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Lu et al. Microbleeds and inflammatory marker levels

INTRODUCTION malignant disease (n = 4) and patients with severe
co-morbid medical conditions (n = 10) and those
Cerebral microbleeds (CMBs) are designated as using anti-inflammatory medications (n = 13) were
a microvascular disease which has no related also excluded. We further excluded patients whose
symptoms and physical signs. CMBs has a round hs-CRP levels were higher than 8 mg/L (n = 11).
[1]
or ovoid signal of hypointensity (d < 10 mm) in T2* Finally, 201 patients were included in the analysis.
Gradient-Recall Echo (GRE) and susceptibility- We divided the patients into 2 groups based on
weighted imaging (SWI) sequences. Previous SWI, CMBs group (n = 49) and no CMBs group
[2]
studies suggested that damage of cerebral (n = 152), CMBs group was further divided into deep
microvasculature resulted from hypertensive or infratentorial CMBs group (n = 30) and lobar
vasculopathy, cerebral amyloid angiopathy (CAA) and CMBs group (n = 19) based on CMBs location.
ischemic brain damage. CMBs are associated with
[3]
hypertensive vasculopathy tends to occur in basal Risk factors assessment
ganglia, whereas advanced CAA is associated with a The data including age, gender, body weight, height
lobar distribution. CMBs exists widely in patients of and medical history of patients such as smoking,
[1]
ischemic and hemorrhagic stroke, but also in normal alcohol intake, heart disease，blood pressure, blood
elderly individuals. Previous studies have shown glucose, serum lipid and the use of antithrombotic drugs
[1]
that stroke patients combined with CMBs have a were recorded for analysis. Hypertension was defined
significantly higher risk of recurrence. The presence as blood pressure ≥ 140/90 mmHg on measurements
[3]
of CMBs was also independently associated with taken on at least two occasions, or patients with a
cognitive functions. Multiple CMBs always indicate history of hypertension and using antihypertensive
[4]
serious microvascular lesion which will increase drug. Hyperlipidemia was defined as triglyceride level
risk of rebleeding. At the same time, patients with ≥ 1.7 mmol/L; low-density lipoprotein cholesterol level
[5]
CMBs had a higher risk of spontaneous hemorrhage ≥ 3.4 mmol/L; total cholesterol level ≥ 5.72 mmol/L,
while receiving anticoagulation and thrombolytic or use of cholesterol-lowering therapy. Diabetes was
therapy. CMBs are related to antiplatelet-related defined as fasting blood-glucose ≥ 7.0 mol/L
[5]
intracerebral hemorrhage. Recently, an individual and/or postprandial blood sugar ≥ 11.1 mol/L, or use of
[6]
participant meta-analysis showed that C-reactive antidiabetic therapy. Body mass index was defined as
protein concentration was associated with the risk weight [kg]/height [m] . Smoking was defined as ever
2
of coronary heart disease and ischemic stroke. smoking but giving up and current smoking. Habitual
[7]
Inflammatory marker interleukin-6 (IL-6) retained a alcohol intake was defined as alcohol drinking more
significant association with coronary heart disease than 20 g/day antiplatelet drugs and anticoagulant
and ischemic stroke. A review revealed that matrix drugs are regarded as antithrombotic drugs. Montreal
[8]
metalloproteinase-9 (MMP-9) levels were significantly Cognitive Assessment Scores were used to assess
correlated with severity of stroke, larger infarct cognitive function.
volume and worse functional outcome. For the
[9]
above reason, we sought to choose high-sensitivity Magnetic resonance imaging parameters and
C-reactive protein (hs-CRP), IL-6 and MMP-9 to diagnosis of CMB
investigate the relationship between inflammatory Brain magnetic resonance imaging (MRI) was
marker levels and CMBs so as to prevent CMBs from performed with a 3.0-tesla MR unit (Achieva; Philips).
developing. Susceptibility-weighted imaging (TR = 17 ms, TE
= 24 ms, 10-mm-thick slices with 5-mm spacing)
METHODS was included in the routine protocol. All the images
were compared and analyzed on the workstation by
Population trained and experienced radiologist and neurologist
Between June 2013 and March 2015, we recruited who were blinded to clinical information at the same
286 participants with a age was greater than 45 time according to the Microbleed Anatomical Rating
years of age from both outpatient and in-patient Scale MARS. [10] A single CMB was defined as a small,
services of the Department of Neurology, Peking round, or ovoid hypointensity of < 10 mm in diameter,
University Binhai Hospital. In this study, the majority evident on T2* GRE or SWI MRI sequences.
[2]
of the patients were without acute or transient Microbleed mimics (e.g. vessels, mineralization, air-
neurologic impairment. We excluded 18 patients with bone interfaces, partial volume artifact at the edges
a history of intracerebral hemorrhage and 9 patients of the cerebellum) were excluded. [10] CMBs were
with a history of traumatic brain injury. In addition, divided into lobar microbleeds (cortex, subcortex,
infectious diseases (n = 12), collagen disease (n = 8), and white matter) and deep or infratentorial
146 Neuroimmunology and Neuroinflammation ¦ Volume 4 ¦ August 08, 2017