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<meta name="DC.Title" content="Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4525" />
<meta name="DC.Date" content="2016-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The literature on the prevalence of Alzheimer disease–associated cerebral microbleeds assessed with MR imaging shows considerable heterogeneity in terms of imaging techniques and parameters. Our aim was to perform a meta-analysis of the role of imaging techniques, including image acquisition, field strength and scanner type, and clinical and demographic factors on the reported prevalence of microbleeds in Alzheimer disease.

MATERIALS AND METHODS: The prevalence of microbleeds was examined with respect to a priori–selected moderating variables via meta-analytic tools of literature reports.

RESULTS: Fourteen unique studies providing 15 microbleed prevalence rates met the selection criteria for inclusion. The aggregate prevalence of microbleeds was 24% (95% CI, 19%–28%). Scan (SWI = 40%, gradient echo = 18%, EPI = 19%) and field strength (slope = 0.39; standard error = 15, P &lt; .01) influenced the prevalence of microbleeds. The associations between microbleeds and age, sex, and global cognitive status were not significant. After updating the literature, the aggregate prevalence remained in the 95% CI range.

CONCLUSIONS: Imaging technique and field strength are strongly associated with the prevalence of microbleeds over the global aggregate. Standardized imaging protocols for identification of microbleeds are recommended to minimize confounds.

AD
:   Alzheimer disease
ER
:   event rate
GRE
:   gradient recalled-echo imaging
MB
:   microbleed
MCI
:   mild cognitive impairment
STROBE
:   STrengthening the Reporting of OBservational studies in Epidemiology" />
<meta name="DC.Contributor" content="A.A. Sepehry" />
<meta name="DC.Contributor" content="D. Lang" />
<meta name="DC.Contributor" content="G.-Y. Hsiung" />
<meta name="DC.Contributor" content="A. Rauscher" />
<meta name="article:published_time" content="2016-02-01" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The literature on the prevalence of Alzheimer disease–associated cerebral microbleeds assessed with MR imaging shows considerable heterogeneity in terms of imaging techniques and parameters. Our aim was to perform a meta-analysis of the role of imaging techniques, including image acquisition, field strength and scanner type, and clinical and demographic factors on the reported prevalence of microbleeds in Alzheimer disease.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The prevalence of microbleeds was examined with respect to a priori–selected moderating variables via meta-analytic tools of literature reports.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Fourteen unique studies providing 15 microbleed prevalence rates met the selection criteria for inclusion. The aggregate prevalence of microbleeds was 24% (95% CI, 19%–28%). Scan (SWI = 40%, gradient echo = 18%, EPI = 19%) and field strength (slope = 0.39; standard error = 15, &lt;i&gt;P&lt;/i&gt; &amp;lt; .01) influenced the prevalence of microbleeds. The associations between microbleeds and age, sex, and global cognitive status were not significant. After updating the literature, the aggregate prevalence remained in the 95% CI range.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Imaging technique and field strength are strongly associated with the prevalence of microbleeds over the global aggregate. Standardized imaging protocols for identification of microbleeds are recommended to minimize confounds.&lt;/p&gt;" />
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<meta name="twitter:title" content="Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The literature on the prevalence of Alzheimer disease–associated cerebral microbleeds assessed with MR imaging shows considerable heterogeneity in terms of imaging techniques and parameters. Our aim was to perform a meta-analysis of the role of imaging techniques, including image acquisition, field strength and scanner type, and clinical and demographic factors on the reported prevalence of microbleeds in Alzheimer disease.

MATERIALS AND METHODS: The prevalence of microbleeds was examined with respect to a priori–selected moderating variables via meta-analytic tools of literature reports.

RESULTS: Fourteen unique studies providing 15 microbleed prevalence rates met the selection criteria for inclusion. The aggregate prevalence of microbleeds was 24% (95% CI, 19%–28%). Scan (SWI = 40%, gradient echo = 18%, EPI = 19%) and field strength (slope = 0.39; standard error = 15, P &lt; .01) influenced the prevalence of microbleeds. The associations between microbleeds and age, sex, and global cognitive status were not significant. After updating the literature, the aggregate prevalence remained in the 95% CI range.

CONCLUSIONS: Imaging technique and field strength are strongly associated with the prevalence of microbleeds over the global aggregate. Standardized imaging protocols for identification of microbleeds are recommended to minimize confounds.

AD
:   Alzheimer disease
ER
:   event rate
GRE
:   gradient recalled-echo imaging
MB
:   microbleed
MCI
:   mild cognitive impairment
STROBE
:   STrengthening the Reporting of OBservational studies in Epidemiology" />
<meta name="og-title" property="og:title" content="Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/37/2/215" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The literature on the prevalence of Alzheimer disease–associated cerebral microbleeds assessed with MR imaging shows considerable heterogeneity in terms of imaging techniques and parameters. Our aim was to perform a meta-analysis of the role of imaging techniques, including image acquisition, field strength and scanner type, and clinical and demographic factors on the reported prevalence of microbleeds in Alzheimer disease.

MATERIALS AND METHODS: The prevalence of microbleeds was examined with respect to a priori–selected moderating variables via meta-analytic tools of literature reports.

RESULTS: Fourteen unique studies providing 15 microbleed prevalence rates met the selection criteria for inclusion. The aggregate prevalence of microbleeds was 24% (95% CI, 19%–28%). Scan (SWI = 40%, gradient echo = 18%, EPI = 19%) and field strength (slope = 0.39; standard error = 15, P &lt; .01) influenced the prevalence of microbleeds. The associations between microbleeds and age, sex, and global cognitive status were not significant. After updating the literature, the aggregate prevalence remained in the 95% CI range.

CONCLUSIONS: Imaging technique and field strength are strongly associated with the prevalence of microbleeds over the global aggregate. Standardized imaging protocols for identification of microbleeds are recommended to minimize confounds.

AD
:   Alzheimer disease
ER
:   event rate
GRE
:   gradient recalled-echo imaging
MB
:   microbleed
MCI
:   mild cognitive impairment
STROBE
:   STrengthening the Reporting of OBservational studies in Epidemiology" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14258--5" data-node-nid="14258" id="top-node-14258--61338860950" data-pisa="ajnr;37/2/215" data-pisa-master="ajnr;ajnr.A4525" data-apath="/ajnr/37/2/215.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">ADULT BRAIN</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A4525" data-atom-uri="/ajnr/37/2/215.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.A. Sepehry</span>, <span class="highwire-citation-author" data-delta="1">D. Lang</span>, <span class="highwire-citation-author" data-delta="2">G.-Y. Hsiung</span> and <span class="highwire-citation-author" data-delta="3">A. Rauscher</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">215-222; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4525 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14258--61338860950" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.A. Sepehry </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurology (A.A.S., G.-Y.H.), Department of Medicine</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Paediatrics (A.A.S., A.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.A.%2BSepehry%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sepehry%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.A.%2BSepehry%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6055-4457" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.A. Sepehry</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D. Lang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Radiology (D.L.); University of British Columbia, Vancouver, British Columbia, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BLang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lang%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BLang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9373-1555" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Lang</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">G.-Y. Hsiung </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurology (A.A.S., G.-Y.H.), Department of Medicine</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.-Y.%2BHsiung%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hsiung%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.-Y.%2BHsiung%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-8017-0856" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G.-Y. Hsiung</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A. Rauscher </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Paediatrics (A.A.S., A.R.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BRauscher%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rauscher%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BRauscher%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1961-8252" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Rauscher</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.215.1" data-doi="10.1161/STR.0b013e3182299496"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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</li><li><span class="cit-auth"><span class="cit-name-surname">Heringa</span>  <span class="cit-name-given-names">SM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Reijmer</span>  <span class="cit-name-given-names">YD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Leemans</span>  <span class="cit-name-given-names">A</span></span>, <span class="cit-etal">et al</span></li></ol><cite>; <span class="cit-auth cit-collab">Utrecht Vascular Cognitive Impairment (VCI) Study Group</span>. <span class="cit-article-title">Multiple microbleeds are related to cerebral network disruptions in patients with early Alzheimer's disease</span>. <abbr class="cit-jnl-abbrev">J Alzheimers Dis</abbr> <span class="cit-pub-date">2014</span>;<span class="cit-vol">38</span>:<span class="cit-fpage">211</span>–<span class="cit-lpage">21</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3233/JAD-130542</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>23948936</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.3233/JAD-130542&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=23948936&amp;link_type=MED&amp;atom=%2Fajnr%2F37%2F2%2F215.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.215.3" data-doi="10.1093/brain/awq321"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Cordonnier</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">van der Flier</span>  <span class="cit-name-given-names">WM</span></span></li></ol><cite>. <span class="cit-article-title">Brain microbleeds and Alzheimer's disease: innocent observation or key player?</span> <abbr class="cit-jnl-abbrev">Brain</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">134</span>:<span class="cit-fpage">335</span>–<span class="cit-lpage">44</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1093/brain/awq321</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>21257651</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToiYnJhaW4iO3M6NToicmVzaWQiO3M6OToiMTM0LzIvMzM1IjtzOjQ6ImF0b20iO3M6MTk6Ii9ham5yLzM3LzIvMjE1LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-37.2.215.4" data-doi="10.3233/JAD-2009-1073"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 37</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2016 </div></div>
      
      
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