Cerebral microbleeds is associated with dementia in Parkinson's disease

Abstract

Introduction: Emerging evidence suggests that cerebral small vessel disease (CSVD) may worsen cognitive functions in Parkinson's disease (PD). However, the effect of microbleeds on cognitive function in patients with PD remains unknown. This study explored the association between the presence, number and location of microbleeds with dementia in PD patients.

Methods: This cross-sectional study included 431 patients with PD from Beijing Tiantan Hospital from May 2016 to August 2019. Cognition assessments (MMSE, MoCA) were performed for these patients. MRI imaging sequences were obtained and reviewed independently by two well-trained readers who were blind to all clinical data. Spearman's correlation analysis and logistic regression model analysis were further used for the assessments.

Results: An association between cerebral microbleeds with cognitive ability and dementia in PD patients was revealed. A significance was observed between the total number of microbleeds and two widely used scores of cognitive assessments (Spearman R = - 0.120 to MMSE with a p = 0.016, and - 0.117 to MoCA with a p = 0.020). In detail, infratentorial microbleeds were associated with the level of cognition in PD patients (Spearman R = - 0.099 to MMSE with a p = 0.049, and - 0.116 to MoCA with a p = 0.021). Furthermore, logistic regression analysis results also confirmed such correlations between the number of microbleeds and cognitive ability after adjusting for age, cholesterol level, Hamilton Anxiety Scale, Hamilton Depression Scale, and white matter hyperintensity Fazekas score (OR 3.28, p = 0.035, 95% CI 1.090-9.892).

Conclusions: The occurrence of microbleeds, especially in the infratentorial locations, may worsen the cognitive function of PD patients and result in dementia. Management of cerebral vascular disease could be beneficial to patients with PD.

Keywords: Cerebral small vessel disease; Cognitive malfunction; Parkinson’s disease.