Abstract
ObjectiveAccumulated data suggests that cerebral microbleeds (CMBs) play an important role in the decline of cognitive function, but the results remain inconsistent. In the current study, we aimed to investigate the association between CMBs and cognitive function, as well as the various effects of CMBs on different domains of cognition.MethodsWe searched through the databases of PubMed, Embase, Cochrane Library, and ScienceDirect. After a consistency test, the publication bias was evaluated and a sensitivity analysis was performed with combined odds ratios (OR) and standardized mean difference (SMD) of CMBs.ResultsA meta-analysis of 25 studies with 9343 participants total was conducted. Patients with CMBs had higher incidence of cognitive impairment (OR:3.5410; 95% confidence interval [CI] [2.2979, 5.4567], p<0.05) and lower scores of cognitive functions (SMD: -0.2700 [-0.4267, -0.1133], p<0.05 in Mini-Mental State Examination [MMSE] group and -0.4869 [-0.8902, -0.0818], p<0.05 in Montreal Cognitive Assessment [MoCA] group). Our results also indicated that patients with CMBs had obvious decline in cognitive functions, for instance, orientation (SMD: -0.9565 [-1.7260, -0.1869], p<0.05), attention and calculation (SMD: -1.1518 [-1.9553, -0.3484], p<0.05) and delayed recall (SMD: -0.5527 [-1.1043, -0.0011], p = 0.05).ConclusionsOur data suggested that CMBs might be an important risk factor for cognitive dysfunction, especially in the domains of orientation, attention and calculation and delayed recall functions. Prospective cohort studies with further investigations will be needed in larger samples.
Highlights
According to the World Alzheimer Report (2015), the increasing prevalence of dementia will be one of the biggest global public health and social care challenges today and in the future. [1] Cerebral small vessel disease (CSVD) is an important clinical and pathological condition causing 20% of strokes worldwide, and one of the most common causes of vascular cognitive impairment (VCI) and mixed dementia. [2] Cerebral microbleeds (CMBs), detected by T2Ãweighted gradient-recalled echo (GRE) or susceptibility-weighted imaging (SWI), have been recognized as an important manifestation and diagnostic marker of CSVD
Our results indicated that patients with CMBs had obvious decline in cognitive functions, for instance, orientation (SMD: -0.9565 [-1.7260, -0.1869], p
Our data suggested that CMBs might be an important risk factor for cognitive dysfunction, especially in the domains of orientation, attention and calculation and delayed recall
Summary
According to the World Alzheimer Report (2015), the increasing prevalence of dementia will be one of the biggest global public health and social care challenges today and in the future. [1] Cerebral small vessel disease (CSVD) is an important clinical and pathological condition causing 20% of strokes worldwide, and one of the most common causes of vascular cognitive impairment (VCI) and mixed dementia. [2] Cerebral microbleeds (CMBs), detected by T2Ãweighted gradient-recalled echo (GRE) or susceptibility-weighted imaging (SWI), have been recognized as an important manifestation and diagnostic marker of CSVD. [3] Studies from Asia suggests that the presence of multiple CMBs, multiple lobar CMBs, was associated with higher global neuropsychiatric burden on the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Such associations were more significant with CMBs located in deep areas and the increasing number of CMBs. Sample sizes of some included studies may be relatively small, and more high-quality studies with follow-ups needed to be further clarified Such limitations may be due to the weakness of the included studies, the population selection bias and the only general cognition tests (MMSE and MoCA) with different sensitivity and specificity
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