244 Scientific Programme 22. European Stroke Conference © 2013 S. Karger AG, Basel Table 1. Patient characteristics Mi-crobleeds All (n=188) Yes (n=39) No (n=149) p-value Age, mean years (SD) 60.0± 12.7 66.0± 10.4 58.5± 12.8 .001 Male sex 109 (58.0) 29 (74.4) 80 (53.7) .020 Hypertension 160 (85.1) 33 (84.6) 127 (85.2) .923 Diabetes 11 (5.9) 1 (2.6) 10 (6.7) .326 Hypercholesterolemia 95 (51.9) 15 (39.5) 80 (55.2) .085 Current smoking 40 (21.4) 10 (25.6) 30 (20.3) .645 cSVD markers - Symptomatic lacunar in-farct 76 (40.4) 22 (56.4) 54 (36.2) .022 - Asymptomatic lacunar in-farcts 63 (33.5) 18 (46.2) 45 (30.2) .060 - WMLs 34 (18.1) 13 (33.3) 21 (14.1) .005 Data are shown in frequencies (%) , except where reported otherwise. WMLs = white matter lesions. P-values refer to the difference between patient with and without brain microbleeds. 12 Small vessel stroke and white matter disease Brain microbleeds do not independently relate to cognition in patients with cerebral small ves-sel disease M. Huijts1, R.J. Van Oostenbrugge2, J. Staals3, A.A. Kroon4, P.W. De Leeuw5, A.A. Duits6 Maastricht University Medical Centre, Maastricht, THE NETHERLANDS1, Maastricht Uni-versity Medical Centre, Maastricht, THE NETHERLANDS2, Maastricht University Medical Cen-tre, Maastricht, THE NETHERLANDS3, Maastricht University Medical Centre, Maastricht, THE NETHERLANDS4, Maastricht University Medical Centre, Maastricht, THE NETHERLANDS5, Maastricht University Medical Centre, Maastricht, THE NETHERLANDS6 Background and purpose – Brain microbleeds (BMBs) are considered to be a marker for cerebral small vessel disease (cSVD). Evidence for an independent association with decreased cognitive performance is found by some, but not by others, and studies in patients at risk for or with manifest cSVD are sparse. The aim of this study was to assess the relationship between cognition and BMBs in terms of presence, number and location, while adjusting for WMLs and lacunar infarcts. Meth-ods – We included 188 patients with a high prevalence of cSVD (112 hypertensive patients and 76 first-ever lacunar stroke patients). Patients underwent brain MRI and neuropsychological assess-ment. We rated the presence and number of BMB and distinguished deep, lobar and infratentorial BMBs. The presence of other markers of cSVD such as (silent) lacunar infarcts and white matter lesions was also rated. Associations with cognitive domains were analyzed using regression analy-ses, adjusting for these other imaging markers of cSVD and age. Results – BMBs were present in 21% of our sample. Patients with BMBs significantly more often presented with the other markers of cSVD. The presence of BMBs was associated with all cognitive domains, except executive func-tion, but results lost significance after correction for the other markers of cSVD and age. Discussion – BMBs are highly prevalent in a population with cSVD and often co-occur with other markers of cSVD. Recently, Charidimou and Werring proposed several different mechanisms by which BMBs might influence cognitive function, since the underlying mechanism is still speculative. Instead of an independent relationship, BMBs most likely are a marker of cSVD severity, without having a direct effect on cognitive function in this population.
Karger_ESC London_2013
To see the actual publication please follow the link above