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We aimed to examine whether MBs are associated with motor or cognitive decline in patients with Parkinson\u2019s disease (PD). We enrolled 135 PD patients and 34 healthy controls. All participants underwent brain MRI and plasma biomarker assays, including tau, A\u03b242, A\u03b240, and \u03b1-synuclein. PD with dementia (PDD) was operationally defined as Mini-Mental State Examination (MMSE) score\u2009&lt;\u200926 and advanced motor stage was defined as Hoehn-Yahr stage\u2009\u2265\u20093 during \u201con\u201d status. The association between MBs and disease severity was examined using multivariate logistic regression models. More lobar MBs were observed in PD patients than controls (20.7% vs. 3.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.031). PDD patients had more lobar MBs (33.3% vs. 15.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.034), more white matter hyperintensity (<jats:italic>p<\/jats:italic>\u2009=\u20090.021) and reduced hippocampal volume (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) than PD with normal cognition. The presence of lobar MB (odds ratio\u2009=\u20092.83 [95% confidence interval 1.04\u20137.70], <jats:italic>p<\/jats:italic>\u2009=\u20090.042) and severe white matter hyperintensity (3.29 [1.21\u20138.96], <jats:italic>p<\/jats:italic>\u2009=\u20090.020) was independently associated with PDD after adjusting for vascular risk factors and other confounders. Furthermore, plasma A\u03b240 levels were associated the MMSE score (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) after adjusting for age and sex. Our findings demonstrated that lobar MBs, reduced hippocampal volume, and elevated plasma A\u03b240 levels are associated with PDD.<\/jats:p>","DOI":"10.1038\/s41598-021-86617-0","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T10:03:03Z","timestamp":1617012183000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Amyloid related cerebral microbleed and plasma A\u03b240 are associated with cognitive decline in Parkinson\u2019s disease"],"prefix":"10.1038","volume":"11","author":[{"given":"Hsin-Hsi","family":"Tsai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Kai","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Ling","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Hsien","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"86617_CR1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","volume":"386","author":"LV Kalia","year":"2015","unstructured":"Kalia, L. 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