Incident Cerebral Microbleeds Detected by Susceptibility Weight-Imaging Help to Identify Patients with Mild Cognitive Impairment Progressing to Alzheimer’s Disease

Article type: Research Article

Authors: Basselerie, Hubert^{a; *} | Bracoud, Luc^b | Zeestraten, Eva^b | Bouguen, Eva^c | Kiyasova, Vera^c | Pueyo, Maria^c | Cognard, Christophe^a | Dumas, Hervé^a | Gramada, Raluca^a | Ousset, Pierre Jean^d | Vellas, Bruno^d | Bonneville, Fabrice^a

Affiliations: [a] Service de Neuro-Radiologie, Centre Hospitalier Universitaire Toulouse - Purpan, Hôpital Pierre Paul Riquet, Toulouse, France | [b] BioClinica, Lyon, France; Newtown, PA, USA | [c] Institut de Recherches Internationales Servier, Suresnes, France | [d] Gerontopôle, Alzheimer’s Research and Clinical Center, CHU Toulouse, CMRR Midi-Pyrénées, France

Correspondence: [*] Correspondence to: Hubert Basselerie, Service de Radiologie, Centre Hospitalier Universitaire Toulouse - Purpan, Hôpital Pierre Paul Riquet, 330 Avenue de Grande Bretagne, 31059 Toulouse, France. E-mail: [email protected].

Abstract: Background:The relationship between cerebral microbleeds (CMB) and Alzheimer’s disease (AD) has not yet been clearly determined, particularly with susceptibility weight-imaging (SWI). Objective:To evaluate the SWI sequence using 3T MRI for the detection of CMB, and its ability to differentiate elderly control subjects (CS), stable mild cognitive impairment patients (MCI-s), MCI patients progressing to AD (MCI-p), and AD patients. Methods:It was a prospective, monocentric, observational study that took place in Toulouse, France. Participants were 65 years and older, enrolled in three groups: CS, MCI, and AD. Based on the longitudinal analysis of cognitive decline, MCI subjects were retrospectively classified as MCI-s or MCI-p. Each patient had a 4-year follow-up with MRI at baseline (MRI#1) and during the fourth year (MRI#3). CMB were counted on native SWI images juxtaposed to minIP reformatted images. Results:150 patients were enrolled: 48 CS, 25 MCI-s, 18 MCI-p, 59 AD. At MRI#1 and at MRI#3, there was no significant difference in the prevalence of CMB between groups (p = 0.75 and p = 0.87). In the MCI-p + AD group, significantly more subjects had≥4 incident CMB compared to the CS + MCI-s group (p = 0.016). In the MCI-p + AD group, the prevalence of patients with >4 CMB was significantly higher at MRI#3 than at MRI#1 (p = 0.008). Conclusion:Using SWI, AD and MCI-p patients had developed significantly more new CMB than CS and MCI-s patients during the follow-up. Incident CMB might be suggested as a potential imaging marker of AD progression.

Keywords: Alzheimer’s disease, disease progression, imaging biomarker, incident cerebral microbleeds, longitudinal MRI, mild cognitive impairment, susceptibility weight imaging

DOI: 10.3233/JAD-170470

Journal: Journal of Alzheimer's Disease, vol. 60, no. 1, pp. 253-262, 2017