Cognitive Dysfunction in Relation to Topography and Burden of Cerebral Microbleeds.

Introduction: Contribution of cerebral microbleeds (CMBs) on cognitive dysfunctions in elderly patients with otherwise asymptomatic white matter lesions (WMLs) is not well-documented.

Methods: MRI parameters of cerebral atrophy, CMBs and WMLs were herein analyzed in relation to global and main domains (attention, executive, memory, visuospatial, language) of cognitive function. Eighty-five patients older than 50, without neurodegenerative/cerebrovascular disease, but had CMBs were recruited from 2562 with T2*-gradient-echo MR imaging during one-year period.

Results: Global cognition, evaluated by mini-mental status examination (MMSE), was impaired (score ≤24) in 42%. In contrast to CMBs load, WML burden and temporal atrophy were significantly higher in cases with MMSE≤24. Cholinergic Pathways HyperIntensities Scale (CHIPS) was positively correlated with global cognitive dysfunction but its CMB counterpart, Cholinergic Pathways Bleeding Scale described herein, was not. However, burden of CMBs in thalamic/cortical regions predicted language dysfunction.

Conclusion: Cognitive dysfunction associated with CMBs may be dependent on their distribution rather than their absolute number.