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Microbleeds in dementia with Lewy bodies

Lookup NU author(s): Dr Paul Donaghy, Dr Michael Firbank, Dr Dipayan Mitra, Dr George Petrides, Dr James Lloyd, Nicola Barnett, Kirsty Olsen, Professor Alan Thomas, Professor John O'Brien

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Introduction Microbleeds are associated with the development of dementia in older people and are common in Alzheimer’s disease (AD). Their prevalence and clinical importance in dementia with Lewy bodies (DLB) is unclear. The objective of this study was to compare the rates of microbleeds in DLB with those in AD and healthy older people, and investigate associations between microbleeds and amyloid deposition, vascular risk and disease severity in DLB. Methods DLB (n=30), AD (n=18) and control (n=20) participants underwent clinical assessment at baseline and 1 year in this longitudinal observational study. 3T MRI (including T2* susceptibility weighted imaging) and Florbetapir PET were carried out at baseline. Microbleeds were rated visually and a standardised uptake value ratio (SUVR) was calculated from Florbetapir PET scans. Results 40% of DLB subjects had microbleeds compared with 50% of AD and 15% of controls. Compared to DLB without microbleeds, those with microbleeds had higher systolic BP (156±26 v. 135±19mmHg; p=0.03) but did not have greater levels of vascular disease or amyloid deposition (SUVR 1.25±0.24 v. 1.25±0.22; p=0.33). There was evidence of less severe dementia in DLB participants with microbleeds, but these differences may have been driven by a shorter disease duration in those with microbleeds. Conclusion The presence of microbleeds in DLB is associated with higher blood pressure but not with other measures of vascular disease or amyloid deposition. The relationship between microbleeds and clinical presentation remains unclear.


Publication metadata

Author(s): Donaghy PC, Firbank M, Mitra D, Petrides G, Lloyd J, Barnett N, Olsen K, Thomas AJ, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Journal of Neurology

Year: 2020

Volume: 267

Pages: 1491-1498

Online publication date: 04/02/2020

Acceptance date: 27/01/2020

Date deposited: 27/01/2020

ISSN (print): 0340-5354

ISSN (electronic): 1432-1459

Publisher: Springer

URL: https://doi.org/10.1007/s00415-020-09736-0

DOI: 10.1007/s00415-020-09736-0


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