Cerebral Amyloid Angiopathy-Related Microbleeds Correlate with Glucose Metabolism and Brain Volume in Alzheimer's Disease

J Alzheimers Dis. 2015;48(2):517-28. doi: 10.3233/JAD-150274.


Background: Microbleeds (MBs) are frequently observed in Alzheimer's disease (AD); however, the relevance to AD pathophysiology has not been elucidated.

Objectives: We investigated correlation of MBs, especially cerebral amyloid angiopathy (CAA)-related MBs with cognitive function, gray matter volume, and glucose metabolism in AD.

Methods: We performed magnetic resonance imaging including T2*-weighted imaging sequence for 206 patients with AD. Among them, 158 AD patients with no focal brain lesions except for MBs were investigated with cognitive tests, voxel-based morphometry, and 18F-fluorodeoxyglucose positron emission tomography in a cross-sectional observational study.

Results: Of the 158 patients with no hemorrhagic and/or ischemic stroke lesions except for MBs, 27 patients had MBs, in which 17 patients showed CAA-related MBs that located only in cortex/subcortex (CAA-related MBs), and 10 patients showed CAA-unrelated MBs that located in deep regions regardless of the presence of MBs in cortical/subcortical regions. There were slightly but significant differences in cognitive functions between the patients without MBs, those with CAA-related MBs, and those with CAA-unrelated MBs. MBs were recognized frequently in the occipital lobe in the patients with CAA-related MBs. The patients with CAA-related MBs showed gray matter atrophy in the temporal lobe and cerebellum, and glucose hypometabolism in the temporal lobe compared with those without MBs.

Conclusions: Our results indicate that MBs, particularly CAA-related MBs would cause gray matter atrophy and glucose hypometabolism in AD.

Keywords: 18F-FDG PET; Alzheimer’s disease; brain microbleeds; cerebral amyloid angiopathy; voxel-based morphometry.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / pathology*
  • Alzheimer Disease / physiopathology
  • Alzheimer Disease / psychology
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Brain / pathology*
  • Cerebral Amyloid Angiopathy / diagnostic imaging
  • Cerebral Amyloid Angiopathy / pathology*
  • Cerebral Amyloid Angiopathy / physiopathology
  • Cerebral Amyloid Angiopathy / psychology
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / pathology*
  • Cerebral Hemorrhage / physiopathology
  • Cerebral Hemorrhage / psychology
  • Cross-Sectional Studies
  • Female
  • Fluorodeoxyglucose F18
  • Glucose / metabolism*
  • Gray Matter / metabolism
  • Gray Matter / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neuropsychological Tests
  • Organ Size
  • Positron-Emission Tomography
  • Radiopharmaceuticals


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Glucose