Deep/mixed cerebral microbleeds are associated with cognitive dysfunction through thalamocortical connectivity disruption: The Taizhou Imaging Study

Yingzhe Wang; Yanfeng Jiang; Chen Suo; Ziyu Yuan; Kelin Xu; Qi Yang; Weijun Tang; Kexun Zhang; Zhen Zhu; Weizhong Tian; Min Fan; Shuyuan Li; Weimin Ye; Qiang Dong; Li Jin; Mei Cui; Xingdong Chen

doi:10.1016/j.nicl.2019.101749

Deep/mixed cerebral microbleeds are associated with cognitive dysfunction through thalamocortical connectivity disruption: The Taizhou Imaging Study

Neuroimage Clin. 2019:22:101749. doi: 10.1016/j.nicl.2019.101749. Epub 2019 Mar 6.

Authors

Yingzhe Wang¹, Yanfeng Jiang², Chen Suo³, Ziyu Yuan⁴, Kelin Xu⁵, Qi Yang¹, Weijun Tang⁶, Kexun Zhang³, Zhen Zhu³, Weizhong Tian⁷, Min Fan⁸, Shuyuan Li⁹, Weimin Ye¹⁰, Qiang Dong¹, Li Jin¹¹, Mei Cui¹², Xingdong Chen¹³

Affiliations

¹ Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
² State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
³ Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
⁴ Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
⁵ School of Data Science and Institute for Big Data, Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
⁶ Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
⁷ Taizhou People's Hospital, Taizhou, Jiangsu, China.
⁸ Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China.
⁹ Institute of Embryo-Fetal Original Adult Disease, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
¹⁰ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
¹¹ State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Human Phenome Institute, Fudan University, Shanghai, China.
¹² Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: cuimei@fudan.edu.cn.
¹³ State Key Laboratory of Genetic Engineering and the Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Human Phenome Institute, Fudan University, Shanghai, China. Electronic address: xingdongchen@fudan.edu.cn.

Abstract

Background: Cerebral microbleeds (CMBs) are considered to be risk factors for cognitive dysfunction. The specific pathology and clinical manifestations of CMBs are different based on their locations. We investigated the association between CMBs at different locations and cognitive dysfunction and explored the potential underlying pathways in a rural Han Chinese population.

Methods: We used baseline data from 562 community-dwelling adults (55-65 years old) in the Taizhou Imaging Study between 2013 and 2015. All individuals underwent multimodal brain magnetic resonance imaging (MRI) and 444 subjects completed neuropsychological tests: the Mini-Mental Status Examination and the Montreal Cognitive Assessment. Multinomial logistic regression was used to estimate the association between CMBs and cognitive dysfunction. The volume of brain regions and white matter microstructure were analyzed using Freesurfer and tract-based spatial statistics, respectively.

Results: CMBs were detected in 104 individuals (18.5%) in our study. Multinomial logistic regression found deep/mixed CMBs were associated with global cognitive dysfunction (OR 3.52; 95% CI 1.21 to 10.26), whereas lobar CMBs (OR 1.76; 95% CI 0.56 to 5.53) were not. Quantification of multimodal brain MRI showed that deep/mixed CMBs were accompanied by decreased thalamic volume and loss of fractional anisotropy of bilateral anterior thalamic radiations.

Conclusion: Deep/mixed CMBs were associated with cognitive dysfunction in this Chinese cross-sectional study. Disruption of thalamocortical connectivity might be a potential pathway underlying this relationship.

Keywords: Cerebral microbleeds; Cognitive impairment; Multimodal imaging.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cerebral Cortex / diagnostic imaging
Cerebral Cortex / pathology*
Cerebral Hemorrhage / complications
Cerebral Hemorrhage / diagnostic imaging
Cerebral Hemorrhage / pathology*
Cerebral Hemorrhage / physiopathology*
China
Cognitive Dysfunction / etiology
Cognitive Dysfunction / physiopathology*
Cross-Sectional Studies
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neuropsychological Tests
Thalamus / diagnostic imaging
Thalamus / pathology*
White Matter / diagnostic imaging
White Matter / pathology*