Basal ganglia cerebral microbleeds and global cognitive function: the Kashima Scan Study

J Stroke Cerebrovasc Dis. 2015 Feb;24(2):431-9. doi: 10.1016/j.jstrokecerebrovasdis.2014.09.015. Epub 2014 Dec 13.

Abstract

Background: We previously showed that global cognitive function was associated with deep or infratentorial (D/I) cerebral microbleeds (CMBs) in a Japanese healthy cohort. We continually recruited participates and performed further investigation to focus on the impact of different distributions of D/I CMBs on gradient-echo magnetic resonance imaging on global cognitive function.

Methods: A total of 1392 subjects including subjects without CMBs (n = 1335), with D/I CMBs limited to the basal ganglia (BG; BG group, n = 33), thalamus (thalamus group, n = 14), and infratentorial area (infratentorial group, n = 10) were included in analyses. Subjects with strictly lobar CMBs (n = 43) were excluded, but subjects in the BG, thalamus, and infratentorial groups could also have lobar CMBs. The mini-mental state examination (MMSE) was administered to determine global cognitive function; scores less than 27 or more than 1.5 standard deviations (SDs) below the age-education-related mean were regarded as impaired.

Results: In the multivariable logistic regression analyses, hypertension and severe white matter hyperintensities were associated with the BG group and the thalamus group. In multivariable logistic regression analysis of the association between D/I CMBs classification and impaired MMSE score, only the BG group consistently displayed associations with both MMSE score less than 27 (odds ratio [OR], 5.96; 95% confidence interval [CI], 2.08-17.09) and MMSE score more than 1.5 SDs below the age-education-related mean (OR, 3.34; 95% CI, 1.24-8.99). In the BG group, adjusted mean scores of total MMSE and "attention and calculation" were lower compared with subjects without CMBs.

Conclusions: In our study of D/I CMBs, only BG CMBs have strong association with global cognitive function. This association was independent of CMBs in other location.

Keywords: Cerebral microbleeds; basal ganglia; cognitive dysfunction; magnetic resonance imaging; small vessel disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Basal Ganglia / pathology*
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / pathology
  • Cerebral Hemorrhage / psychology*
  • Cognition Disorders / etiology*
  • Cognition Disorders / pathology
  • Cognition Disorders / psychology
  • Cognition*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Risk Factors