Cerebral microbleeds are associated with deficits in cognitive processing speed and executive functions in middle-aged adults with type 1 diabetes

AIMS: Adults with type 1 diabetes (T1D) have an increased risk of cerebral small vessel disease (cSVD)-related brain changes already in midlife, yet their significance for cognitive functions remains poorly understood. We investigated associations between cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), and cognition in individuals with T1D and without any neurological symptoms. METHODS: Participants (n=167; age 46.4±7.7 years) underwent cross-sectional clinical and biochemical evaluations, brain magnetic resonance imaging, and neuropsychological assessment. CMB number and topography (lobar, deep/infratentorial, or mixed location) and WMHs, quantified volumetrically, were evaluated. RESULTS: Compared to absence of CMBs, higher burden of CMBs (≥3) was associated independently of age with poorer processing speed (standardized β from 0.18 to 0.23, p