Microbleeding in the Brain Associated with Postural Instability, Gait Disturbance Subtype Of Parkinson’s, Study Shows.
parkinsonsnewstoday.com/201...
The study, “Cerebral Microbleeds are Associated with Postural Instability and Gait Disturbance Subtype in People with Parkinson’s Disease,” was published in the journal European Neurology.
The microbleeds article adds to an important thread about PD subtypes and differing efficacies of thiamine dosing levels.
Interesting.
Yet another reason not to take ASA
See also:
The prevalence and risk factors of cerebral microbleeds in patients with Parkinson's disease.
Yamashiro K, et al. Parkinsonism Relat Disord.
2015.
ncbi.nlm.nih.gov/pubmed/261...
INTRODUCTION: Cerebral microbleeds (CMBs) are frequently observed in patients with cerebrovascular disease and Alzheimer's disease. CMBs that are located in the deep or infratentorial regions and those that are present strictly in the lobar regions reflect hypertensive vasculopathy and cerebral amyloid angiopathy, respectively. The development of CMBs can be accelerated by clinical factors. Orthostatic hypotension (OH) has been reported to be associated with cerebral small vessel disease, such as white matter lesions in Parkinson's disease (PD). We investigated the prevalence, location and risk factors, including OH, for CMBs in patients with PD...
RESULTS: CMBs were detected in 29 (17.4%) patients. Among the patients with CMBs, 19 (65.5%) had deep or infratentorial CMBs and 10 (34.5%) had strictly lobar CMBs. Hypertension, OH and a history of ischemic stroke were independently associated with deep or infratentorial CMBs, whereas antiplatelet use was independently associated with strictly lobar CMBs.
CONCLUSIONS: In patients with PD, deep or infratentorial CMBs were more frequent than strictly lobar CMBs, and were associated with hypertension, OH and a history of ischemic stroke.
Copyright © 2015 Elsevier Ltd.
Let us not pretend (suffer under the delusionz) that all strokes are ischaemic.
Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting.
Charlotte Cordonnier Rustam Al-Shahi SalmanJoanna Wardlaw.
Brain, Volume 130, Issue 8, August 2007, Pages 1988–2003.
ncbi.nlm.nih.gov/pubmed/173...
Brain microbleeds (BMBs) are seen as small, homogeneous, round foci of low signal intensity on magnetic resonance imaging gradient echo (GRE) T2 sequences. BMBs might only be a biomarker for microangiopathy, or alternatively BMBs might provide useful diagnostic and prognostic information, potentially with therapeutic implications for the treatment of stroke.
Because of the rapid expansion in recent BMB research, we systematically reviewed and critically appraised the published literature according to QUADAS, STARD and Cochrane principles. Our selection criteria were met by 54 studies of 53 case series involving 9073 participants, 4432 of whom were people with cerebrovascular diseases. There were significant biases in many of the studies: variation in MRI magnet strength, flip angle, slice gap and slice thickness; inconsistent definitions of BMB size (23% did not define size at all, and of those that did 44% chose a diameter of < or =5 mm); only 30% included participants who were representative of the disease under study; and only 53% mentioned that BMB evaluation was blinded to other factors of interest.
By pooling data from similar studies, we found that the prevalence of BMBs was 5% [95% confidence interval (CI) 4-6] in healthy adults, 34% (95% CI 31-36) in people with ischaemic stroke, and 60% (95% CI 57-64) in people with non-traumatic intracerebral haemorrhage (ICH).
In the studies where a distinction could be made, BMBs were more prevalent among recurrent strokes than first-ever strokes: they affected 23% (95% CI 18-29) with first-ever ischaemic stroke but 44% (95% CI 34-54) with recurrent ischaemic stroke, and 52% (95% CI 47-56) with first-ever ICH but 83% (95% CI 71-90) with recurrent ICH.
By pooling data that could be extracted from similar studies, it appears that BMBs are associated with hypertension (OR 3.9, 95% CI 2.4-6.4) and diabetes mellitus (OR 2.2, 95% CI 1.2-4.2) in otherwise healthy adults, and that they are associated with hypertension (OR 2.3, 95% CI 1.7-3.0) in adults with cerebrovascular diseases. The association with hypertension was robust in sensitivity analyses. There is a pressing need for better designed studies to assess the diagnostic utility of BMBs, disentangle the many likely influences on their occurrence, and determine their prognostic utility and whether they should influence treatment. We conclude by proposing criteria for ideal study design and reporting.
PMID: 17322562 DOI: 10.1093/brain/awl387
[Indexed for MEDLINE]
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If one is a PIGD subtype with slight hypotension issues, is it possible it is because of microbleeds? I know I have some cognition issues (bad memory for names, lyrics etc.) and have a hopeless sense of direction. I remember 13 years before diagnosis that my neurologist found white matter lesions, but didn't seem overly concerned and said (back then) that they weren't uncommon, and weren't fully understood. Anyway, if microbleeds are responsible, is there another approach for treatment?
Microbleeds and small vessel diseases are complex , important areas of concern.
Cerebral Small Vessel Disease.
Qian Li, Yang Yang, [...], and John H. Zhang.
ncbi.nlm.nih.gov/pmc/articl...
Thanks - Ah yes, you are right - tis' too complex for my broken brain but I really appreciate your reply with the link.
SVD and mitochondria:
Cerebral small vessel disease: Capillary pathways to stroke and cognitive decline.
ncbi.nlm.nih.gov/pmc/articl...
Mitochondria in vascular disease.
academic.oup.com/cardiovasc...
Also:
Cerebral Small Vessel Disease: Targeting Oxidative Stress as a Novel Therapeutic Strategy?
ncbi.nlm.nih.gov/pmc/articl...
scholar.google.com/scholar?...
ncbi.nlm.nih.gov/pmc/articl...
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