Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease
Abstract Background The burden of cerebral microbleeds (CMBs) is greater in patients with dementia with Lewy bodies (DLB) than in those with Parkinson disease dementia (PDD), while few studies have been carried out in a large sample size, or focused on the prodromal stage. Thus, we investigated the...
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2025-04-01
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| author | Zhihong Ren Jinghuan Gan Zhichao Chen Zhihong Shi Shuai Liu Hao Lu Guili Zhang Yong Ji |
| author_facet | Zhihong Ren Jinghuan Gan Zhichao Chen Zhihong Shi Shuai Liu Hao Lu Guili Zhang Yong Ji |
| author_sort | Zhihong Ren |
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| description | Abstract Background The burden of cerebral microbleeds (CMBs) is greater in patients with dementia with Lewy bodies (DLB) than in those with Parkinson disease dementia (PDD), while few studies have been carried out in a large sample size, or focused on the prodromal stage. Thus, we investigated the clinical prevalence of CMBs and its relationship to clinical features in patients with DLB, PDD, mild cognitive impairment with Lewy bodies (MCI-LB) and Parkinson’s disease with MCI (PD-MCI) in this study. Methods In this retrospective multicenter cohort study, the study population consisted of 486 patients with DLB, 262 cases with PDD, 74 cases with MCI-LB and 107 cases with PD-MCI from 22 memory clinics between January 2018 and June 2022 in China. Demographic and clinical information were collected by reviewing medical records. CMBs were classified as “present” or “absent” in the Gradient Recalled-Echo or Susceptibility Weighted Imaging. Results The prevalence of CMBs was significantly greater in patients with DLB with 24.69% (95% CI [20.92%, 28.78%]) than patients with PDD with 20.23% (95% CI [5.54%, 25.61%]), patients with MCI-LB with 16.22% (95% CI [8.67%, 26.61%]), and patients with PD-MCI with 12.15% (95% CI [6.63%, 19.88%]). There were sex and age differences in this prevalence. In all patients, the presence of CMBs was significantly and independently associated with the presence of visual hallucination (OR = 1.597, 95% CI [1.014, 2.517], p = 0.044) and fluctuating cognition (OR = 1.707, 95% CI [1.140, 2.556], p = 0.009); and it was associated with the severity of hallucination (B = 0.775, SE = 0.368, p = 0.036) and disinhibition (B = 0.363, SE = 0.148, p = 0.014) reflected by NPI. Moreover, CMBs in DLB were associated with the presence of parkinsonism symptoms (OR = 1.821, 95% CI [1.001, 3.314], p = 0.05), and the scores of UPDRS-III (B = 4.711, SE = 1.939, p = 0.016) and Hoehn-Yahn stage (B = 0.452, SE = 0.165, p = 0.007). Conclusion Patients with DLB had a higher proportion of CMBs than PDD, MCI-LB and PD-MCI. CMBs in all DLB, PDD, MCI-LB and PD-MCI cases were associated with the presence of visual hallucination and fluctuating cognition; in DLB were associated with motor function. |
| format | Article |
| id | doaj-art-2a10fb7ab30744aebb9416291668ebb4 |
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| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-2a10fb7ab30744aebb9416291668ebb42025-08-20T02:30:18ZengBMCBMC Neurology1471-23772025-04-0125111410.1186/s12883-025-04181-wCerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body diseaseZhihong Ren0Jinghuan Gan1Zhichao Chen2Zhihong Shi3Shuai Liu4Hao Lu5Guili Zhang6Yong Ji7Department of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Neurology, Tianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Huanhu Hospital, Tianjin dementia instituteDepartment of Neurology, Tianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Huanhu Hospital, Tianjin dementia instituteDepartment of Radiology, Tianjin Huanhu HospitalDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityAbstract Background The burden of cerebral microbleeds (CMBs) is greater in patients with dementia with Lewy bodies (DLB) than in those with Parkinson disease dementia (PDD), while few studies have been carried out in a large sample size, or focused on the prodromal stage. Thus, we investigated the clinical prevalence of CMBs and its relationship to clinical features in patients with DLB, PDD, mild cognitive impairment with Lewy bodies (MCI-LB) and Parkinson’s disease with MCI (PD-MCI) in this study. Methods In this retrospective multicenter cohort study, the study population consisted of 486 patients with DLB, 262 cases with PDD, 74 cases with MCI-LB and 107 cases with PD-MCI from 22 memory clinics between January 2018 and June 2022 in China. Demographic and clinical information were collected by reviewing medical records. CMBs were classified as “present” or “absent” in the Gradient Recalled-Echo or Susceptibility Weighted Imaging. Results The prevalence of CMBs was significantly greater in patients with DLB with 24.69% (95% CI [20.92%, 28.78%]) than patients with PDD with 20.23% (95% CI [5.54%, 25.61%]), patients with MCI-LB with 16.22% (95% CI [8.67%, 26.61%]), and patients with PD-MCI with 12.15% (95% CI [6.63%, 19.88%]). There were sex and age differences in this prevalence. In all patients, the presence of CMBs was significantly and independently associated with the presence of visual hallucination (OR = 1.597, 95% CI [1.014, 2.517], p = 0.044) and fluctuating cognition (OR = 1.707, 95% CI [1.140, 2.556], p = 0.009); and it was associated with the severity of hallucination (B = 0.775, SE = 0.368, p = 0.036) and disinhibition (B = 0.363, SE = 0.148, p = 0.014) reflected by NPI. Moreover, CMBs in DLB were associated with the presence of parkinsonism symptoms (OR = 1.821, 95% CI [1.001, 3.314], p = 0.05), and the scores of UPDRS-III (B = 4.711, SE = 1.939, p = 0.016) and Hoehn-Yahn stage (B = 0.452, SE = 0.165, p = 0.007). Conclusion Patients with DLB had a higher proportion of CMBs than PDD, MCI-LB and PD-MCI. CMBs in all DLB, PDD, MCI-LB and PD-MCI cases were associated with the presence of visual hallucination and fluctuating cognition; in DLB were associated with motor function.https://doi.org/10.1186/s12883-025-04181-wCerebral microbleedsLewy body diseaseMild cognitive impairmentDementiaCerebral small vascular disease |
| spellingShingle | Zhihong Ren Jinghuan Gan Zhichao Chen Zhihong Shi Shuai Liu Hao Lu Guili Zhang Yong Ji Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease BMC Neurology Cerebral microbleeds Lewy body disease Mild cognitive impairment Dementia Cerebral small vascular disease |
| title | Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease |
| title_full | Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease |
| title_fullStr | Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease |
| title_full_unstemmed | Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease |
| title_short | Cerebral microbleeds: prevalence and relationship to clinical features in cognitive impairment with lewy body disease |
| title_sort | cerebral microbleeds prevalence and relationship to clinical features in cognitive impairment with lewy body disease |
| topic | Cerebral microbleeds Lewy body disease Mild cognitive impairment Dementia Cerebral small vascular disease |
| url | https://doi.org/10.1186/s12883-025-04181-w |
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