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Supplemental material, sj-docx-1-wso-10.1177_17474930221137019 for The global burden of cerebral small vessel disease in low- and middle-income countries: A systematic review and meta-analysis by Bonnie Yin Ka Lam, Yuan Cai, Rufus Akinyemi, Geert Jan Biessels, Hilde van den Brink, Christopher Chen, Chin Wai Cheung, King Ngai Chow, Henry Kwun Hang Chung, Marco Duering, Siu Ting Fu, Deborah Gustafson, Saima Hilal, Vincent Ming Ho Hui, Rajesh Kalaria, SangYun Kim, Maggie Li Man Lam, Frank Erik de Leeuw, Ami Sin Man Li, Hugh Stephen Markus, Anna Marseglia, Huijing Zheng, John O’Brien, Leonardo Pantoni, Perminder Singh Sachdev, Eric E Smith, Joanna Wardlaw and Vincent Chung Tong Mok in International Journal of Stroke

Supplemental material, sj-docx-1-wso-10.1177_17474930221137019 for The global burden of cerebral small vessel disease in low- and middle-income countries: A systematic review and meta-analysis by Bonnie Yin Ka Lam, Yuan Cai, Rufus Akinyemi, Geert Jan Biessels, Hilde van den Brink, Christopher Chen, Chin Wai Cheung, King Ngai Chow, Henry Kwun Hang Chung, Marco Duering, Siu Ting Fu, Deborah Gustafson, Saima Hilal, Vincent Ming Ho Hui, Rajesh Kalaria, SangYun Kim, Maggie Li Man Lam, Frank Erik de Leeuw, Ami Sin Man Li, Hugh Stephen Markus, Anna Marseglia, Huijing Zheng, John O’Brien, Leonardo Pantoni, Perminder Singh Sachdev, Eric E Smith, Joanna Wardlaw and Vincent Chung Tong Mok in International Journal of Stroke

In the paper by Mok et al. (“Tackling challenges in care of Alzheimer's disease and other dementias amid the COVID-19 pandemic, now and in the future.”Alzheimer's Dement. 2020; 16: 1571-1581. https://doi.org/10.1002/alz.12143), an error occurred in the preparation of the paper for publication, requiring the following correction. In the initial publication of this article, Vorapun Senanarong, BSc, MD, was inadvertently omitted from the author group. The corrected author group and affiliations list appear above. We regret the error.

BACKGROUND Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. METHODS We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. FINDINGS Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1·34 years [IQR 0·19-2·44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1·35 (95% CI 1·20-1·50) for the composite outcome of intracranial haemorrhage and ischaemic stroke; 2·45 (1·82-3·29) for intracranial haemorrhage and 1·23 (1·08-1·40) for ischaemic stroke. The aHR increased with increasing cerebral microbleed burden for intracranial haemorrhage but this effect was less marked for ischaemic stroke (for five or more cerebral microbleeds, aHR 4·55 [95% CI 3·08-6·72] for intracranial haemorrhage vs 1·47 [1·19-1·80] for ischaemic stroke; for ten or more cerebral microbleeds, aHR 5·52 [3·36-9·05] vs 1·43 [1·07-1·91]; and for ≥20 cerebral microbleeds, aHR 8·61 [4·69-15·81] vs 1·86 [1·23-1·82]). However, irrespective of cerebral microbleed anatomical distribution or burden, the rate of ischaemic stroke exceeded that of intracranial haemorrhage (for ten or more cerebral microbleeds, 64 ischaemic strokes [95% CI 48-84] per 1000 patient-years vs 27 intracranial haemorrhages [17-41] per 1000 patient-years; and for ≥20 cerebral microbleeds, 73 ischaemic strokes [46-108] per 1000 patient-years vs 39 intracranial haemorrhages [21-67] per 1000 patient-years). INTERPRETATION In patients with recent ischaemic stroke or transient ischaemic attack, cerebral microbleeds are associated with a greater relative hazard (aHR) for subsequent intracranial haemorrhage than for ischaemic stroke, but the absolute risk of ischaemic stroke is higher than that of intracranial haemorrhage, regardless of cerebral microbleed presence, antomical distribution, or burden. FUNDING British Heart Foundation and UK Stroke Association.