Cerebral microbleed assessment on MRI in a memory clinic: Reliability, prevalence, and implications for anti-amyloid therapy.

IF 4.4 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2026-09-30 eCollection Date: 2026-10-01 DOI:10.1002/dad2.70472

Ernest Privšek, Anna Marseglia, Igor Košutić, Anna Rosenberg, Tobias Granberg, Milica G Kramberger, Miia Kivipelto, Eric Westman

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引用次数: 0

Abstract

Introduction: Cerebral microbleeds (CMBs) represent an important magnetic resonance imaging (MRI) marker of cerebral small vessel pathology in memory-clinic populations, where vascular and neurodegenerative pathologies frequently overlap.

Methods: This cross-sectional study included 747 patients from a Swedish memory clinic who underwent 3T MRI with susceptibility-weighted imaging. Two readers assessed CMBs using standardized criteria. Inter- and intra-observer agreement were evaluated before and after protocol refinement. CMB prevalence and burden were analyzed across diagnostic groups and by cerebrospinal fluid amyloid status.

Results: CMBs were present in 28.6% of patients and frequently observed in subjects with mild cognitive impairment or dementia. Inter-observer agreement improved from κ = 0.71 to κ = 0.82 after protocol refinement. Among amyloid-positive patients with cognitive impairment, 11.2% exceeded proposed CMB thresholds for anti-amyloid therapy eligibility.

Discussion: Standardized CMB assessment improves reliability in memory-clinic populations. Given its growing impact on treatment eligibility and safety, consistent evaluation is essential for patient management.

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记忆临床的MRI脑微出血评估：可靠性，患病率和抗淀粉样蛋白治疗的意义。

脑微出血（CMBs）是记忆临床人群中重要的脑小血管病理磁共振成像（MRI）标志物，在这些人群中，血管和神经退行性病变经常重叠。方法：这项横断面研究包括来自瑞典记忆诊所的747例患者，他们接受了3T MRI和敏感性加权成像。两位读者使用标准化标准评估了CMBs。在协议改进之前和之后，评估了观察员之间和观察员内部的一致性。通过诊断组和脑脊液淀粉样蛋白状态分析CMB患病率和负担。结果：28.6%的患者存在CMBs，并且经常在轻度认知障碍或痴呆患者中观察到。改进方案后，观察者间一致性从κ = 0.71提高到κ = 0.82。在淀粉样蛋白阳性的认知障碍患者中，11.2%超过了CMB推荐的抗淀粉样蛋白治疗资格阈值。讨论：标准化CMB评估提高了记忆门诊人群的可靠性。鉴于其对治疗资格和安全性的影响越来越大，一致的评估对患者管理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.