Incident Cerebral Microbleeds Detected by Susceptibility Weight-Imaging Help to Identify Patients with Mild Cognitive Impairment Progressing to Alzheimer's Disease

J Alzheimers Dis. 2017;60(1):253-262. doi: 10.3233/JAD-170470.


Background: The relationship between cerebral microbleeds (CMB) and Alzheimer's disease (AD) has not yet been clearly determined, particularly with susceptibility weight-imaging (SWI).

Objective: To evaluate the SWI sequence using 3T MRI for the detection of CMB, and its ability to differentiate elderly control subjects (CS), stable mild cognitive impairment patients (MCI-s), MCI patients progressing to AD (MCI-p), and AD patients.

Methods: It was a prospective, monocentric, observational study that took place in Toulouse, France. Participants were 65 years and older, enrolled in three groups: CS, MCI, and AD. Based on the longitudinal analysis of cognitive decline, MCI subjects were retrospectively classified as MCI-s or MCI-p. Each patient had a 4-year follow-up with MRI at baseline (MRI#1) and during the fourth year (MRI#3). CMB were counted on native SWI images juxtaposed to minIP reformatted images.

Results: 150 patients were enrolled: 48 CS, 25 MCI-s, 18 MCI-p, 59 AD. At MRI#1 and at MRI#3, there was no significant difference in the prevalence of CMB between groups (p = 0.75 and p = 0.87). In the MCI-p + AD group, significantly more subjects had≥4 incident CMB compared to the CS + MCI-s group (p = 0.016). In the MCI-p + AD group, the prevalence of patients with >4 CMB was significantly higher at MRI#3 than at MRI#1 (p = 0.008).

Conclusion: Using SWI, AD and MCI-p patients had developed significantly more new CMB than CS and MCI-s patients during the follow-up. Incident CMB might be suggested as a potential imaging marker of AD progression.

Keywords: Alzheimer’s disease; disease progression; imaging biomarker; incident cerebral microbleeds; longitudinal MRI; mild cognitive impairment; susceptibility weight imaging.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / etiology
  • Cerebral Hemorrhage* / diagnostic imaging
  • Cerebral Hemorrhage* / epidemiology
  • Cerebral Hemorrhage* / etiology
  • Cognitive Dysfunction / complications*
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Longitudinal Studies
  • Magnetic Resonance Imaging*
  • Male
  • Mental Status Schedule
  • Neuropsychological Tests