Neurology: Big data for 10,000 people, what are the risk factors for microbleeding?

 

Cerebral microbleeds (CMB) is a small (<10 mm), low density, oval shape found on T2*-weighted gradient-recalled echo (GRE) or sensitivity weighted imaging (SWI) Or the radiological appearance of a circular area
.

Pathologically, they mostly correspond to hemoglobin deposits near arteries and blood vessels , which are thought to be the result of small bleeding in the past
.

Blood vessel

They are considered to be one of a series of radiological features related to cerebral small vessel disease (SVD), and have a common pathophysiological process with small vessel arterial disease of ischemic lacunar stroke and intracerebral hemorrhage
.

It has been proposed from a pathological point of view that lobar microhemorrhage corresponds to cerebral amyloid angiopathy (CAA), and deep CMB may indicate arteriosclerosis

Stroke

Some studies have explored the risk factors of CMB
.

They have been shown to be related to age and some risk factors, including high blood pressure, obesity and diabetes

The use of diabetes medications such as clopidogrel or anticoagulants has also been shown to be associated with a higher prevalence of CMB

A complicating factor is that the sensitivity of MRI to CMB depends on many factors, including the field strength of the scanner, the acquisition sequence, and whether to use gradient echo or a more sensitive susceptibility weighted sequence (SWI); many studies use multiple Different kinds of scanners
.

In this way, Dongwei Lu and others of the University of Cambridge used the UK biobank to study the relationship between risk factors and CMB in more than 8,000 healthy middle-aged and elderly individuals
.

All patients were scanned on one of two identical scanners, using the same acquisition parameters and SWI sequence

To study the relationship between risk factors and CMB in more than 8,000 healthy middle-aged and elderly individuals

They included 8159 subjects from the UK Biobank, whose MRI data were used for CMB analysis
.

The brain SWI data was obtained on two identical 3.
0T scanners

Among people with CMB, 439 people (76.
7%) have lobar CMB, 103 (18.
0%) have deep CMB, and 83 (14.
5%) have submeningeal CMB
.

Age is an independent risk factor for CMB in all parts
.

ApoE4, gender male and brain lobe CMB are positively correlated, while higher BMI is negatively correlated

In this large population-based study, the prevalence of CMB detected using a low-sensitivity and high-specificity system was 7%
.

There are different risk factors for large-leaf and deep CMB, which are consistent with different underlying pathophysiological processes

There are different risk factors for large leaf and deep CMB, which are consistent with different underlying pathophysiological processes

Original source:
Lu D, Liu J, MacKinnon AD, Tozer DJ, Markus HS.
Prevalence and Risk Factors of Cerebral Microbleeds: An Analysis From the UK Biobank.
Neurology.
Published online August 18, 2021:10.
1212/WNL.
0000000000012673.
doi: 10.
1212/WNL.
0000000000012673

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