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Cerebral microbleeds in dementia with Lewy bodies

  • Author Footnotes
    1 Joint first authors.
    Kai Sin Chin
    Correspondence
    Corresponding author.The Royal Melbourne Hospital, 34-54 Poplar Road, Parkville, VIC, 3052, Australia.
    Footnotes
    1 Joint first authors.
    Affiliations
    Department of Medicine – the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia

    Department of Aged Care, The Royal Melbourne Hospital, Parkville, Australia

    Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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  • Author Footnotes
    1 Joint first authors.
    Zina Hijazi
    Footnotes
    1 Joint first authors.
    Affiliations
    Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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  • Leonid Churilov
    Affiliations
    Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia

    Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Australia
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  • Sanuji Gajamange
    Affiliations
    Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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  • Patricia M. Desmond
    Affiliations
    Department of Radiology, The Royal Melbourne Hospital, Parkville, Australia
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  • Victor Villemagne
    Affiliations
    The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
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  • Christopher Rowe
    Affiliations
    Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Australia
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  • Nawaf Yassi
    Affiliations
    Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia

    Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
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  • Rosie Watson
    Affiliations
    Department of Medicine – the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia

    Department of Aged Care, The Royal Melbourne Hospital, Parkville, Australia

    Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
    Search for articles by this author
  • Author Footnotes
    1 Joint first authors.

      Highlights

      • Cerebral microbleeds (CMB) were present in 30% of dementia with Lewy bodies (DLB).
      • CMB were not associated with clinical features in DLB.
      • CMB in DLB were associated with hypertension, but not amyloid-beta deposition.

      Abstract

      Introduction

      Cerebral microbleeds (CMB) are associated with cognitive impairment and hypertensive or cerebral amyloid angiopathy. The pathophysiology and clinical significance of CMB in dementia with Lewy bodies (DLB) are not well understood. Our study aimed to investigate the prevalence of CMB in DLB and to estimate the magnitudes of their clinical associations.

      Methods

      Twenty participants with DLB (mean age 74 ± 5 years) were included in this cross-sectional study. All participants underwent 3 T magnetic resonance imaging. CMB number and location were assessed on susceptibility-weighted imaging or quantitative susceptibility mapping. Amyloid-beta (Aβ) positron emission tomography (PET) scans were also performed. Between-group comparisons were estimated using risk ratios (RR) for categorical variables, and mean differences or median regression coefficients for continuous variables.

      Results

      CMB were present in 30% of the DLB participants, with a lobar predominance observed. DLB with CMB were more likely to be on antithrombotic therapy (100%), compared to those without CMB (43%; RR 2.33 [95% CI 1.27, 4.27]). Those with CMB were also more likely to report a history of hypertension (100%) compared to those without (70%; RR 1.75 [95% CI 1.11, 2.75]). DLB core clinical features, cognition and functional status did not differ between the two groups. There was no association found between the presence of CMB and cortical Aβ deposition on PET imaging.

      Conclusion

      CMB are not uncommon in DLB and may be associated with hypertensive small vessel disease. Further studies into the pathophysiology and clinical implications of CMB in DLB are needed.

      Keywords

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