☆ 4.5 Article

Cerebral Microbleeds in Patients with Dementia with Lewy Bodies and Parkinson Disease Dementia

AMERICAN JOURNAL OF NEURORADIOLOGY (2015)

Journal

AMERICAN JOURNAL OF NEURORADIOLOGY

Volume 36, Issue 9, Pages 1642-1647

Publisher

AMER SOC NEURORADIOLOGY

DOI: 10.3174/ajnr.A4337

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Funding

Korea Health Technology R&D Project through Korea Health Industry Development Institute (KHIDI) - Ministry of Health & Welfare, Republic of Korea [HI14C0093]

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Abstract

BACKGROUND AND PURPOSE: The burden of amyloid beta is greater in patients with dementia with Lewy bodies than in those with Parkinson disease dementia, and an increased amyloid beta load is closely related to a higher incidence of cerebral microbleeds. Here, we investigated the prevalence and topography of cerebral microbleeds in patients with dementia with Lewy bodies and those with Parkinson disease dementia to examine whether cerebral microbleeds are more prevalent in patients with dementia with Lewy bodies than in those with Parkinson disease dementia. MATERIALS AND METHODS: The study population consisted of 42 patients with dementia with Lewy bodies, 88 patients with Parkinson disease dementia, and 35 controls who underwent brain MR imaging with gradient recalled-echo. Cerebral microbleeds were classified as deep, lobar, or infratentorial. RESULTS: The frequency of cerebral microbleeds was significantly greater in patients with dementia with Lewy bodies (45.2%) than in those with Parkinson disease dementia (26.1%) or in healthy controls (17.1%; P = .017). Lobar cerebral microbleeds were observed more frequently in the dementia with Lewy bodies group (40.5%) than in the Parkinson disease dementia (17%; P = .004) or healthy control (8.6%; P = .001) group, whereas the frequencies of deep and infratentorial cerebral microbleeds did not differ among the 3 groups. Logistic regression analyses revealed that, compared with the healthy control group, the dementia with Lewy bodies group was significantly associated with the presence of lobar cerebral microbleeds after adjusting for age, sex, nonlobar cerebral microbleeds, white matter hyperintensities, and other vascular risk factors (odds ratio, 4.39 [95% CI, 1.27-15.25]). However, compared with the healthy control group, the Parkinson disease dementia group was not significantly associated with lobar cerebral microbleeds. CONCLUSIONS: This study showed that patients with dementia with Lewy bodies had a greater burden of cerebral microbleeds and exhibited a lobar predominance of cerebral microbleeds than did patients with Parkinson disease dementia.

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Cerebral microbleeds in dementia with Lewy bodies

Kai Sin Chin, Zina Hijazi, Leonid Churilov, Sanuji Gajamange, Patricia M. Desmond, Victor Villemagne, Christopher Rowe, Nawaf Yassi, Rosie Watson

Summary: Cerebral microbleeds (CMB) are present in 30% of individuals with dementia with Lewy bodies (DLB), with a lobar predominance. DLB patients with CMB are more likely to receive antithrombotic therapy and have a history of hypertension compared to those without CMB. However, no significant differences were found in DLB core clinical features, cognition, and functional status between the two groups. The presence of CMB did not show an association with cortical amyloid-beta deposition on PET imaging in DLB patients. Further research into the pathophysiology and clinical implications of CMB in DLB is needed.

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