High Blood Pressure Increases the Risk of Cerebral Microbleeds in Hypertensive Individuals

Introduction: Hypertension is the leading preventable risk factor for major cardiovascular diseases worldwide. Recently, compelling evidence has emerged associating hypertension with cerebral microbleeds (CMBs), which are subclinical hemorrhages in the brain resulting from structural abnormalities in the small vessels that supply the brain. In addition to overall elevated blood pressure (BP), elevation in individual parameters such as systolic BP, diastolic BP, pulse pressure and mean arterial pressure could also individually be important risk factors for CMBs. This study aimed to assess the association between CMBs and blood pressure, and assess blood pressure parameters that could be possible risk factors for CMB. Methods: A retrospective case-control study was conducted from August 2021 to September 2022 on patients who underwent MRI due to primary complaints of limb disorders, loss of consciousness, persistent dizziness, and intermittent headaches. The patients were divided according to MRI results into 52 cases (those who had CMBs) and 52 controls (those who had no CMBs). Extracted data were analyzed in SPSS. Chi-square test, binary logistic regression, and Spearman’s correlation analysis were conducted. Results: In total, 104 cases and control patients were assessed, with mean (±SD) age 70.6 ± 8.56 vs 68.9 ± 8.93 years respectively (p > 0.05). CMB patients had more cases of stroke, hyperlipidemia and diabetes than non-CMB patients. Systolic blood pressure (SBP), diastolic blood pressure, pulse pressure (PP) and mean arterial pressure (MAP) were all considerably raised in CMB patients than non-CMBs patients. Blood pressure grades were positively correlated with the severity of CMBs (r = 0.22;p = 0.044). Logistic regression analysis showed that SBP and MAP were independent risk factors for CMBs (age and sex adjusted odds ratio = 1.420;95% CI: 1.030 - 1.851, and 1.310;95% CI: 1.011 - 1.631 respectively). Conclusions: In summary, this study found that hypertension was positively correlated with CMBs severity, and that SBP and MAP are independent risk factors for CMBs in patients with hypertension.

Elevated Pulse Pressure Is a Risk Factor for Cerebral Microbleeds. A Single Center Case-Control Study

Recent developments in brain magnetic resonance imaging using advanced Susceptibility Weighted Imaging (SWI) have significantly increased the detection and prevalence of Cerebral Microbleeds (CMBs). Here, we aimed to explore the association between Pulse Pressure (PP) and CMBs. Having been implicated in various arteriopathies, we hypothesized that elevated PP could also be a risk for CMBs. A retrospective case-control study was conducted from August 2021 to September 2022 at Zhongnan Hospital of Wuhan University China. Extracted data were analyzed in SPSS. Chi-square test, binary logistic regression, and Spearman’s correlation analysis were conducted.104 patients were analyzed. Univariate analysis showed no significant association between PP and CMBs, OR 1.65 (95% CI: 0.737 - 3.694;p > 0.05), while DBP and alcohol consumption were significant, ORs 2.956 (95% CI: 1.249 - 6.997, p < 0.05) and 2.525 (95% CI: 1.062 - 6.002, p < 0.05) respectively. Multivariate analysis, showed that PP was significantly associated with CMBs, OR 3.194 (95% CI: 1.024 - 9.964, p < 0.05) in combination with SBP, DBP, gender, age, smoking and alcohol consumption. Taken together, the study showed that elevated PP is associated with CMB, but is not an independent risk factor for CMBs.

Diffuse axonal injury after traumatic cerebral microbleeds: an evaluation of imaging techniques

Previous neuropathological studies regarding traumatic brain injury have primarily focused on changes in large structures, for example, the clinical prognosis after cerebral contusion, intrace- rebral hematoma, and epidural and subdural hematoma. In fact, many smaller injuries can also lead to severe neurological disorders. For example, cerebral microbleeds result in the dysfunc- tion of adjacent neurons and the disassociation between cortex and subcortical structures. These tiny changes cannot be adequately visualized on CT or conventional MRI. In contrast, gradient echo sequence-based susceptibility-weighted imaging is very sensitive to blood metabolites and microbleeds, and can be used to evaluate traumatic cerebral microbleeds with high sensitivity and accuracy. Cerebral microbleed can be considered as an important imaging marker for dif- fuse axonal injury with potential relevance for prognosis. For this reason, based on experimental and clinical studies, this study reviews the role of imaging data showing traumatic cerebral microbleeds in the evaluation of cerebral neuronal injury and neurofunctional loss.

Microbleeds in fronto-subcortical circuits are predictive of dementia conversion in patients with vascular cognitive impairment but no dementia

Cerebral small vessel disease（CSVD） is a common etiology of vascular cognitive impairment with no dementia（V-CIND）. Studies have revealed that cerebral microbleeds（CMBs）, a feature of CSVD, contribute to cognitive impairment. However, the association between CMBs and dementia conversion in individuals with V-CIND is still unclear. Here, we analyzed the predictive role of CMBs in the conversion from V-CIND to dementia in CSVD patients. We recruited and prospectively assessed 85 patients with CSVD and V-CIND. V-CIND was evaluated using a series of comprehensive neuropsychological scales, including the Chinese version of the Montreal Cognitive Assessment and the Clinical Dementia Rating. MRI assessments were used to quantify lacunar infarcts, white matter hyperintensities, CMBs, and medial temporal lobe atrophy. Eighty-two of the 85 patients completed the assessment for dementia conversion at a 1-year follow-up assessment. Multivariate logistic regression analyses were conducted to examine independent clinical and MRI variables associated with dementia conversion. Twenty-four patients（29.3%） had converted to dementia at the 1-year follow-up, and these individuals had significantly more CMBs in the fronto-subcortical circuits. Multivariate logistic regression analyses revealed that the patients with CMBs in the fronto-subcortical circuits（odds ratio = 4.4; 95% confidence interval： 1.602-12.081, P = 0.004） and 5 or more CMBs overall（odds ratio = 17.6, 95% confidence interval： 3.23-95.84, P = 0.001） had a significantly increased risk of dementia at the 1-year follow-up. These findings indicate that CMBs in the fronto-subcortical circuits may be predictive of dementia conversion in CSVD patients with V-CIND, and thus extend the clinical significance of CMBs.

A Transfer Learning-Based Approach to Detect Cerebral Microbleeds

Cerebral microbleeds are small chronic vascular diseases that occur because of irregularities in the cerebrum vessels.Individuals and elderly people with brain injury and dementia can have small microbleeds in their brains.A recent study has shown that cerebral microbleeds could be remarkably risky in terms of life and can be riskier for patients with dementia.In this study,we proposed an efficient approach to automatically identify microbleeds by reducing the false positives in openly available susceptibility-weighted imaging(SWI)data samples.The proposed structure comprises two different pretrained convolutional models with four stages.These stages include(i)skull removal and augmentation,(ii)making clusters of data samples using the k-mean classifier,(iii)reduction of false positives for efficient performance,and(iv)transfer-learning classification.The proposed technique was assessed using the SWI dataset available for 20 subjects.For our findings,we attained an accuracy of 97.26%with a 1.8%false-positive rate using data augmentation on the AlexNet transfer learning model and a 1.1%false-positive rate with 97.89%accuracy for the ResNet 50 model with data augmentation approaches.The results show that our models outperformed the existing approach for the detection of microbleeds.

Cerebral Microbleeds Identified by Susceptibility-Weighted Imaging in Two Cases of Fabry Disease without Neurological Symptoms

Cerebrovascular disease is one of the fatal causes of Fabry disease (FD). Brain magnetic resonance imaging findings typically show lacunar infarcts in young patients with FD, but brain hemorrhages in FD are rarely reported. We report two cases of FD focusing on cerebral microbleeds (CMBs). Susceptibility-weighted imaging (SWI) and T2*-weighted imaging reveal several lobar and deep CMBs in two patients with no medical history of stroke symptoms, hypertension, and anticoagulant/antiplatelet treatment. SWI can detect a greater number of CMBs than T2*-weighted imaging. Thus, SWI is an excellent tool for identifying underlying CMBs in FD.

An Efficient False-Positive Reduction System for Cerebral Microbleeds Detection

Cerebral Microbleeds(CMBs)are microhemorrhages caused by certain abnormalities of brain vessels.CMBs can be found in people with Traumatic Brain Injury(TBI),Alzheimer’s disease,and in old individuals having a brain injury.Current research reveals that CMBs can be highly dangerous for individuals having dementia and stroke.The CMBs seriously impact individuals’life which makes it crucial to recognize the CMBs in its initial phase to stop deterioration and to assist individuals to have a normal life.The existing work report good results but often ignores false-positive’s perspective for this research area.In this paper,an efficient approach is presented to detect CMBs from the Susceptibility Weighted Images(SWI).The proposed framework consists of four main phases(i)making clusters of brain Magnetic Resonance Imaging(MRI)using k-mean classifier(ii)reduce false positives for better classification results(iii)discriminative feature extraction specific to CMBs(iv)classification using a five layers convolutional neural network(CNN).The proposed method is evaluated on a public dataset available for 20 subjects.The proposed system shows an accuracy of 98.9%and a 1.1%false-positive rate value.The results show the superiority of the proposed work as compared to existing states of the art methods.

Ischaemic Stroke Complicating Infective Endocarditis: Microbleeds Are the Diagnostic Clue

Introduction: Ischemic strokes represent a classic complication of infective endocarditis (IE) and are most often related to the fragmentation of valvular vegetation. In most cases, they occur in the Sylvian territory and are related to Staphylococcus aureus. MRI can demonstrate, in addition to the AVCI image, cerebral microbleeds (CMBs) that are very suggestive of the diagnosis. We present the case of a patient who presented an ischemic stroke occurring in the context of infective endocarditis. Observation: A 32-year-old woman with no previous medical history initially presented with acute febrile headache, two weeks later she developed right hemiplegia with aphasia in the context of fever. Her general examination revealed lesions on the soles of her feet, in the form of nodules, infected in places, suggestive of Janeway nodules (characteristic of IE). The brain MRI showed an ischemic stroke in the Sylvian territory, with the presence of multiple microbleeds on the magnetic susceptibility sequences. The biological examination showed a severe inflammatory syndrome;the transthoracic echocardiography (TTE) confirmed the presence of vegetation on the aortic valve;and the blood cultures showed a Staphylococcus aureus. Antibiotic therapy was started, and the patient was transferred to the cardiology department. Discussion: Our observation has a double interest. The first is clinical due to the presence of plantar nodules (Janeway’s nodules) that are characteristic of IE which should orientate the diagnosis before the installation of the stroke, and the second is radiological and linked to the discovery of microbleeds. Their presence is increasingly reported in the literature, but their pathophysiology is not yet very clear. Conclusion: Stroke is the most frequent extracardiac complication during IE. The presence of microbleeds contributes to early diagnosis, especially in asymptomatic forms.

Original article ：Cerebral microbleeds prevalence, distribution and risk factors in northeast population without preceding large-area stroke

Background Cerebral microbleeds （CMBs） occur frequently in patients suspected of cerebrovascular disease and they are the principle radiographic findings in patients with sub-clinical neurological impairment. The objective of this study was to assess the prevalence, distribution, severity and associated clinical features of CMBs in a prospective hospital patient based cohort undergoing brain MRI for suspected cerebrovascular disease, excluding cases with known intracranial hemorrhage or prior large-area stroke. Methods The study population consisted of 447 patients who were evaluated with T2＊-gradient echo sequences to detect the CMBs lesion number, location, and their association with white matter hyperintensities and clinical parameters, including blood pressure. Results CMB lesions were presented in 95 of the 447 patients （21.3%）. The distribution of CMBs was 43.95% cortical, 19.77% thalamic, 14.41% in the brainstem, 11.58% cerebellar, 6.21% periventricular white matter, 5.64% involving the basal ganglia regions, and 0.28% involving the hippocampus. There was a statistically significant association between the presence of CMBs and advancing age （adjusted OR 2.082, P 〈0.01）, the severity of hypertension （adjusted OR 2.208 P 〈0.01）. Also there was a statistically significant （P 〈0.01） correlation between the presence of CMBs and the severity of hypertension and white matter lesions. Conclusions CMBs occur frequently in patients with no prior large-area stroke who were referred for brain MRI for suspected cerebrovascular disease. The severity of CMBs correlates with the severity of hypertension and the presence of cerebral white matter changes detected by MRI.

脑小血管病影像学标志物与认知功能障碍相关性研究进展

脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。

Relationship of cerebral microbleeds to inflammatory marker levels

Aim: The purpose of this study is to investigate the incidence, distribution and risk factors of cerebral microbleeds (CMBs) and the relation between CMBs and inflammation in ischemic cerebrovascular disease. Methods: Two hundred and one patients without acute infarction or transient ischemic attack were enrolled. The presence and number of CMB were assessed on susceptibility-weighted imaging. The traditional risk factors of CMB were recorded. Levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and matrix metalloproteinase-9 (MMP-9) were tested. Logistic regression analyses were used for multiple-factor analysis of risk factors of CMB. Results: Of the 201 patients, 49 (24.38%) had CMB. Multivariate logistic regression analyses showed that the age, the prevalence of hypertension, silent lacunar infarction, white matter lesion, Montreal Cognitive Assessment Score, the using rate of antithrombotic drugs and levels of hs-CRP, IL-6, MMP-9 were the risk factors for CMB. After adjustments for traditional risk factors, inflammatory marker levels remained to be associated with CMBs. The adjusted odd ratios of hs-CRP, IL-6 and MMP-9 were 1.745 (1.342-2.270), 1.223 (1.018-1.533) and 1.284 (1.082-1.423), respectively. Furthermore, inflammatory marker levels were the risk factor for deep or infratentorial CMBs and lobar CMBs. Conclusion: The age, prevalence of hypertension, silent lacunar infarction, white matter lesion, MoCA Score, the using rate of antithrombotic drugs and serum hs-CRP, IL-6, and MMP-9 levels were the independent risk factors for CMBs.

急性脑梗死伴微出血患者血清中TNF-α、miR-19a、CD147的检测意义

目的探讨肿瘤坏死因子-α(TNF-α)、非编码单链RNA-19a(miR-19a)、单次跨膜糖蛋白147(CD147)在急性脑梗死(ACI)伴脑微出血(CMB)患者中的诊断价值。方法选取2020年1月至2022年1月广元市中心医院神经内科收治的140例ACI患者,根据是否合并CMB分组,比较有无CMB患者血清中的TNF-α、miR-19a、CD147的表达水平,并分析上述这些指标表达水平在ACI合并CMB中的诊断价值。结果CMB组血清中的TNF-α、miR-19a、CD147相比无CMB组患者都有明显升高(P<0.05);Spearman等级相关分析CMB严重程度与TNF-α、miR-19a、CD147表达水平呈正相关(r=0.67~0.89,P<0.05);以SIEMENS MAGNETOM 3.0T超导MRI扫描仪和Kim评定标准为金标准,判断外周血TNF-α、miR-19a、CD147对CMB的诊断价值。受试者工作特征曲线(ROC)分析结果显示,单指标用于CMB诊断价值曲线下面积分别为0.725,0.753、0.748,联合诊断时曲线下面积为0.865。结论对ACI患者血清TNF-α、miR-19a、CD147水平进行联合检测,能够增加检测效能,为及早实现CMB治疗个性化方案的制定提供可靠的线索。

定量磁化率成像在急性缺血性脑卒中微出血灶中的应用价值

目的探讨定量磁化率成像(quantitative susceptibility mapping,QSM)在急性缺血性脑卒中微出血灶中的应用价值。方法选取2022年1~7月台州市第二人民医院收治的49例急性缺血性脑卒中合并脑内微出血的患者。所有患者均进行磁敏感加权成像(susceptibility weighted imaging,SWI)和QSM扫描,比较两种方法的脑微出血灶检出数量、不同回波时间下的微出血病灶面积及图像质量评分。结果QSM对幕下、基底节区及幕上基底节外区微出血灶的检出数量均多于SWI。QSM不同回波时间所测微出血病灶面积比较差异无统计学意义(P>0.05);回波时间80ms时SWI所测微出血病灶面积大于回波时间40ms(P<0.05);回波时间80ms时,SWI所测微出血病灶面积大于QSM(P<0.05)。QSM幕下及基底节区的图像质量评分显著高于SWI(P<0.05),两种方法幕上基底节外区的图像质量评分比较差异无统计学意义(P>0.05)。结论与SWI相比,QSM在急性缺血性脑卒中微出血灶诊断中更有助于提高检出率、病灶面积及图像质量,可为急性缺血性脑卒中微出血灶的影像鉴别诊断提供一定的参考价值。

伴皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病与颅内出血关系的研究进展

伴皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病(CADASIL)是一种由NOTCH3基因突变导致的遗传性脑小血管病,其主要临床特点包括偏头痛、皮质下缺血性卒中事件、认知功能障碍;主要影像学特点包括多发腔隙性脑梗死和脑白质脱髓鞘。通常认为,CADASIL发生颅内出血的风险较低,但近年来随着影像学技术的进步,相当数量的CADASIL患者可发现脑微出血,且不断有研究报道CADASIL患者发生症状性颅内出血。作者就CADASIL和颅内出血的关系作一综述。

急性脑梗死患者脑微出血的危险因素分析

目的:分析急性脑梗死患者脑微出血(CMBs)的危险因素。方法:回顾性分析急性脑梗死患者336例临床资料,根据磁敏感加权成像(SWI)扫描是否存在CMBs分为无CMBs组154例,CMBs组182例;CMBs组按CMBs分布的位置分为大脑皮质、皮质下、基底节及幕下。比较2组患者人口学特征、相关危险因素、血液检验结果及美国国立卫生研究院卒中量表(NIHSS)评分,并进行相关性分析;比较CMBs组中不同出血部位患者的尿酸、同型半胱氨酸(Hcy)和NIHSS评分。结果:与无CMBs组相比,CMBs组的尿酸和Hcy水平更高,合并高血压病、糖尿病、高总胆固醇及既往脑卒中病史的几率均更高(P<0.05);Logistic回归分析结果显示,高血压、高血糖、高胆固醇血症、脑卒中病史、Hcy和尿酸水平与CMBs的发生有关(P<0.05);高尿酸、高Hcy、糖尿病、脑卒中病史、高胆固醇血症和高血压均为CMBs发生的独立预测因素;不同部位CMBs的发生率差异无统计学意义(P>0.05);CMBs分布于不同部位患者的尿酸水平、Hcy水平及NIHSS评分差异无统计学意义(P>0.05)。结论:高尿酸、高Hcy、糖尿病、脑卒中病史、高胆固醇血症和高血压可能是急性脑梗死患者发生CMBs的独立危险因素。CMBs分布的部位对NIHSS评分无影响。

自发性脑出血患者的他汀应用和脑微出血情况分析

目的探讨他汀的应用是否和不断增长的脑微出血相关,尤其与皮质、皮质下微出血(csMB)的相关性。方法回顾分析163例发病30 d内经过磁共振检查的脑出血的临床资料,将患者分为皮质、皮质下微出血(csMB)和其他位置的微出血(oMB),并对磁共振上微出血的位置和数量进行比较,根据是否应用他汀、是否存在微出血(MB)、是否有皮质、皮质下微出血(csMB)分别进行分组比较。结果 64%患者有脑叶出血,53%患者有微出血(MB),39%患者皮质、皮质下微出血(csMB)。他汀的应用导致胆固醇和低密度脂蛋白显著降低,其中应用他汀的患者患有高血压、糖尿病、血脂紊乱、抗血小板的几率较大,应用他汀治疗的和未应用的患者中其他位置的微出血(oMB)数量相似,他汀治疗患者中存在更多的csMB(57%vs.33%,P=0.007),几乎是未应用他汀患者的2倍(4.6±2.7 vs.2.4±1.8,P<0.001)。多变量因素分析表明,年龄和他汀的应用是MB(OR=1.03;95%CI∶1.00~1.05;P=0.01和OR=2.72;95%CI∶1.02~7.22;P=0.04)和csMB(OR=1.03;95%CI∶1.00~1.06;P=0.01和OR=4.15;95%CI∶1.54~11.20,P<0.01)的独立危险因素。结论脑出血患者中他汀的应用与MB尤其是csMB相关,但需要更多的研究去确认csMB是否可以作为他汀应用患者脑出血的风险标志。

ESWAN序列在脑出血诊断中的应用价值

目的探讨磁敏感加权成像(ESWAN)在脑出血诊断中应用价值。方法对41例临床确诊脑出血患者行常规MR序列(T1WI、T2WI、FLAIR、DWI)、T2*GRE、ESWAN检查,对ESWAN图像进行后处理,获得ESWAN幅度图、相位图及最小密度投影(MinIP)图。对常规序列、T2*GRE、ESWAN各序列检出的出血灶数量、大小进行评估及统计分析。结果常规序列、T2*GRE、ESWAN对总出血灶及脑微出血灶(CMB)的检出率比较为:ESWAN>T2*GRE>常规序列;ESWAN序列对于微出血灶的检出率明显高于T2*GRE及常规序列。结论相对于常规序列及T2*GRE,ESWAN能更准确的检测出血灶数量,对梗死后微出血独具诊断优势。

脑出血患者服用抗血小板药物的长期随访研究

目的研究脑出血患者长期随访过程中使用抗血小板药物与脑卒中复发的关系。方法筛选2008年至2011年本院神经内科诊治的脑出血患者138例为研究对象,脑出血后6个月内开始使用抗血小板药物治疗患者37例纳入早期抗血小板治疗组（使用的抗血小板药物均为阿司匹林肠溶片100mg/d或氯吡格雷75 mg/d）,未在脑出血后6个月内使用抗血小板药物治疗患者101例纳入非早期抗血小板治疗组,所有患者均随访36个月,并记录随访期两组患者抗血小板药物使用情况以及缺血性脑卒中和脑出血的发生情况;有条件的患者在随访满36个月时进行磁共振磁敏感加权成像（MRI-SWI）序列检查脑微出血情况,并采用MARS评分分级。结果随访完成时,早期抗血小板治疗组患者缺血性脑卒中（包括脑梗死和短暂性脑缺血发作）发生率为8.1%（3/37）,非早期抗血小板治疗组发生率为16.8%（17/101）,两组比较差异具有显著性（P=0.035）;早期抗血小板治疗组患者症状性脑出血发生率为2.7%（1/37）,非早期抗血小板治疗组发生率为3.0%（3/101）,两组比较差异无显著性（P=0.078）。87例患者完成了MRI-SWI检查,早期抗血小板治疗组患者MARS评分2~3级（代表较严重微出血）的比例为12.0%（3/25）,非早期抗血小板治疗组为9.7%（6/62）,两组比较差异无显著性（P=0.083）。结论脑出血后整体使用抗血小板药物进行缺血性脑卒中预防的比例较低,脑出血后6个月开始使用抗血小板药物治疗可以降低缺血性脑卒中发生风险,不明显增加症状性脑出血复发以及严重脑微出血。

3.0T磁敏感加权成像在脑卒中患者脑微出血中的诊断价值

目的探讨磁敏感加权成像对脑卒中患者脑微出血的诊断价值。方法通过MRI T1Flair、T2WI、T2Flair及磁敏感加权成像(SWI),探讨65例脑卒中患者脑微出血灶的形态、数目及其分布。结果 57例患者发现脑微出血灶,共489个,病变最好发部位为皮层-皮层下(221个,45.2%)、其次为基底节(175个,35.8%)、丘脑(45个,9.2%)、脑干(28个,5.7%)、其他部位(20个,4.1%)。其中25例患者为缺血性脑卒中,32例患者为出血性脑卒中。结论磁敏感加权成像在检出脑微出血灶方面具有明显优势,能够清晰显示脑微出血灶的形态、数目,并对其解剖学位置进行精确定位。

Gastroprotection induced by capsaicin in healthy human subjects

AIM： To evaluate the gastro-protective effect of capsaicin against the ethanol- and indomethacin （IND）-induced gastric mucosal damage in healthy human subjects. METHODS： The effects of small doses （1-8 μg/mL, 100 mL） of capsaicin on the gastric acid secretion basal acid output （BAO） and its electrolyte concentration, gastric transmucosal potential difference （GTPD）, ethanol- （5 mL 300 mL/L i.g.） and IND- （3×25 mg/d） induced gastric mucosal damage were tested in a randomized, prospective study of 84 healthy human subjects. The possible role of desensitization of capsaicin-sensitive afferents was tested by repeated exposures and during a prolonged treatment. RESULTS： Intragastric application of capsaicin decreased the BAO and enhanced “non-parietal” component, GTPD in a dose-dependent manner. The decrease of GTPD evoked by ethanol was inhibited by the capsaicin application, which was reproducible. Gastric microbleeding induced by IND was inhibited by co-administration with capsaicin, but was not influenced by two weeks pretreatment with a daily capsaicin dose of 3×400μg i.g. CONCLUSION： Capsaicin in low concentration range protects against gastric injuries induced by ethanol or IND, which is attributed to stimulation of the sensory nerve endings.