Cerebral Microbleeds Are Associated with Cerebral Hypoperfusion in Patients with Alzheimer’s Disease

Article type: Research Article

Authors: Hatada, Yutaka^{a; *} | Hashimoto, Mamoru^b | Shiraishi, Shinya^c | Ishikawa, Tomohisa^d | Fukuhara, Ryuji^d | Yuki, Seiji^d | Tanaka, Hibiki^d | Miyagawa, Yusuke^d | Kitajima, Mika^c | Uetani, Hiroyuki^c | Tsunoda, Naoko^d | Koyama, Asuka^d | Ikeda, Manabu^e

Affiliations: [a] Department of Psychiatry, Heisei Hospital, Yatsushiro, Kumamoto, Japan | [b] Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan | [c] Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan | [d] Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan | [e] Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

Correspondence: [*] Correspondence to: Yutaka Hatada, MD, Department of Psychiatry, Heisei Hospital, 720-1 Ohmura-machi, Yatsushiro-shi, Kumamoto 866-0895, Japan. Tel.: +81 965 32 8171; Fax: +81 965 32 8172; E-mail: [email protected].

Abstract: Background:Although cerebral microbleeds (CMBs) are commonly observed in patients with Alzheimer’s disease (AD), their clinical relevance for AD remains unclear. Objective:We investigated the significance of CMBs in AD by examining the relationship between CMBs and cerebral blood flow (CBF) in patients with AD. Methods:Thirty-four patients (aged 77.9±7.6 years; 17 men) with probable AD and multiple (≥8) CMBs were selected from 394 consecutive patients. For each lobe of the brain, the correlation between the number of CMBs observed on susceptibility-weighted images and the decrease in CBF observed on single-photon emission computed tomography was assessed. Results:The number of microbleeds was significantly correlated with the severity of decrease in the occipital lobe (Spearman’s r = 0.531, p < 0.001) and temporal lobe (r = 0.437, p < 0.001) but not in the frontal lobe (r = 0.201, p = 0.101) and parietal lobe (r = 0.178, p = 0.146). These results were unchanged in the partial correlational analysis after controlling the effect of other small vessel disease such as lacunars and white matter hyperintensities. Conclusion:Multiple CMBs are associated with cerebral hypoperfusion in AD. The effects of CMBs on CBF differed according to brain location, possibly reflecting different distributions of the underlying cerebral amyloid angiopathy and AD-related histopathology, such as neurofibrillary tangles.

Keywords: Alzheimer’s disease, amyloid angiopathy, cerebral blood flow, cerebral microbleeds

DOI: 10.3233/JAD-190272

Journal: Journal of Alzheimer's Disease, vol. 71, no. 1, pp. 273-280, 2019