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Abstract
Objectives: Incidental cerebral microhemorrhage (MH) is frequently found in older individuals scanned with susceptibility-weighted MRI (SWI) or gradient-recalled echo MRI. MH have been linked with β-amyloid (Aβ) deposition using 11C-Pittsburgh compound B (PiB) PET in Alzheimer disease (AD) and cerebral amyloid angiopathy (CAA). We hypothesized that Aβ deposition in asymptomatic elderly individuals is associated with lobar MH (LMH).
Methods: This was a cross-sectional study of 84 elderly healthy controls (HC), 28 subjects with mild cognitive impairment (MCI), and 26 subjects with probable AD who underwent 3-T SWI and 11C-PiB PET. 11C-PiB cortical binding was quantified normalized to cerebellar cortex (standardized uptake value ratio [SUVR]) and scans classified as positive (PiB+) or negative (PiB−) by visual inspection. MH were manually counted and categorized by region and as lobar or nonlobar.
Results: LMH were present in 30.8% of AD, 35.7% of MCI, and 19.1% of HC. The prevalence of LMH among PiB+ subjects was similar, regardless of clinical classification (AD 30.8%, MCI 38.9%, HC 41.4%, p > 0.7). HC with LMH had significantly higher mean neocortical SUVR (1.7 ± 0.5) than HC without LMH (1.3 ± 0.3, p ± 0.01). In HC, there was a positive correlation between number of LMH and SUVR, and between LMH and age. In HC, PiB+ (odds ratio [OR] 7.3, 95% confidence interval [CI] 1.6–33.7, p = 0.01) and age (OR 1.2, 95% CI 1.03–1.3, p = 0.02) both independently predicted the occurrence of LMH using logistic regression.
Conclusion: Asymptomatic Aβ deposition in older adults is strongly associated with LMH.
Footnotes
Study funding: Supported by CSIRO and National Health and Medical Research Council Dementia Collaborative Research Centres Early Diagnosis and Prevention Program.
-
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- AIBL=
- Australian Imaging, Biomarkers and Lifestyle Study of Ageing;
- CAA=
- cerebral amyloid angiopathy;
- CAAH=
- CAA-associated hemorrhage;
- CDR=
- Clinical Dementia Rating;
- CI=
- confidence interval;
- HC=
- healthy controls;
- ICH=
- intracerebral hemorrhage;
- LMH=
- lobar microhemorrhage;
- MCI=
- mild cognitive impairment;
- MH=
- microhemorrhage;
- MMSE=
- Mini-Mental State Examination;
- OR=
- odds ratio;
- PiB=
- Pittsburgh compound B;
- SUVR=
- standardized uptake value ratio;
- SWI=
- susceptibility-weighted MRI
- Received December 9, 2010.
- Accepted March 1, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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