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Cerebral microbleeds in early Alzheimer’s disease
PoliakovaT.1Levin O.2, Arablinskiy A.2, Zerr I.3**
1-Belgorod State National Research University, Belgorod, Russia
2-Russian Medical Academy of Postgraduate Education, Moscow, Russia
3-University Medical School, Department of Neurology, Göttingen, Germany
Abstract
Objective:We hypothesize that cerebral microbleeds (CMB) in patients with different neuropsychological profile (amnestic or non-amnestic) and MRI features of vascular damages could provide important information about the underlying pathological process in early Alzheimer’s disease.
Methods:The study was performed on two trial sides. We studied 136 outpatients with suspiciously cognitive decline. MRI was performed on MR tomograph with a magnetic field of 1.5 and 3 Tesla. Neuropsychological battery included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Addenbrooke's Cognitive Examination (ACE-R), Cambridge Cognitive Examination battery (CAMCOG) (Part 3), Clock Drawing Test, fluency test and the visual memory test (SCT). CSF was examined for standard parameters such as tau, phosphorylated tau and amyloid-ß 1–40 and 42, QAlbumin, according to established protocols and genotype.
Results: Sixty-one patients (45%) had at least 1 CMB. Most of them were observed in amnestic profile (67%). In most of them (86%), multiple CMB were observed. The ratio of Aß1-40/42 in non-amnestic patients with CMB was significantly lower (mean 0.6) than in patients without CMB (mean 1.2). A relevant difference in albumin ratio as an indicator of the BBB was observed between groups with and without CMB. In our study E2 genotype was observed more frequently in CMB positive than in group without CMB but E4 was less.
Conclusions:We proved that patients with CMB have more features of BBB dysfunction by cerebrospinal fluid-serum albumin ratio. According to logistic regression the predictive factors for CMB in patients with cognitive decline were age, WMHs score and albumin ratio. We found a significant reduction of Aß-amyloid ratio in non-amnestic profile group with CMB (especially cortical) in comparison to those without CMB. While this is an interesting finding, its significance needs to be assessed in a prospective follow up.
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