Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 17:7:44715.
doi: 10.1038/srep44715.

Correlation of Cerebral Microbleed Distribution to Amyloid Burden in Patients with Primary Intracerebral Hemorrhage

Hsin-Hsi Tsai  1 , Li-Kai Tsai  1 , Ya-Fang Chen  2 , Sung-Chun Tang  1 , Bo-Ching Lee  2 , Ruoh-Fang Yen  3 , Jiann-Shing Jeng  1
Affiliations

Correlation of Cerebral Microbleed Distribution to Amyloid Burden in Patients with Primary Intracerebral Hemorrhage

Hsin-Hsi Tsai et al. Sci Rep. .

Abstract

The underlying pathology of cerebral microbleeds (CMBs) with mixed lobar and deep distribution remains contentious. The aim of this study was to correlate CMBs distribution to β-amyloid burden in patients with primary intracerebral hemorrhage (ICH). Fourty-seven ICH patients underwent magnetic resonance susceptibility-weighted imaging and 11C-Pittsburgh Compound B positron emission tomography. The amyloid burden was expressed as standardized uptake value ratio with reference to cerebellum, and presented as median (interquartile range). Patients were categorized into the lobar, mixed (both lobar and deep regions), and deep types of CMB. Comparing the lobar (17%), mixed (59.6%) and deep (23.4%) CMB types, the global amyloid burden was significantly higher in the mixed type than the deep type (1.10 [1.03-1.25] vs 1.00 [0.97-1.09], p = 0.011), but lower than in the lobar type (1.48 [1.18-1.50], p = 0.048). On multivariable analysis, the ratio of lobar to deep CMB number was positively correlated with global (p = 0.028) and occipital (p = 0.031) amyloid burden. In primary ICH, patients with lobar and mixed CMB types are associated with increased amyloid burden than patients with deep type. The ratio of lobar to deep CMB number is an independent indicator of cerebral β-amyloid deposition.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Image findings in patients with primary intracerebral hemorrhage.
(A) A 94-year-old man with right parietal lobe hemorrhage. SWI shows cortical superficial siderosis and multiple cerebral microbleeds (CMBs) exclusively in the lobar regions (lobar type). Increased amyloid burden is shown on the Pittsburgh compound B (PiB) PET. (B) A 57-year-old woman with left thalamic hemorrhage. SWI shows a few CMBs at basal ganglia and thalamus (deep type). PET shows normal amyloid burden. (C) A 82-year-old woman with left parietal hemorrhage. SWI shows some CMBs in the lobar region and a few CMBs in the thalamus and basal ganglia (mixed type; CMB ratio = 6/3). PET shows increased PiB uptakes, especially on the occipital lobes. (D) A 73-year-old man with left parietal ICH. The SWI shows CMB in both lobar and deep regions (mixed type; CMB ratio = 9/10). PET shows normal amyloid burden.
Figure 2
Figure 2. The global and regional amyloid burden in different microbleed patterns.
Box plot showing the median values and interquartile ranges of the standardized uptake value ratio (SUVR) representing the global and regional (frontal, temporal, parietal and occipital lobes) amyloid burden in patients with different patterns of cerebral microbleeds. *p < 0.05; **p < 0.01.
Figure 3
Figure 3. Correlation of cerebral microbleeds ratio and amyloid burden.
The correlation of cerebral microbleed (CMB) ratio to the global PiB standardized uptake value ratio (SUVR) (A), frontal PiB SUVR (B) and occipital PiB SUVR (C).
See this image and copyright information in PMC

References

    1. van Asch C. J. et al.. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol 9, 167–176 (2010). - PubMed
    1. Qureshi A. I. et al.. Spontaneous intracerebral hemorrhage. N Engl J Med 344, 1450–1460 (2001). - PubMed
    1. Meretoja A. et al.. SMASH-U: a proposal for etiologic classification of intracerebral hemorrhage. Stroke 43, 2592–2597 (2012). - PubMed
    1. Yeh S. J., Tang S. C., Tsai L. K. & Jeng J. S. Pathogenetical subtypes of recurrent intracerebral hemorrhage: designations by SMASH-U classification system. Stroke 45, 2636–2642 (2014). - PubMed
    1. Cappellari M. et al.. The etiologic subtype of intracerebral hemorrhage may influence the risk of significant hematoma expansion. J Neurol Sci 359, 293–297 (2015). - PubMed

LinkOut - more resources