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

BACKGROUND AND PURPOSE: Cerebral small vessel disease, including white matter lesions and lacunar infarcts, is related to cognitive impairment. Cerebral microbleeds (MBs) are increasingly being recognized as another manifestation of small vessel disease and are also related to cognitive function. However, it remains unclear whether this relation is independent of white matter lesions and lacunar infarcts and if location of MB plays a role. We investigated the relation between the presence, number, and location of MB and cognitive performance adjusted for white matter lesions and lacunar infarcts. METHODS: Presence, number, and location of MB were rated on a gradient echo T2*-weighted MRI in 500 nondemented elderly patients with small vessel disease. Cognitive performance was assessed in different domains. Analyses were adjusted for age, sex, education, depressive symptoms, total brain volume, white matter lesion volume, and lacunar and territorial infarcts. RESULTS: Mean age was 65.6 years (SD 8.8) and 57% were male. MBs were present in 10.4% of the participants. Subjects with MBs were significantly older, had a higher white matter lesion volume, and more lacunar infarcts (P<0.001). Presence and number of MBs were related to global cognitive function (ß-0.10, P=0.008; ß-0.20, P=0.002), psychomotor speed (ß-0.10, P=0.012; ß-0.19, P=0.006), and attention (ß-0.10, P=0.02; ß-0.205, P=0.001). The relations with cognitive performance were mainly driven by frontal, temporal, and strictly deep located MB. CONCLUSIONS: Frontal and temporal located MBs correlate with cognitive performance in nondemented elderly patients independent of coexisting other small vessel disease-related lesions. MBs are clinically not silent and may help to understand the role of vascular disease in cognitive decline.

Microbleeds are independently related to gait disturbances in elderly individuals with cerebral small vessel disease.

BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD), including white matter lesions and lacunar infarcts, is related to gait disturbances. Microbleeds (MB) are another manifestation of SVD, but their clinical impact remains unclear. We therefore investigated the relation between the number and location of MB and gait, independently of white matter lesions and lacunar infarcts. METHODS: MRI scanning was performed in 485 nondemented elderly individuals with cerebral SVD. The number and location of MB were rated. Gait was assessed with a GAITRite system and the Tinetti and Timed-Up-and-Go tests. MB were related to gait parameters by age, height, total brain volume, white matter lesions, and number of lacunar infarcts-adjusted linear regression. RESULTS: A higher number of MB was independently related to a shorter stride length and poorer performance on the Tinetti and Timed-Up-and-Go tests. These relations seemed to be explained by MB in the temporal and frontal lobe and basal ganglia, including the thalamus. CONCLUSIONS: This study offers the first indication that MB may be associated with gait disturbances, independently of other coexisting markers of SVD.