Microbleeds in fronto-subcortical circuits are predictive of dementia conversion in patients with vascular cognitive impairment but no dementia
Yang-Kun Chen
Wei-Min Xiao
Wei Li
Zhuo-Xin Ni
Yong-Lin Liu
Li Xu
Jian-Feng Qu
Chee H. Ng
Yu-Tao Xiang
摘要：Cerebral small vessel disease (CSVD) is a common etiology of vascular cognitive impairment with no dementia (V-CIND). Studies have re-vealed that cerebral microbleeds (CMBs), a feature of CSVD, contribute to cognitive impairment. However, the association between CMBs and dementia conversion in individuals with V-CIND is still unclear. Here, we analyzed the predictive role of CMBs in the conversion from V-CIND to dementia in CSVD patients. We recruited and prospectively assessed 85 patients with CSVD and V-CIND. V-CIND was eval-uated using a series of comprehensive neuropsychological scales, including the Chinese version of the Montreal Cognitive Assessment and the Clinical Dementia Rating. MRI assessments were used to quantify lacunar infarcts, white matter hyperintensities, CMBs, and medial temporal lobe atrophy. Eighty-two of the 85 patients completed the assessment for dementia conversion at a 1-year follow-up assessment. Multivariate logistic regression analyses were conducted to examine independent clinical and MRI variables associated with dementia conversion. Twenty-four patients (29.3％) had converted to dementia at the 1-year follow-up, and these individuals had significantly more CMBs in the fronto-subcortical circuits. Multivariate logistic regression analyses revealed that the patients with CMBs in the fronto-sub-cortical circuits (odds ratio = 4.4; 95％ confidence interval: 1.602–12.081, P = 0.004) and 5 or more CMBs overall (odds ratio = 17.6, 95％confidence interval: 3.23–95.84, P = 0.001) had a significantly increased risk of dementia at the 1-year follow-up. These findings indicate that CMBs in the fronto-subcortical circuits may be predictive of dementia conversion in CSVD patients with V-CIND, and thus extend the clinical significance of CMBs. This trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800017077). Protocol version: 1.0.
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资助基金：the Medical Scientific Research Foundation of Guangdong Province, China (A2015160)
论文发表日期：2018-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：6( 1913-1918 )
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