Surgery News

Cerebral microbleeds more common than previously thought

October 30, 2015

The study is published in the April 1, 2008, issue of Neurology, the medical journal of the American Academy of Neurology.

???We found a three-to-four-fold higher overall prevalence of cerebral microbleeds compared to other studies,??? according to study author Monique M.B. Breteler, MD, PhD, with the Erasmus MC University Medical Center in Rotterdam, the Netherlands. ???These findings are of major importance since cerebral microbleeds likely reflect cerebrovascular pathology and may be associated with an increased risk of cerebrovascular problems.???

Cerebral microbleeds are lesions that can be seen on brain scans, such as an MRI brain scan. The lesions are deposits of iron from red blood cells that have presumably leaked out of small brain vessels.

For the study, 1,062 healthy men and women who were an average age of 70 underwent an MRI to scan for the presence of cerebral microbleeds. Of the participants, 250 were found to have cerebral microbleeds.

The study found overall prevalence of cerebral microbleeds was high and increased with age from 18 percent in people age 60 to 69 to 38 percent in people over age 80. People with the e4 allele of the APOE gene, which is known to increase the risk of Alzheimer's disease and of cerebral amyloid angiopathy, had significantly more microbleeds than people without this genetic variant.

???We also found that the risk factors for cerebral microbleeds appear to vary according to the location of the microbleed,??? said Breteler. ???Our results show people with high blood pressure and a history of smoking had microbleeds in a different location in the brain than people with the APOE e4 allele, suggesting different causes for microbleeds in different locations.???

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Given the aging population, without the availability of medicines that delay or prevent the onset of Alzheimer's disease, the number of affected people is expected to at least triple by the year 2050 in developed nations(7). The average duration between onset of symptoms and death due to complications of Alzheimer's disease is about 8-10 years(8). The burden to caregivers and health care costs can increase dramatically in the late stages of Alzheimer's disease, when patients cannot maintain independent function and are frequently bedridden.

To more completely characterize the disease-modifying effects of LY450139, a number of optional biomarker sub-studies will be available to patients. These optional sub-studies will utilize new brain-scanning techniques to determine the amount of amyloid beta plaque in the brain, employ other, more established scanning techniques to examine brain structure and function, and evaluate a number of additional biochemical measures of Alzheimer's disease. By determining the effect of LY450139 on these objective biomarkers, a more complete understanding of the effect of LY450139 on underlying Alzheimer's disease pathology is possible.

Additional information regarding the IDENTITY trial, including global recruitment sites, may be found by visiting www.clinicaltrials or www.lillytrials, or by calling 1-877-CTLilly (1-877-285-4559).

About LY450139

LY450139 inhibits gamma secretase, an enzyme that cuts a protein, creating a shorter, sticky protein called amyloid beta. Alzheimer's disease theory suggests that some subtypes of amyloid beta clump together into plaques that eventually kill off brain cells. Clinical studies have examined the effect of LY450139 on amyloid beta in blood and cerebrospinal fluid. The most frequently occurring side effects experienced in earlier clinical studies with LY450139 include diarrhea, upset stomach, and fatigue. For a more complete listing of potential side effects, prospective clinical trial participants should refer to the informed consent document.

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