% CI, 0.88-28.41). These trends were also seen in analysis using another cut-off point for subnormal score. Scores for total Mini-Mental State Examination and attention and calculation were significantly lower in the deep group and the diffuse groups compared with the without-MBs group.This Japanese cross-sectional study demonstrated that MB-related global cognitive dysfunction seems to occur based on hypertensive pathogenesis rather than on cerebral amyloid angiopathy.
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