Independent Risk Factors For Cerebral Microbleeds Research Articles

Gender heterogeneity in the influencing factors for cerebral microbleeds in acute ischemic stroke patients

Background Cerebral microbleeds (CMBs) are common in acute ischemic stroke (AIS) patients. The presence of CMBs increases the risk of hemorrhagic transformation in AIS patients, and it is also closely associated with cognitive decline and even dementia. At present, there exist different opinions on the independent risk factors for CMBs, and there is no consensus on whether there are gender differences in -post-stroke CMB. Therefore, this study sought to investigate gender heterogeneity in the influencing factors for CMBs by studying male and female AIS patients. Methods This was a China-based, Single-center, retrospective review of data from 482 AIS inpatients at the Neurology Department of Hebei General Hospital (NCT05882123). Both demographic and clinical data were collected from the study subjects. Different head magnetic resonance imaging sequences were used to assess the subjects’ CMBs, white matter lesions, and old lacunar infarcts (LI). Various statistical methods, including the t-test, χ 2 test, and logistic regression, were used to analyze the gender heterogeneity of the influencing factors for CMBs in AIS patients. Results When compared with the male AIS patients, the female AIS patients were older and had higher total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, ApoA, ApoB, and fibrinogen levels. The female AIS patients also had higher National Institute of Health Stroke Scale scores and hypertension disease composition ratios. By contrast, the proportions of female AIS patients with a history of smoking and a history of alcohol consumption were both lower than the corresponding proportions of male AIS patients. These differences were all statistically significant (p < .05). There were no statistically significant differences in the incidence and severity of CMBs between the male and female AIS patients (χ 2 ＝ 0.851, 3.092, p > .05). The univariate and multivariate stepwise logistic regression analyses confirmed that age (OR = 1.074, 95% CI: 1.013–1.139, p = .016) and old LI (OR = 4.295, 95% CI: 1.062–17.375, p = .041) were independent risk factors for comorbid CMBs in the female AIS patients, while blood glucose (OR = 0.692, 95% CI: 0.494–0.968, p = .031) was an independent protective factor for comorbid CMBs in the female AIS patients. However, these factors were not found to be independent risk or protective factors for comorbid CMBs in male AIS patients. Conclusion There are gender differences in the influencing factors for CMBs in AIS patients. Age, old LIs, and blood glucose are independent risk or protective factors for comorbid CMBs in female AIS patients, although they are not associated with the risk of developing CMBs in male AIS patients.

High Blood Pressure Increases the Risk of Cerebral Microbleeds in Hypertensive Individuals

Introduction: Hypertension is the leading preventable risk factor for major cardiovascular diseases worldwide. Recently, compelling evidence has emerged associating hypertension with cerebral microbleeds (CMBs), which are subclinical hemorrhages in the brain resulting from structural abnormalities in the small vessels that supply the brain. In addition to overall elevated blood pressure (BP), elevation in individual parameters such as systolic BP, diastolic BP, pulse pressure and mean arterial pressure could also individually be important risk factors for CMBs. This study aimed to assess the association between CMBs and blood pressure, and assess blood pressure parameters that could be possible risk factors for CMB. Methods: A retrospective case-control study was conducted from August 2021 to September 2022 on patients who underwent MRI due to primary complaints of limb disorders, loss of consciousness, persistent dizziness, and intermittent headaches. The patients were divided according to MRI results into 52 cases (those who had CMBs) and 52 controls (those who had no CMBs). Extracted data were analyzed in SPSS. Chi-square test, binary logistic regression, and Spearman’s correlation analysis were conducted. Results: In total, 104 cases and control patients were assessed, with mean (±SD) age 70.6 ± 8.56 vs 68.9 ± 8.93 years respectively (p > 0.05). CMB patients had more cases of stroke, hyperlipidemia and diabetes than non-CMB patients. Systolic blood pressure (SBP), diastolic blood pressure, pulse pressure (PP) and mean arterial pressure (MAP) were all considerably raised in CMB patients than non-CMBs patients. Blood pressure grades were positively correlated with the severity of CMBs (r = 0.22; p = 0.044). Logistic regression analysis showed that SBP and MAP were independent risk factors for CMBs (age and sex adjusted odds ratio = 1.420; 95% CI: 1.030 - 1.851, and 1.310; 95% CI: 1.011 - 1.631 respectively). Conclusions: In summary, this study found that hypertension was positively correlated with CMBs severity, and that SBP and MAP are independent risk factors for CMBs in patients with hypertension.

Elevated Pulse Pressure Is a Risk Factor for Cerebral Microbleeds. A Single Center Case-Control Study

Recent developments in brain magnetic resonance imaging using advanced Susceptibility Weighted Imaging (SWI) have significantly increased the detection and prevalence of Cerebral Microbleeds (CMBs). Here, we aimed to explore the association between Pulse Pressure (PP) and CMBs. Having been implicated in various arteriopathies, we hypothesized that elevated PP could also be a risk for CMBs. A retrospective case-control study was conducted from August 2021 to September 2022 at Zhongnan Hospital of Wuhan University China. Extracted data were analyzed in SPSS. Chi-square test, binary logistic regression, and Spearman’s correlation analysis were conducted.104 patients were analyzed. Univariate analysis showed no significant association between PP and CMBs, OR 1.65 (95% CI: 0.737 - 3.694; p > 0.05), while DBP and alcohol consumption were significant, ORs 2.956 (95% CI: 1.249 - 6.997, p < 0.05) and 2.525 (95% CI: 1.062 - 6.002, p < 0.05) respectively. Multivariate analysis, showed that PP was significantly associated with CMBs, OR 3.194 (95% CI: 1.024 - 9.964, p < 0.05) in combination with SBP, DBP, gender, age, smoking and alcohol consumption. Taken together, the study showed that elevated PP is associated with CMB, but is not an independent risk factor for CMBs.

Prevalence and Risk Factors of Cerebral Microbleeds: Analysis From the UK Biobank.

To determine the prevalence of and risk factors for cerebral microbleeds (CMBs) at different locations in a large healthy community population. A total of 8,159 participants from the UK Biobank with MRI scans suitable for CMB analysis were included. Brain susceptibility-weighted imaging data were acquired on 2 identical 3.0T scanners. The Microbleed Anatomical Rating Scale was used to identify definite CMBs. Generalized linear models were used to determine independent associations with all CMBs and lobar, deep, and infratentorial CMBs. The mean age at scan was 62.1 ± 7.4 years. One or more definite CMBs were detected in 572 (7.0%) participants. Of those with CMBs, 439 (76.7%) had lobar CMBs, 103 (18.0%) had deep CMBs, and 83 (14.5%) had infratentorial CMBs. Age was an independent risk factor for CMBs in all locations. APOE4 and male sex were positively associated and higher body mass index was negatively associated with lobar CMBs. Hypertension, smoking, and alcohol consumption were associated with deep CMBs, but not with lobar CMBs. Only age was associated with infratentorial CMBs. The associations were unchanged after controlling for white matter hyperintensity lesion volume as a marker of small vessel disease severity. In this large population-based study, CMB prevalence detected using a low sensitivity and high specificity system was 7%. There were distinct risk factor profiles for CMBs in lobar and deep locations consistent with different underlying pathophysiologic processes. Clinical Trial registration number: UK Biobank application number 19463.

The clinical risk factors of cerebral microbleeds and its relationship with cognitive dysfunction

AbstractBackgroundTo explore the risk factors of cerebral microbleeds (CMBs) and the relationship between CMBs and cognitive impairment, and to provide more theoretical basis for the prevention and treatment of CMBs and vascular cognitive impairment.MethodThe CMBs group was classified according to the number and location. The basic clinical data were collected and the subjects all received the cognitive tests using Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and the Neuropsychological Assessment Scales.ResultA total of 138 subjects [71 participants in CMBs group and 67 as control] were enrolled, with an average age of 64.36±10.14 years. Ordered logistic regression analysis showed diastolic blood pressure (OR=1.05, 95% CI: 1.01‐1.09), history of ischemic stroke and transient ischemic attack (TIA) (OR=7.74, 95% CI: 2.74) ‐21.88), white matter hyperintensities (OR = 2.01, 95% CI: 1.46‐2.78) are independently associated with CMBs (P&lt;0.05). Spearman correlation analysis showed that MMSE, MoCA, memory and executive function were correlated with CMBs (MMSE r=‐0.24, P=0.005; MoCA r=‐0.32, P&lt;0.001; memory r=‐0.28, P=0.001; execution function r = ‐0.33, P&lt;0.001). Multivariate linear regression analysis showed that MoCA score, memory and executive function were negatively correlated with CMBs number after adjusting for gender, age, years of education, other imaging biomarkers of cerebral small vessel disease and vascular risk factors (MoCA β=‐0.88, P=0.012; memory β = ‐0.22, P = 0.002; executive function β = ‐0.13, P = 0.001). As for the location, the results showed that the executive function of patients with strict lobe CMBs was lower than that of control group (P=0.046). In terms of speed and motion control, the differences between deep group and control group (P=0.037), deep group and infratentorial group (P=0.005) were statistically significant.ConclusionDiastolic blood pressure, history of ischemic stroke / TIA, white matter hyperintensities were independent risk factors for CMBs. CMBs are associated with cognitive dysfunction. CMBs in the strict lobe area are associated with the decline of executive function, and CMBs in the deep area are associated with the decline of speed and motor control ability.

Effect of coagulation function on cerebral microbleeds in intracerebral hemorrhage.

ObjectiveOur study aimed to confirm whether coagulation function of patients presenting with intracerebral hemorrhage (ICH) was associated with onset of cerebral microbleeds (CMBs).MethodsA total of 174 patients with basal ganglia ICH were divided into CMBs and non‐CMBs groups. Indicators of coagulation function and other clinical data that included fibrinogen (FBI), prothrombin time (PT), activated partial thromboplastin time (APTT), and the international normalized ratio (INR) were compared by univariate and multivariate analysis between the two groups. A receiver operating characteristic (ROC) curve was plotted to determine the predictive value of coagulation function indicators for CMBs.ResultsUnivariate analysis showed that APTT levels was significantly higher in the CMBs group than the non‐CMBs group (30.20 ± 5.18 vs. 27.95 ± 4.19; p = .004), while there was no significant difference between PT, INR, and FBI. The proportion of male patients in the CMBs group was significantly higher than the non‐CMBs group (76.58% vs. 52.38%, p = .001). Multifactor logistic regression analysis demonstrated that APTT and male gender were independent risk factors for CMBs in patients with ICH (OR 1.100, 95% CI: 1.026–1.180, p = .008; OR 2.957, 95% CI: 1.500–5.826, p = .002; respectively). ROC curve analysis indicated that the area under the curve of APTT and male gender for CMBs in patients with ICH was 0.641 and 0.621, respectively (p = .002 and .008; respectively).ConclusionAPTT was an independent risk factor for CMBs in patients with ICH.

Cerebral microbleeds are associated with blood pressure levels in individuals with hypertension

ABSTRACTObjective: Cerebral microbleeds (CMBs), which appear as small dot-like hypointense lesions, are strongly associated with cerebrovascular disease. Recently, numerous investigations have suggested that hypertension and age are risk factors for CMBs; however, whether blood pressure grade and age rank are related to the severity of CMBs remains unclear. The purpose of this research was to assess the association between cerebral microbleeds and blood pressure levels.Methods: In total, 460 consecutive hypertension patients (214 males and 246 females; aged 44–96 years, mean age 60.95 ± 6.82 years) from Lishui Central Hospital were enrolled and classified as CMB or non-CMB patients according to magnetic resonance imaging (MRI). Gradient echo T2*-weighted MRI was used to detect CMBs. Differences in blood pressure, CMB severity, and other patient characteristics were compared between the two groups. Multifactorial logistic regression was used to analyze the correlation between blood pressure and microbleeds.Results: In our study, CMB lesions were identified in 123 patients (26.7%), including 39 patients with CMB lesions located deep in the brain. In the hypertensive population, smoking is an independent risk factor for CMBs. Additionally, systolic blood pressure (SBP), diastolic blood pressure (DBP) and age are also independent risk factors for CMBs. Furthermore, a modest correlation was noted between the number of microbleeds and grade of hypertension.Conclusions: This study provides novel evidence that microbleed severity is associated with hypertension grade. This conclusion emphasizes the importance of antihypertensive therapy in hypertension patients to avoid an increase in CMBs.

Deep cerebral microbleeds are associated with the severity of lacunar infarcts and hypertension: A retrospective analysis.

Cerebral microbleeds (CMBs) and lacunar infarcts are common manifestations of cerebral small vessel disease. However, the association between the location of CMBs and lacunar infarcts is unclear. Our study aimed to clarify the relationship between the location of CMBs and lacunar infarcts.This study retrospectively analyzed 166 patients with ischemic stroke or transient ischemic attacks admitted in the Geriatric Neurology Department of Chinese PLA General Hospital between February 2010 and December 2012. We collected clinical characteristics and risk factors of CMBs. The location of CMBs on T2∗-weighted angiography was assessed by the Microbleed Anatomical Rating Scale. The number of lacunar infarcts and the severity of white matter hyperintensities were also recorded. The association between the location of CMBs and lacunar infarcts parameters was examined.CMBs were present in 77 (46.4%) patients. The presence [odds ratios (OR), 2.14; 95% confidence interval (CI), 1.02–4.48], number (OR, 1.17; 95% CI, 1.02–1.36 per lesion), severity (OR, 1.61; 95% CI, 1.07–2.42) of lacunar infarcts, and hypertension (OR, 5.76; 95% CI, 2.01–16.55) were independent risk factors for CMBs. Stratified by the location of CMBs, lobar CMBs and infratentorial CMBs did not show significant association with lacunar infarcts. Deep CMBs were significantly associated with the number (OR 1.18, 95% CI 1.03–1.36) and severity (OR 1.71, 95% CI 1.11–2.63) of lacunar infarcts. Moreover, the percentage of deep CMBs increased with the increased severity of lacunar infarcts (P = .003).Deep CMBs rather than lobar and infratentorial CMBs are associated with lacunar infarcts.

Cerebral Microbleeds Are Associated with Deep White Matter Hyperintensities, but Only in Hypertensive Patients

Cerebral microbleeds (CMBs) and white matter hyperintensities (WMH) are the most common manifestations of small vessel disease, and often co-occur in patients with cerebral vascular disease. Hypertension is widely accepted as a risk factor for both CMBs and WMH. However, the effect of hypertension on the association between CMBs and WMH remains unclear. We hypothesized that the relationship between CMBs and WMH is determined by hypertension. One hundred forty-eight patients with acute cerebrovascular disease who were admitted to PLA general hospital in Beijing, China from February 2010 to May 2011 were recruited in this study. CMBs on T2*-weighted angiography (SWAN) were assessed using the Brain Observer Microbleed Rating Scale criteria. The severity of the WMH was separately assessed as either peri-ventricular hyperintensities (PVH) or deep white matter hyperintensities (DWMH). The association among CMBs and the severity of WMH, and hypertension were determined. CMBs were found in 65 (43.9%) patients. The frequency of CMBs was related to the severity of DWMH and PVH. CMBs were more frequently observed in patients with hypertension compared to patients without hypertension (51.3% vs. 20.0%, p = 0.001). Hypertension was an independent risk factor for CMBs (odds ratio 5.239, p = 0.001) and DWMH (odds ratio 2.373, p = 0.040). Furthermore, the relationship between the presence of CMBs and the severity of DWMH was only found in patients with hypertension (r = 0.298, p<0.01). However, CMBs were associated with PVH independently of hypertension. This study demonstrated that hypertension determined the association between CMBs and DWMH.

Correlation between cerebral microbleeds and hypertension and other risk factors

Objective: In order to investigate the influence of cerebral microbleeds (CMBs) on hypertension, and study association between CMBs grading severity and classification of hypertension. Methods: We performed a hospital-based survey of patients with hypertension undergoing gradient-echo T2-weighted imaging. One hundred and twenty consecutive inpatients were recruited from March 2009 to February 2011 by our hospital. We detected the CMBs lesion number, location and clinical parameters. Multivariate logistic regression was used to find the independent risk factors for CMBs.