Topic: Plasma and spinal-fluid biomarkers
Emerging evidence and expert opinion suggest that subcortical microhaemorrhages may be less closely related to cerebral amyloidosis than lobar lesions and may therefore warrant separate consideration in anti-amyloid treatment eligibility criteria. Multivariable logistic regression was used to assess whether baseline lobar and subcortical microhaemorrhage counts were independently associated with the development of additional lobar and subcortical microhaemorrhages. Results Among 1,146 participants followed for a mean of 4.55 years (SD = 1.78), 38 had subcortical-only and 157 had lobar-only microhaemorrhages at baseline. Baseline subcortical microhaemorrhage count was associated with additional subcortical lesions (OR 3.60, 95% CI 2.00–6.47), but not with additional lobar lesions (OR 1.25, 95% CI 0.73–2.15). Conversely, baseline lobar microhaemorrhage count was associated with additional lobar lesions (OR 2.74, 95% CI 2.06–3.64), but not with additional subcortical lesions (OR 1.08, 95% CI 0.77–1.53). White matter hyperintensity burden was associated with subcortical progression, while APOE ε4 homozygosity and greater cerebral amyloid burden were associated with lobar progression. Systolic blood pressure was directionally positive but not associated with lobar microhaemorrhage accumulation in either analysis. Discussion Our findings support the emerging view that subcortical and lobar microhaemorrhages exhibit distinct longitudinal patterns and associated risk profiles.
Key findings
- Emerging evidence and expert opinion suggest that subcortical microhaemorrhages may be less closely related to cerebral amyloidosis than lobar lesions and may therefore warrant separate consideration in anti-amyloid treatment eligibility criteria.
- Multivariable logistic regression was used to assess whether baseline lobar and subcortical microhaemorrhage counts were independently associated with the development of additional lobar and subcortical microhaemorrhages.
- Results Among 1,146 participants followed for a mean of 4.55 years (SD = 1.78), 38 had subcortical-only and 157 had lobar-only microhaemorrhages at baseline.
- Baseline subcortical microhaemorrhage count was associated with additional subcortical lesions (OR 3.60, 95% CI 2.00–6.47), but not with additional lobar lesions (OR 1.25, 95% CI 0.73–2.15).
- Conversely, baseline lobar microhaemorrhage count was associated with additional lobar lesions (OR 2.74, 95% CI 2.06–3.64), but not with additional subcortical lesions (OR 1.08, 95% CI 0.77–1.53).
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Study details
- Study designlongitudinal study
- Participants1,146
- Effect sizeOR 3.60; OR 1.25; OR 2.74
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 50 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 31 of the 62 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,146 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 31 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 31 of the 62 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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APA 7th
Hill, C., Michopoulou, S., Niranjan, M., & Kipps, C. M. (2026). Location-specific Longitudinal Patterns of Subcortical and Lobar Cerebral Microhemorrhages in Preclinical Alzheimer Disease. medRxiv. https://doi.org/10.64898/2026.10.12.26365339
Vancouver
Hill C, Michopoulou S, Niranjan M, Kipps CM. Location-specific Longitudinal Patterns of Subcortical and Lobar Cerebral Microhemorrhages in Preclinical Alzheimer Disease. medRxiv. 2026. doi:10.64898/2026.10.12.26365339.
BibTeX
@article{hill2026-1e2a59ae,
author = {Hill, C. and Michopoulou, S. and Niranjan, M. and Kipps, C. M.},
title = {{Location-specific Longitudinal Patterns of Subcortical and Lobar Cerebral Microhemorrhages in Preclinical Alzheimer Disease}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.10.12.26365339},
url = {https://doi.org/10.64898/2026.10.12.26365339}
}