Cerebral microbleeds in community-based older adults imaged both in-vivo and ex-vivo: A clinical, MRI and pathology study

Motivation: Cerebral microbleeds (CMBs) are studied in research of aging in-vivo or ex-vivo to study associations with amyloid-related imaging abnormalities (ARIA) and neuropathologies. However, a systematic comparison of CMBs imaged in-vivo and ex-vivo has not been conducted. Goal(s): To compare CMBs imaged in-vivo and ex-vivo in the same older adults. Approach: Longitudinal clinical evaluation, in-vivo MRI, ex-vivo MRI and detailed neuropathologic evaluation were combined in 37 community-based older adults. Results: Most CMBs were detected both in-vivo and ex-vivo. Ex-vivo CMB counts were higher than in-vivo with higher antemortem intervals. Participants with cognitive impairment or cerebral amyloid angiopathy have a higher odd of developing CMBs. Impact: We demonstrated that cerebral microbleeds (CMB) detected in-vivo were also detected ex-vivo. Also, cognitive impairment and cerebral amyloid angiopathy were associated with higher risk of CMB occurrence prior to death in older adults.