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Superficial siderosis in the general population
Vernooij MW, Ikram MA, Hofman A, Krestin GP, Breteler MM, van der Lugt A.. Neurology, 2009-07-01
Topic: Risk, prevention and care in population studies
Background Superficial siderosis is a rare radiologic diagnosis of hemosiderin deposition in subpial brain layers. In case studies, an association between superficial siderosis and cerebral amyloid angiopathy (CAA) has been described. Also, a potential role of superficial siderosis in Alzheimer disease (AD) was hypothesized. All previously reported cases of superficial siderosis were detected because of overt clinical symptoms. We studied the occurrence of superficial siderosis on brain MRI in a general population of nondemented elderly. Methods In 1,062 persons (mean age 69.6 years) from the population-based Rotterdam Scan Study, we performed T2*-weighted MRI to assess the presence of superficial siderosis. Furthermore, the presence, number, and location of cerebral microbleeds were rated, as lobar microbleeds are thought to be indicative of CAA. Results We found that superficial siderosis was present in 7 (0.7%) individuals, all of whom had cerebral microbleeds in lobar locations. Furthermore, in all 7 persons, microbleeds were located in close vicinity to superficial siderosis. Conclusions Our results provide further indirect support for the presumed link between superficial siderosis and cerebral amyloid angiopathy (CAA). Whether superficial siderosis may be a marker for severity or worse prognosis of CAA needs to be further evaluated in longitudinal follow-up.
Key findings
- Results We found that superficial siderosis was present in 7 (0.7%) individuals, all of whom had cerebral microbleeds in lobar locations.
- Conclusions Our results provide further indirect support for the presumed link between superficial siderosis and cerebral amyloid angiopathy (CAA).
Why it matters
Until this study, superficial siderosis, a thin layer of iron deposits on the brain's surface, had only been reported in people whose symptoms led to a scan. MRI of 1,062 older adults without dementia in the Rotterdam Scan Study found it in 7 people (0.7%), and every one also had lobar microbleeds nearby, which the authors call "indirect support" for a link with cerebral amyloid angiopathy. The study did not follow people over time, so whether siderosis signals more severe disease or a worse outlook is still untested, and it says nothing about treating or preventing Alzheimer's.
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Study details
- Study designlongitudinal study
- Participants1,062
- Effect size0.7%
- Evidence strengthModerate
How this study scored 62/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| 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 | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,062 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 5 / 7 | Cited 122 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.4 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 3 / 6 | Cited 5.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 9 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Aad van der Lugt: h-index 120 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Erasmus MC: institution h-index 1,321 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19620607) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 62 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Vernooij, M. W., Ikram, M. A., Hofman, A., Krestin, G. P., Breteler, M. M., & van der Lugt, A. (2009). Superficial siderosis in the general population. Neurology. https://doi.org/10.1212/wnl.0b013e3181ae7c5e
Vancouver
Vernooij MW, Ikram MA, Hofman A, Krestin GP, Breteler MM, van der Lugt A. Superficial siderosis in the general population. Neurology. 2009. doi:10.1212/wnl.0b013e3181ae7c5e. PMID: 19620607.
BibTeX
@article{vernooij2009-19620607,
author = {Vernooij, M. W. and Ikram, M. A. and Hofman, A. and Krestin, G. P. and Breteler, M. M. and van der Lugt, A.},
title = {{Superficial siderosis in the general population}},
journal = {Neurology},
year = {2009},
doi = {10.1212/wnl.0b013e3181ae7c5e},
pmid = {19620607},
url = {https://doi.org/10.1212/wnl.0b013e3181ae7c5e}
}
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