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However, its application to participants with cerebral microbleeds (CMBs) to explore cognitive impairment mechanisms and potential imaging biomarkers remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study used NODDI to assess cortical microstructural changes in three groups: 52 participants with cerebral small vessel disease and CMBs (CSVD-c), 78 CSVD participants without CMBs (CSVD-n), and 37 healthy controls. Multivariable regression analysis examined the correlation between altered NODDI metrics, CMB severity, and cognitive function. Cox regression analysis evaluated the association between altered NODDI metrics and dementia risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The CSVD-c group showed a significant decrease in Intracellular Volume Fraction (ICVF) in the bilateral caudate nucleus and an increase in Isotropic volume fraction (ISOVF) in the right precuneus compared to both the controls and CSVD-n groups. Decreased ICVF in the bilateral caudate nucleus correlated with the number of CMBs (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.023), lower logical memory scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003), and higher Rey Auditory Verbal Learning Test and Clinical Dementia Rating-Sum of Boxes scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.011;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Increased ISOVF in the right precuneus was significantly associated with a higher risk of dementia (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.039), but this significance was lost after adjusting for age, sex and years of education.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participants with CMBs exhibit decreased ICVF in the bilateral caudate nucleus and increased ISOVF in the right precuneus, associated with cognitive impairment and increased dementia risk. NODDI metrics may serve as valuable markers for investigating CMB-related cognitive impairment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-026-04994-3","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T05:14:57Z","timestamp":1779513297000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurite orientation dispersion and density imaging identifies microstructural alterations in patients with cerebral microbleeds and correlations with cognitive impairment"],"prefix":"10.1186","volume":"26","author":[{"given":"Fang","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4088-1063","authenticated-orcid":false,"given":"Qili","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"issue":"7","key":"4994_CR1","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1016\/S1474-4422(23)00131-X","volume":"22","author":"M Duering","year":"2023","unstructured":"Duering M, Biessels GJ, Brodtmann A, Chen C, Cordonnier C, de Leeuw FE, Debette S, Frayne R, Jouvent E, Rost NS, et al. 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NeuroImage. 2006;31(3):968\u201380.","journal-title":"NeuroImage"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-026-04994-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04994-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04994-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:12:17Z","timestamp":1785517937000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12883-026-04994-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4994"],"URL":"https:\/\/doi.org\/10.1186\/s12883-026-04994-3","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]},"assertion":[{"value":"26 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval was not provided for this study on human participants because data used in the preparation of this article were obtained from the ADNI. All procedures involving human participants in the original ADNI study were conducted in accordance with the Declaration of Helsinki and its later amendments.The ADNI study was approved by the institutional review boards of all participating sites, which reviewed and approved the data collection protocol. Ethics approval was obtained from the institutional review boards of each institution involved: Oregon Health and Science University; University of Southern California; University of California\u2014San Diego; University of Michigan; Mayo Clinic, Rochester; Baylor College of Medicine; Columbia University Medical Center; Washington University, St. Louis; University of Alabama at Birmingham; Mount Sinai School of Medicine; Rush University Medical Center; Wien Center; Johns Hopkins University; New York University; Duke University Medical Center; University of Pennsylvania; University of Kentucky; University of Pittsburgh; University of Rochester Medical Center; University of California, Irvine; University of Texas Southwestern Medical School; Emory University; University of Kansas, Medical Center; University of California, Los Angeles; Mayo Clinic, Jacksonville; Indiana University; Yale University School of Medicine; McGill University, Montreal-Jewish General Hospital; Sunnybrook Health Sciences, Ontario; U.B.C. Clinic for AD & Related Disorders; Cognitive Neurology\u2014St. Joseph\u2019s, Ontario; Cleveland Clinic Lou Ruvo Center for Brain Health; Northwestern University; Premiere Research Inst (Palm Beach Neurology); Georgetown University Medical Center; Brigham and Women\u2019s Hospital; Stanford University; Banner Sun Health Research Institute; Boston University; Howard University; Case Western Reserve University; University of California, Davis\u2014Sacramento; Neurological Care of CNY; Parkwood Hospital; University of Wisconsin; University of California, Irvine\u2014BIC; Banner Alzheimer\u2019s Institute; Dent Neurologic Institute; Ohio State University; Albany Medical College; Hartford Hospital, Olin Neuropsychiatry Research Center; Dartmouth-Hitchcock Medical Center; Wake Forest University Health Sciences; Rhode Island Hospital; Butler Hospital; UC San Francisco; Medical University South Carolina; St. Joseph\u2019s Health Care Nathan Kline Institute; University of Iowa College of Medicine; Cornell University; and University of South Florida: USF Health Byrd Alzheimer\u2019s Institute. For up-to-date information, see https:\/\/adni.loni.usc.edu\/.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"480"}}