Original Article
Basal Ganglia Cerebral Microbleeds and Global Cognitive Function: The Kashima Scan Study

https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.09.015Get rights and content

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.

Section snippets

Subjects

This is a cross-sectional study based on the Kashima Scan Study, an ongoing population-based cohort study investigating age-related brain changes on MRI.6, 10, 16 A total of 1739 consecutive adults, who underwent health-screening tests of the brain in our center at their own expense between December 2005 and November 2011, were considered for this study. Inclusion criteria were: (1) 20 years of age or older; (2) no disability in instrumental activities of daily living; (3) ability to

Results

In total, 244 CMBs (range, 0-26) were detected in 116 of 1451 subjects (8.0%). A total of 113 CMBs were located in lobar areas. A total of 131 CMBs were located in D/I areas (D/I CMBs were the most common in the BG [58 CMBs]). Of the 116 subjects with CMBs, 43 (3%) were classified in the strictly lobar CMBs group and 73 (5%) in the D/I CMBs group, which composed of the following subgroups (Fig 1: BG group, n = 33; thalamus group, n = 14; infratentorial group, n = 10; other deep areas group,

Discussion

In our ongoing population-based Kashima Scan Study, we have previously demonstrated an association between global cognitive dysfunction and CMBs,6 especially D/I CMBs,10 in Japanese adults, living independently, with no history of neurological disorder, and normal results in neurological examination. Our present cross-sectional study further expands these findings as it demonstrates that BG CMBs (but not thalamic or infratentorial CMBs) are significantly associated with global cognitive

Acknowledgments

We wish to thank Ms. Mai Miyamoto, Dr. Hirotsu Tatsumi, Dr. Junko Nakashima, Dr. Masamichi Oda, and the medical staff of Yuai-Kai Oda Hospital for their help in conducting medical interviews, acquiring clinical data, and inputting data.

References (33)

  • D.J. Werring et al.

    Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI

    Brain

    (2004)
  • C. Cordonnier et al.

    Prevalence and severity of microbleeds in a memory clinic setting

    Neurology

    (2006)
  • Y. Yakushiji et al.

    Brain microbleeds and global cognitive function in adults without neurological disorder

    Stroke

    (2008)
  • C. Qiu et al.

    Cerebral microbleeds, retinopathy, and dementia: the AGES-Reykjavik Study

    Neurology

    (2010)
  • A.G. van Norden et al.

    Frontal and temporal microbleeds are related to cognitive function: the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) Study

    Stroke

    (2011)
  • M.M. Poels et al.

    Cerebral microbleeds are associated with worse cognitive function: the Rotterdam Scan Study

    Neurology

    (2012)
  • Cited by (0)

    The Kashima Scan Study was partially supported by a Grant-in-Aid for University Reform 2006 from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

    The authors declare that there are no conflicts of interest.

    View full text