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Cerebral microhemorrhages (CMHs) are more common in the elderly, especially in patients with Alzheimer's disease.
These hemorrhages are usually related to hypertension, Alzheimer's disease (AD)-related cerebral amyloid angiopathy (CAA), and Aβ-modified therapy treated amyloid-related imaging abnormality (ARIA) AD.
Therefore, in order to study the inherent clinical risks associated with CMHs and determine the characteristics of high-risk individuals with ARIA-H abnormalities, American scholar Nelly Joseph-Mathurin analyzed 511 families from 19 DIAN locations with dominant inherited AD (DIAD).
Participants were evaluated.
The research results were published in the recent Neurology.
Yimaitong compiles and organizes, please do not reprint without authorization.
Research Introduction The researchers divided 511 participants into gene mutation carrier group (n=310) and non-carrier group (n=201), and performed neuroimaging examinations on them to evaluate the gradient echo MRI sequence and nerve of CMHs.
Psychological and clinical results.
Cross-sectional and longitudinal analyses were used to assess the association between CMHs and neuroimaging and clinical disease markers.
Main findings ➤ The clinical assessment based on the Clinical Dementia Assessment Scale (CDR) and the Clinical Dementia Assessment Scale (CDR-SB) did not differ between the presence or absence of CMHS carriers, while the comprehensive cognitive measurement assessment showed that CMHs carriers The cognitive impairment was more severe than that of non-CMHs and non-carriers (0.
31 vs.
1.
67 vs.
1.
05), and the difference was statistically significant (P<0.
001).
➤ Of the 511 participants, 32 (6.
3%) participants had CMHs at baseline.Of 310 carriers, 26 (8.
4%) had CMHs, and out of 201 non-carriers, only 6 (3.
0%) had CMHs.
The prevalence of CMH in asymptomatic carriers was 3.
0%, and the prevalence of CMH in symptomatic carriers was 18.
3%.
➤ Multivariate logistic regression analysis found that carriers are more likely to develop CMH than non-carriers (OR = 3.
575, 95%CI: 1.
499, 9.
904).
Age and diastolic blood pressure were significantly correlated with the risk of CMHS (OR = 1.
071, 95%CI: 1.
034, 1.
110; OR = 1.
068, 95%CI: 1.
030, 1.
108).
The APOE e4 status has nothing to do with the prevalence or incidence of CMHS.
Over time, the presence of ≥2 CMHs was significantly associated with the risk of continuing to promote CMH (8.
95 ± 10.
04 per year).
Conclusion The results of this cross-sectional and longitudinal analysis describe the factors associated with microbleeds in the DIAD population.
CMHs are part of the underlying disease process of DIAD and are significantly associated with dementia.
These findings have important implications for the selection and monitoring of DIAD populations participating in clinical trials.
Yimaitong compiled from: Joseph-Mathurin N, Wang G, Kantarci K, et al.
Longitudinal Accumulation of Cerebral Microhemorrhages in Dominantly Inherited Alzheimer Disease[J].
Neurology, 2021,96(12):e1632-e1645.
These hemorrhages are usually related to hypertension, Alzheimer's disease (AD)-related cerebral amyloid angiopathy (CAA), and Aβ-modified therapy treated amyloid-related imaging abnormality (ARIA) AD.
Therefore, in order to study the inherent clinical risks associated with CMHs and determine the characteristics of high-risk individuals with ARIA-H abnormalities, American scholar Nelly Joseph-Mathurin analyzed 511 families from 19 DIAN locations with dominant inherited AD (DIAD).
Participants were evaluated.
The research results were published in the recent Neurology.
Yimaitong compiles and organizes, please do not reprint without authorization.
Research Introduction The researchers divided 511 participants into gene mutation carrier group (n=310) and non-carrier group (n=201), and performed neuroimaging examinations on them to evaluate the gradient echo MRI sequence and nerve of CMHs.
Psychological and clinical results.
Cross-sectional and longitudinal analyses were used to assess the association between CMHs and neuroimaging and clinical disease markers.
Main findings ➤ The clinical assessment based on the Clinical Dementia Assessment Scale (CDR) and the Clinical Dementia Assessment Scale (CDR-SB) did not differ between the presence or absence of CMHS carriers, while the comprehensive cognitive measurement assessment showed that CMHs carriers The cognitive impairment was more severe than that of non-CMHs and non-carriers (0.
31 vs.
1.
67 vs.
1.
05), and the difference was statistically significant (P<0.
001).
➤ Of the 511 participants, 32 (6.
3%) participants had CMHs at baseline.Of 310 carriers, 26 (8.
4%) had CMHs, and out of 201 non-carriers, only 6 (3.
0%) had CMHs.
The prevalence of CMH in asymptomatic carriers was 3.
0%, and the prevalence of CMH in symptomatic carriers was 18.
3%.
➤ Multivariate logistic regression analysis found that carriers are more likely to develop CMH than non-carriers (OR = 3.
575, 95%CI: 1.
499, 9.
904).
Age and diastolic blood pressure were significantly correlated with the risk of CMHS (OR = 1.
071, 95%CI: 1.
034, 1.
110; OR = 1.
068, 95%CI: 1.
030, 1.
108).
The APOE e4 status has nothing to do with the prevalence or incidence of CMHS.
Over time, the presence of ≥2 CMHs was significantly associated with the risk of continuing to promote CMH (8.
95 ± 10.
04 per year).
Conclusion The results of this cross-sectional and longitudinal analysis describe the factors associated with microbleeds in the DIAD population.
CMHs are part of the underlying disease process of DIAD and are significantly associated with dementia.
These findings have important implications for the selection and monitoring of DIAD populations participating in clinical trials.
Yimaitong compiled from: Joseph-Mathurin N, Wang G, Kantarci K, et al.
Longitudinal Accumulation of Cerebral Microhemorrhages in Dominantly Inherited Alzheimer Disease[J].
Neurology, 2021,96(12):e1632-e1645.