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Research ArticleADULT BRAIN
Open Access

Clinicoradiologic Correlations of Cerebral Microbleeds in Advanced Age

I. Barnaure, M.-L. Montandon, C. Rodriguez, F. Herrmann, K.O. Lövblad, P. Giannakopoulos and S. Haller
American Journal of Neuroradiology January 2017, 38 (1) 39-45; DOI: https://doi.org/10.3174/ajnr.A4956
I. Barnaure
aFrom the Division of Neuroradiology (I.B., K.O.L.)
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M.-L. Montandon
bDepartment of Mental Health and Psychiatry (M.-L.M., C.R., P.G.)
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C. Rodriguez
bDepartment of Mental Health and Psychiatry (M.-L.M., C.R., P.G.)
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F. Herrmann
cDepartments of Internal Medicine, Rehabilitation, and Geriatrics (F.H.), Geneva University Hospitals, Geneva, Switzerland
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K.O. Lövblad
aFrom the Division of Neuroradiology (I.B., K.O.L.)
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P. Giannakopoulos
bDepartment of Mental Health and Psychiatry (M.-L.M., C.R., P.G.)
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S. Haller
dAffidea Centre de Diagnostique Radiologique de Carouge CDRC (S.H.), Geneva, Switzerland
eDepartments of Surgical Sciences and Radiology (S.H.), Uppsala University, Uppsala, Sweden
fDepartment of Neuroradiology (S.H.), University Hospital Freiburg, Germany
gFaculty of Medicine (S.H.), University of Geneva, Geneva, Switzerland.
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    Figure.

    Cerebral microbleeds. Axial SWI of 2 subjects. A, Lobar CMB. Right inferior frontal CMB (arrow) close to the corticomedullary junction. B, Right thalamic CMB (arrow).

Tables

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    • View popup
    Table 1:

    Demographic data for sCON, dCON, and MCI

    sCON (n = 152)dCON (n = 176)MCI (n = 72)P Value
    Females (%)93 (61.2)111 (63.1)25 (34.7)<.001
    Age (M, SD)73.8 (3.9)74.5 (4.1)74 (6.2).372
    Educationa.070
        <9 (%)24 (15.8)31 (17.6)8 (11.1)
        9–12 (%)62 (40.8)93 (52.8)37 (51.4)
        >12 (%)66 (43.4)52 (29.6)27 (37.5)
    • Note:—M indicates mean.

    • ↵a Education in years of schooling.

    • View popup
    Table 2:

    Neuropsychological data of control subjects

    sCON (n = 152)dCON (n = 176)P Value
    MSDMSD
    MMSE28.61.228.41.5.439
    IADL8.30.828.31.1.933
    HADS total5.73.56.23.91.000
        Anxiety4.32.64.52.71.000
        Depression1.41.61.81.9.248
    Digit Span Forward5.61.15.80.96.386
    Visual Memory Span Forward (Corsi)5.10.975.10.89.876
    RI-48 Cued Recall Test
        Delayed cued recall27.35.026.85.11.000
    Shapes test
        Total score (3 immediate recalls)33.93.232.74.3.004a
        Delayed recall11.70.7411.41.3.024a
    Boston Naming Test19.31.019.21.2.680
    Digit Symbol Coding56.111.850.811.0<.001a
    Trail-Making Test A
        Time (s)42.116.042.011.41.000
        Error0.050.250.070.311.000
    Trail-Making Test B
        Time (s)98.741.9105.743.0.667
        Error0.510.730.480.751.000
    Verbal Fluency22.05.622.56.51.000
    Wisconsin Card Sorting Test
        No. of categories completed4.62.14.32.2.223
    Praxis
        Constructional10.90.4810.70.77.032
        Ideomotor transitive9.40.819.11.2.008a
        Ideomotor intransitive19.51.119.51.0.686
        Reflexive7.00.986.91.1.665
    Visual gnosis (Ghent Overlapping Figures)5.00.085.00.08.917
    • Note:—IADL indicates Lawton Instrumental Activities of Daily Living scale; HADS, Hospital Anxiety and Depression Scale; M, mean.

    • ↵a Significant.

    • View popup
    Table 3:

    Microbleed numbers in the present seriesa

    MicrobleedssCON (n = 152)dCON (n = 176)MCI (n = 72)
    No.%No.%No.%
    011475.012872.74968.1
    125 (25)16.530 (30)17.121 (21)29.2
    29 (18)5.912 (24)6.82 (4)2.8
    33 (9)2.06 (18)3.40 (0)0.00
    41 (4)0.660 (0)0.000 (0)0.00
    Totalb152 (56)100176 (72)10072 (25)100
    • ↵a Number and proportion of subjects with x numbers of CMB in each group. Number of CMBs is in parentheses.

    • ↵b The total number of microbleeds for the 3 groups was 153.

    • View popup
    Table 4:

    Microbleed distributiona

    MicrobleedsCON (n = 152)dCON (n = 176)MCI (n = 72)
    No.%No.%No.%
    Location
        None11475.012872.74968.1
        Lobar3120.43419.31825.0
        Deep74.6148.056.9
    Lobes
        Frontal1711.21910.8912.5
        Parietal53.3116.356.9
        Temporal53.363.434.2
        Occipitalb159.995.122.8
    • ↵a Number and proportion of subjects with CMBs for each location.

    • ↵b P = .03 (between sCON and MCI).

    • View popup
    Table 5:

    Multivariate logistic regression to predict progression (sCON/dCON distinction)

    OR95% CIP Value
    Male1.11(0.68–1.81).687
    Age (yr)1.03(0.97–1.10).289
    MMSE0.89(0.74–1.07).216
    Education (yr)
        <91.00––
        9–120.76(0.38–1.50).427
        >120.44(0.22–0.92).028
    Fazekas score
        Absent1.00––
        Mild0.69(0.41–1.18).176
        Moderate0.50(0.24–1.04).062
        Severe1.30(0.51–3.31).586
    No. of microbleeds2.14(0.70–6.48).180
    Microbleed lobar location
        Frontal0.41(0.07–2.58).343
        Parietal1.18(0.22–6.17).847
        Temporal0.63(0.08–5.13).667
        Occipital0.26(0.05–1.28).098
        Other8.09(0.73–89.20).088
    Microbleed depth
        Absent1.00––
        Lobar0.85(0.21–3.46).825
        At least 1 deep0.18(0.02–2.09).171
    • View popup
    Table 6:

    Multivariate linear regression to predict the number of cognitive tests (n = 14) that showed improvement minus the number of tests in which scores declined >0.5 SDs

    Coefficient95% CIP Value
    Male−0.39(−1.29–0.51).391
    Age (yr)−0.06(−0.18–0.05).260
    MMSE−0.35(−0.68–0.01).042
    Education (yr)
        <91.00––
        9–120.21(−1.02–1.44).739
        >120.76(−0.54–2.07).252
    Fazekas score
        Absent1.00––
        Mild0.57(−0.40–1.55).247
        Moderate0.71(−0.63–2.05).298
        Severe0.18(−1.44–1.81).826
    No. of microbleeds−0.36(−2.27–1.54).707
    Microbleed lobar location
        Frontal0.58(−2.56–3.72).716
        Parietal−0.89(−3.81–2.02).546
        Temporal0.80(−2.91–4.50).672
        Occipital1.78(−0.98–4.55).205
        Other−2.01(−6.12–2.09).336
    Microbleed depth
        Absent1.00––
        Lobar−1.39(−3.93–1.16).284
        At least 1 deep1.11(−3.18–5.40).612
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I. Barnaure, M.-L. Montandon, C. Rodriguez, F. Herrmann, K.O. Lövblad, P. Giannakopoulos, S. Haller
Clinicoradiologic Correlations of Cerebral Microbleeds in Advanced Age
American Journal of Neuroradiology Jan 2017, 38 (1) 39-45; DOI: 10.3174/ajnr.A4956

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Clinicoradiologic Correlations of Cerebral Microbleeds in Advanced Age
I. Barnaure, M.-L. Montandon, C. Rodriguez, F. Herrmann, K.O. Lövblad, P. Giannakopoulos, S. Haller
American Journal of Neuroradiology Jan 2017, 38 (1) 39-45; DOI: 10.3174/ajnr.A4956
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