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Cited by 36Intracerebral and Subarachnoid Hemorrhage ResearchCerebrovascular and genetic disordersNeurological Complications and Syndromes

No neuropathological evidence for a direct topographical relation between microbleeds and cerebral amyloid angiopathy

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Kövari, Enikö, Charidimou, Andreas, Herrmann, François R., Giannakopoulos, Panteleimon, Bouras, Constantin, Gold, Gabriel·2015·Acta Neuropathologica Communications
DOI 10.1186/s40478-015-0228-9PMC PMC4535376
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Abstract

INTRODUCTION: Cerebral microbleeds correspond to blood breakdown products, including hemosiderin-containing macrophages around small vessels on histological examination. Superficial lobar cerebral microbleeds are increasingly recognized on MRI as a biomarker of cerebral amyloid angiopathy but the direct association between amyloid-laden vessels burden and cerebral microbleeds has yet to be validated neuropathologically. To address this issue, we examined the frequency of histopathologically-defined cerebral microbleeds in different brain regions and their relationship with cerebral amyloid angiopathy in a large autopsy population. RESULTS: The frontal, parietal and occipital cortex as well as the adjacent white matter and basal ganglia of 113 consecutive autopsies were examined. Cerebral microbleedss were identified on haematoxylin-eosin-stained histological slides, cerebral amyloid angiopathy using anti-amyloid antibody. Cerebral microbleeds were present in 92.9 % of the cases and cerebral amyloid angiopathy in 44.3 % of them. Cerebral microbleeds were more frequent in parietal and frontal lobes followed by the occipital region and basal ganglia. In contrast, cerebral amyloid angiopathy was most frequent in the occipital lobe. There was no significant topographical association between cerebral amyloid angiopathy presence or severity and cerebral microbleeds in any brain region. In lobar areas, cerebral amyloid angiopathy was found in the cortex, predominantly affecting pial arteries and their superficial cortical branches, in contrast to microbleeds which were mainly in the white matter and occurred around deeper arteries and arterioles, including the subcortical segment of long penetrating branches of pial vessels. CONCLUSIONS: Our study does not support a direct relation between cerebral microbleeds and cerebral amyloid angiopathy burden at the neuropathological level, raising intriguing questions on the potential pathophysiological mechanisms of cerebral microbleeds in the context of cerebral amyloid angiopathy or other small vessel disease pathology.

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  • An autopsy study reported histological evidence of ensued microhemorrhages in 92.9% of elderly individuals with mean age of 81.1 ± 10.8 years, including both AD and non-demented subjects.

    “For comparison an autopsy study reported histological evidence of ensued microhemorrhages in 92.9% of elderly individuals with mean age of 81.1 ± 10.8 years, which included both AD and non-demented subjects [53].”

    From APOE Genotype Differentially Modulates Effects of Anti-Aβ, Passive Immunization in APP Transgenic Mice (2017) · cites this paper as [53]

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Authors
Kövari, E., Charidimou, A., Herrmann, F. R., Giannakopoulos, P., Bouras, C., & Gold, G.
Affiliations
  • Harvard University (US)
  • University of Geneva (CH)
ORCID
Venue
Acta Neuropathologica Communications
Publisher
Springer Science and Business Media LLC
Published
2015-08-14
Volume
3
Issue
1
Pages
49-49
ISSN
2051-5960 (ISSN-L)
DOI
10.1186/s40478-015-0228-9
PMC
PMC4535376
OpenAlex
W2142740085
Cited by
36
References
41
Citations by year
2026: 1 · 2025: 3 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 8 · 2018: 4 · 2017: 4 · 2016: 7
FWCI
3.53
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Acta Neuropathologica Communications (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • UCL Discovery (University College London) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
Funders
Swiss National Foundation (Grant code:ID0E1JAC82)
Topics
  • Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
  • Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
Keywords
cerebral microbleeds, cerebral amyloid angiopathy, topographic distribution, neuropathology, pial arteries, cerebral small vessel disease, white matter, basal ganglia, occipital lobe, anti-amyloid antibodies
MeSH terms
Aged, Aged, 80 and over, Brain, Cerebral Hemorrhage, Female, Humans, Male, Middle Aged, Nerve Tissue Proteins, Severity of Illness Index, Amyloid beta-Peptides, Cerebral Amyloid Angiopathy, Statistics, Nonparametric, White Matter

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