The significant effects of cerebral microbleeds on cognitive dysfunction: An updated meta-analysis

PLOS ONE, Nov 2019

Objective Accumulated data suggests that cerebral microbleeds (CMBs) play an important role in the decline of cognitive function, but the results remain inconsistent. In the current study, we aimed to investigate the association between CMBs and cognitive function, as well as the various effects of CMBs on different domains of cognition. Methods We searched through the databases of PubMed, Embase, Cochrane Library, and ScienceDirect. After a consistency test, the publication bias was evaluated and a sensitivity analysis was performed with combined odds ratios (OR) and standardized mean difference (SMD) of CMBs. Results A meta-analysis of 25 studies with 9343 participants total was conducted. Patients with CMBs had higher incidence of cognitive impairment (OR:3.5410; 95% confidence interval [CI] [2.2979, 5.4567], p<0.05) and lower scores of cognitive functions (SMD: -0.2700 [-0.4267, -0.1133], p<0.05 in Mini-Mental State Examination [MMSE] group and -0.4869 [-0.8902, -0.0818], p<0.05 in Montreal Cognitive Assessment [MoCA] group). Our results also indicated that patients with CMBs had obvious decline in cognitive functions, for instance, orientation (SMD: -0.9565 [-1.7260, -0.1869], p<0.05), attention and calculation (SMD: -1.1518 [-1.9553, -0.3484], p<0.05) and delayed recall (SMD: -0.5527 [-1.1043, -0.0011], p = 0.05). Conclusions Our data suggested that CMBs might be an important risk factor for cognitive dysfunction, especially in the domains of orientation, attention and calculation and delayed recall functions. Prospective cohort studies with further investigations will be needed in larger samples.

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The significant effects of cerebral microbleeds on cognitive dysfunction: An updated meta-analysis

September The significant effects of cerebral microbleeds on cognitive dysfunction: An updated meta- analysis Xuanting Li☯ 0 1 2 Junliang Yuan☯ 0 1 2 Lei Yang 0 1 2 Wei Qin 0 1 2 Shuna Yang 0 1 2 Yue Li 0 1 2 Huimin Fan 0 1 2 Wenli Hu 0 1 2 0 Natural Science Foundation of China (81271309, 81301016) and Beijing Municipal Administration of Hospitals' Youth Programme , QML20150303 1 Editor: Stephen D Ginsberg, Nathan S Kline Institute , UNITED STATES 2 Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University , Beijing , China A meta-analysis of 25 studies with 9343 participants total was conducted. Patients with CMBs had higher incidence of cognitive impairment (OR:3.5410; 95% confidence interval [CI] [2.2979, 5.4567], p<0.05) and lower scores of cognitive functions (SMD: -0.2700 [-0.4267, -0.1133], p<0.05 in Mini-Mental State Examination [MMSE] group and -0.4869 [-0.8902, -0.0818], p<0.05 in Montreal Cognitive Assessment [MoCA] group). Our results also indicated that patients with CMBs had obvious decline in cognitive functions, for instance, orientation (SMD: -0.9565 [-1.7260, -0.1869], p<0.05), attention and calculation (SMD: -1.1518 [-1.9553, -0.3484], p<0.05) and delayed recall (SMD: -0.5527 [-1.1043, -0.0011], p = 0.05). Conclusions Our data suggested that CMBs might be an important risk factor for cognitive dysfunction, especially in the domains of orientation, attention and calculation and delayed recall Accumulated data suggests that cerebral microbleeds (CMBs) play an important role in the decline of cognitive function, but the results remain inconsistent. In the current study, we aimed to investigate the association between CMBs and cognitive function, as well as the various effects of CMBs on different domains of cognition. We searched through the databases of PubMed, Embase, Cochrane Library, and Science Direct. After a consistency test, the publication bias was evaluated and a sensitivity analysis was performed with combined odds ratios (OR) and standardized mean difference (SMD) of CMBs. a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Competing interests: The authors have declared that no competing interests exist. Objective Methods Results functions. Prospective cohort studies with further investigations will be needed in larger samples. Introduction According to the World Alzheimer Report (2015), the increasing prevalence of dementia will be one of the biggest global public health and social care challenges today and in the future. [ 1 ] Cerebral small vessel disease (CSVD) is an important clinical and pathological condition causing 20% of strokes worldwide, and one of the most common causes of vascular cognitive impairment (VCI) and mixed dementia. [ 2 ] Cerebral microbleeds (CMBs), detected by T2 weighted gradient-recalled echo (GRE) or susceptibility-weighted imaging (SWI), have been recognized as an important manifestation and diagnostic marker of CSVD. Although CMBs have traditionally been considered as a part of clinical silence, a growing body of evidence has indicated that CMBs play a crucial role in the pathophysiology of VCI. A population-based Rotterdam Scan Study shows that the incidence of CMBs was approxi mately 10% and CMBs rarely disappeared. [ 3 ] Studies from Asia also suggests that the presence of multiple CMBs, particularly multiple lobar CMBs, was associated with higher global neuropsychiatric burden on the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Such associations were more significant with CMBs located in deep areas and the increasing number of CMBs. [4±6] The Rotterdam Scan Study also suggested that presence of numerous microbleeds, especially in a strictly lobar location, was associated with worse performance on neuropsychological tests of information processing speed and motor speed. [ 7 ] According to a recent longitudinal study, participants with 3 CMBs had a substantial decline of global cognitive function, memory, and processing speed. [ 8 ] Over CMBs burden has a prognostic significance of cognitive impairment, however, there are also some controversies need to be clarified. For instance, one study from Netherland showed that CMBs were not associated with cognitive performances. [9] Another Dutch study also suggested that CMBs may have less featured influence on specific types of dementia such as frontotemporal lobar degeneration, progressive supranuclear palsy, and corticobasal degeneration. [10] To date, there are two studies that performed meta-analysis to exam the relationship between CMBs and cognition. In 2013, a systematic review including 7 studies demonstrated that the presence of CMBs was significantly associated with cognitive impairment. [ 11 ] One year later, another meta-analysis also came to the similar conclusion that (...truncated)


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Xuanting Li, Junliang Yuan, Lei Yang, Wei Qin, Shuna Yang, Yue Li, Huimin Fan, Wenli Hu. The significant effects of cerebral microbleeds on cognitive dysfunction: An updated meta-analysis, PLOS ONE, 2017, Volume 12, Issue 9, DOI: 10.1371/journal.pone.0185145