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(Stroke. 2008;39:3323.)
© 2008 American Heart Association, Inc.

Original Contributions

Brain Microbleeds and Global Cognitive Function in Adults Without Neurological Disorder

Yusuke Yakushiji, MD; Masanori Nishiyama, MD; Satomi Yakushiji, MD; Tatsumi Hirotsu, MD; Akira Uchino, MD; Junko Nakajima, MD; Makoto Eriguchi, MD; Yusuke Nanri, MD; Megumi Hara, MD; Etsuo Horikawa, PhD Yasuo Kuroda, MD

From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., K.Y.), Department of Radiology (A.U.), Department of Preventive Medicine (M.H.), and Center for Comprehensive Community Medicine (E.H.), Faculty of Medicine, Saga University, Saga, Japan; and Yuai-Kai Oda Hospital (M.N, S.Y., T.H., J.N.), Kashima, Saga, Japan.

Correspondence to Yusuke Yakushiji, Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan. E-mail yakushij{at}cc.saga-u.ac.jp

Background and Purpose— Increasing attention has been paid to associations between cognitive dysfunction and brain microbleeds (MBs). Because all previous studies have investigated patients with neurological disorders, we examined subjects without neurological disorder in order to clarify pathogenic relationships.

Methods— A total of 518 consecutive adults without neurological disorder who had undergone health-screening tests of the brain were studied prospectively. Gradient-echo T2*-weighted MRI using a 1.5-T system was used to detect MBs. The Mini-Mental State Examination (MMSE) was administered to determine cognitive functions. MMSE scores <27 or >1.5 SDs below the age-related mean were regarded as subnormal.

Results— MBs were found in 35 subjects (6.8%). MMSE score <27 was found in 25 subjects (4.8%), with MMSE score >1.5 SDs below the age-related mean in 34 subjects (6.6%). Univariate analysis showed presence and number of MBs, short duration of education, and severe white matter hyperintensities as significantly associated with subnormal scores. In logistic regression analysis, presence of MBs (odds ratio [OR], 5.44; 95% CI, 1.83 to 16.19) and number of MBs (OR, 1.32; 95% CI, 1.04 to 1.68) still displayed significant associations with MMSE score <27. Logistic regression analysis revealed a significant relationship between presence (OR, 3.93; 95% CI, 1.44 to 10.74) and number (OR, 1.26; 95% CI, 1.01 to 1.59) of MBs and MMSE score >1.5 SDs below the age-related mean. Among MMSE subscores, "attention and calculation" was significantly lower in MB-positive subjects (P=0.017).

Conclusions— MBs appear to be primarily associated with global cognitive dysfunction.

Key Words: brain microbleeds • small-vessel diseases • magnetic resonance imaging • cognitive dysfunction • Mini-Mental State Examination

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