Cerebral Microbleeds May Be Linked to Disability in Multiple Sclerosis

A greater volume of microbleeds was associated with worse auditory and verbal learning and memory.

Cerebral microbleeds may be associated with cognitive and physical disability in patients with multiple sclerosis (MS), according to results from a case-control study published in Radiology.

Cerebral microbleeds are typically associated with aging and neurodegenerative disorders, however their role in clinical outcomes in MS is not well known.

In order to better understand their association with disability in MS and clinically isolated syndrome (CIS), Robert Zivadinov, MD, PhD, of the University of Buffalo, and colleagues performed 3T MRI and clinical examinations on 445 patients with MS, 445 patients with CIS, 51 patients with other neurological diseases, and 177 healthy controls. A subset of 168 patients with MS and 50 controls also underwent neuropsychological testing. Prevalence was examined in participants at least 50 years old and those younger than 50 years.

The investigators found that 19.8% of patients with MS aged 50 years and older had cerebral microbleeds compared to 7.4% of healthy controls (P=.01). In the group aged 50 years and younger (P=.039), a trend toward greater presence of cerebral microbleeds was observed in patients with MS (P=.016) and CIS.

After adjusting for age, hypertension, and normalized brain volume, cerebral microbleed volume was found to be significantly associated with increased physical disability in patients with MS (R2 = 0.23, P< .0001). After correlation analysis, an increased volume of cerebral microbleeds was found to be significantly associated with deteriorated auditory and verbal learning and memory (P=.006), as well as visual information processing speed trends (P=.049) in patients with MS.

The authors suggest that clinicians should monitor cerebral microbleed burden in patients with MS or CIS who may be at greater risk of developing cognitive or physical disabilities.


Zivadinov R, Ramasamy DP, Benedict RRH, et al. Cerebral Microbleeds in Multiple Sclerosis Evaluated on Susceptibility-weighted Images and Quantitative Susceptibility Maps: A Case-Control Study. Radiology. 2016; doi: 10.1148/radiol.2016160060.