Advertisement

Journal of Neurology

, Volume 266, Issue 5, pp 1091–1094 | Cite as

Cerebral microbleeds are associated with cognitive decline early after ischemic stroke

  • Nicolas ChristEmail author
  • Viola Mocke
  • Felix Fluri
Original Communication
  • 218 Downloads

Abstract

Background and purpose

The present study aimed to investigate whether cerebral microbleeds (CMB) are associated with vascular cognitive decline (VCD) already in the early course after ischemic stroke, and—if so—whether distinct cognitive domains are affected more preferentially by CMB.

Methods

In a prospective cohort study, cognitive performance was examined in 33 stroke patients showing ≥ 1 CMB on MRI. Matched for age, gender, clinical and radiological characteristics, 33 stroke survivors without CMB served as a control group. Neuropsychological testing was performed in both groups six months after the index event using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-plus test battery.

Results

CMB-positive stroke patients showed more severe cognitive decline in mini mental state test compared to the control group (p = 0.024). Regarding the episodic memory, CMB-positive patients reached lower scores in Word-List-Learning- (p = 0.009) and the Word-List-Recognition-test (p = 0.006), whereas the findings in Word-List-Recall-test were similar in both groups. While semantic fluency is not more affected in CMB-positive than in CMB-negative patients, those with CMB reveal a significantly impaired phonemic fluency (p = 0.007). Concerning the visuospatial abilities, stroke patients with CMB showed restricted recall of recently learned visual information. Only slight differences between both groups were found in any test investigating the participants’ executive functions.

Conclusion

Cognitive abilities are more severely impaired in CMB-positive stroke patients compared to CMB-free controls, whereby memory-associated functions are most affected. CMB might be associated with post-stroke cognitive decline, particularly with impaired memory and phonemic fluency.

Keywords

Cerebral microbleeds Ischemic stroke Cognitive impairment Magnetic resonance imaging CERAD plus test Executive function 

Notes

Author Contributions

Conceived and designed the study: FF. Performed the study: NC, FF. Analyzed the data: NC, FF, VM. Contributed analysis tools: NC, FF, VM. Wrote the paper: NC, FF, VM.

Funding

None.

Compliance with ethical standards

Conflicts of interest

All authors report no disclosures.

References

  1. 1.
    Barbay M, Diouf M, Roussel M et al (2018) Systematic review and meta-analysis of prevalence in post-stroke neurocognitive disorders in hospital-based studies. Dement Geriatr Cogn Disord 46:322–334CrossRefPubMedGoogle Scholar
  2. 2.
    Leys D, Hénon H, Mackowiak-Cordoliani M-A, Pasquier F (2005) Poststroke dementia. Lancet Neurol 4:752–759CrossRefPubMedGoogle Scholar
  3. 3.
    de Groot JC, de Leeuw FE, Oudkerk M et al (2000) Cerebral white matter lesions and cognitive function: t he Rotterdam Scan Study. Ann Neurol 47:145–151CrossRefPubMedGoogle Scholar
  4. 4.
    Ding J, Sigurðsson S, Jónsson PV et al (2017) Space and location of cerebral microbleeds, cognitive decline, and dementia in the community. Neurology 88:2089–2097CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Akoudad S, Wolters FJ, Viswanathan A et al (2016) Association of cerebral microbleeds with cognitive decline and dementia. JAMA Neurol 73:934–943CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Werring DJ, Frazer DW, Coward LJ et al (2004) Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI. Brain 127:2265–2275CrossRefPubMedGoogle Scholar
  7. 7.
    Gregoire SM, Scheffler G, Jäger HR et al (2013) Strictly lobar microbleeds are associated with executive impairment in patients with ischemic stroke or transient ischemic attack. Stroke 44:1267–1272CrossRefPubMedGoogle Scholar
  8. 8.
    Poels MMF, Ikram MA, van der Lugt A et al (2012) Cerebral microbleeds are associated with worse cognitive function: the Rotterdam Scan Study. Neurology 78:326–333CrossRefPubMedGoogle Scholar
  9. 9.
    van Es ACGM, van der Grond J, de Craen AJM et al (2011) Cerebral microbleeds and cognitive functioning in the PROSPER study. Neurology 77:1446–1452CrossRefPubMedGoogle Scholar
  10. 10.
    Werring DJ, Gregoire SM, Cipolotti L (2010) Cerebral microbleeds and vascular cognitive impairment. J Neurol Sci 299:131–135CrossRefPubMedGoogle Scholar
  11. 11.
    Li X, Yuan J, Yang L et al (2017) The significant effects of cerebral microbleeds on cognitive dysfunction: An updated meta-analysis. PLoS One 12:e0185145.  https://doi.org/10.1371/journal.pone.0185145 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Van Heugten CM, Walton L, Hentschel U (2015) Can we forget the mini-mental state examination? A systematic review of the validity of cognitive screening instruments within one month after stroke. Clin Rehabil 29:694–704CrossRefPubMedGoogle Scholar
  13. 13.
    Welsh KA, Butters N, Mohs RC et al (1994) The consortium to establish a registry for alzheimer’s disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology 44:609–614CrossRefPubMedGoogle Scholar
  14. 14.
    Fazekas F, Chawluk J, Alavi A et al (1987) MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. Am J Roentgenol 149:351–356CrossRefGoogle Scholar
  15. 15.
    Gregoire SM, Smith K, Jäger HR et al (2012) Cerebral microbleeds and long-term cognitive outcome: longitudinal cohort study of stroke clinic patients. Cerebrovasc Dis 33:430–435CrossRefPubMedGoogle Scholar
  16. 16.
    Ahn SJ, Anrather J, Nishimura N, Schaffer CB (2018) Diverse inflammatory response after cerebral microbleeds includes coordinated microglial migration and proliferation. Stroke 49:1719–1726CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Cordonnier C, van der Flier WM (2011) Brain microbleeds and Alzheimer’s disease: innocent observation or key player? Brain 134:335–344CrossRefGoogle Scholar
  18. 18.
    Sepehry AA, Rauscher A, Hsiung G-Y, Lang DJ (2016) Microbleeds in Alzheimer’s disease: a neuropsychological overview and meta-analysis. Can J Neurol Sci 43:753–759CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurologyUniversity Hospital of WürzburgWürzburgGermany
  2. 2.Institute of PsychologyUniversity of WürzburgWürzburgGermany

Personalised recommendations