COPD increases risk of cerebral microbleeds

By Bruce Sylvester – Chronic obstructive pulmonary disease (COPD) is related to an increased risk of cerebral microbleeds, researchers from the Netherlands reported online on July 19, 2013 in the Journal of  Respiratory and Critical Care Medicine.

“The connection between COPD and  cerebral small vessel disease was suggested by two earlier studies, but the  connection between COPD and cerebral microbleeds, the location of which can  help elucidate underlying disease mechanisms, has not been studied,” said researchers and authors  Lies Lahousse, PhD, of the Department of Respiratory Medicine at Ghent  University Hospital in Belgium and Bruno Stricker, PhD,  of the Department of Epidemiology at Erasmus Medical Center in  Rotterdam, the Netherlands. “In the current  study, we found, for the first time, that COPD increases the risk of cerebral  microbleeds in deep or infratentorial brain regions, not only in a cross-sectional  analysis but also in a longitudinal analysis in subjects without microbleeds at  baseline.”

The investigators evaluated data from 165 subjects with COPD and 645 subjects with normal lung function from the Rotterdam Study, a prospective population-based cohort study  in subjects ≥55 years.

They confirmed COPD using spirometry and detected cerebral  microbleeds with high-resolution MRI.

They reported that, compared to subjects with normal lung function, COPD subjects had a significantly higher prevalence of cerebral microbleeds. The higher prevalence was independent of age, sex, smoking status, atherosclerotic large vessel disease, antithrombotic use, total  cholesterol, triglycerides, and serum creatinin levels.

They also found that the prevalence of microbleeds  in deep or infratentorial locations was significantly higher among the COPD subjects, and that the prevalence of such microbleeds increased with greater airflow limitation.

Notably, a longitudinal analysis which was limited to subjects without microbleed at baseline showed that COPD was an independent predicter of incident cerebral microbleeds in deep or  infratentorial locations.

The researchers noted that the study had limitations, including the cross-sectional design of the main analysis and the association of COPD with multiple comorbidities that could affect cerebral small vessel  disease.

“We have shown that COPD is associated with an increased risk of developing cerebral microbleeds in deep or  infratentorial locations,” said Dr. Lahousse. “Given the potential cognitive and functional consequences of these microbleeds, preventive strategies for  vulnerable patients need to be developed.”