Compromised Blood–Brain Barrier Integrity Is Associated With Total Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease

Frontiers in Neurology

Lei Yang¹  Yue Li¹  Wenli Hu¹  Wei Qin¹  Long Zuo²  Tao Jiang²  Man Li²  Qinglei Shi³ 

[1] Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;Diagnosis Imaging, Siemens Healthcare Ltd., Beijing, China;

关键词: cerebral small vessel disease;    blood–brain barrier;    lacunes;    white matter hyperintensities;    cerebral microbleeds;    enlarged perivascular spaces;   

DOI  :  10.3389/fneur.2018.00221

来源: DOAJ

【 摘 要 】

ObjectiveSeveral studies have demonstrated that compromised blood–brain barrier (BBB) integrity may play a pivotal role in the pathogenesis of individual cerebral small vessel disease (cSVD) markers, but the association between BBB permeability and total magnetic resonance imaging (MRI) cSVD burden remains unclear. This study aimed to investigate the relationship between BBB permeability and total MRI cSVD burden.MethodsConsecutive participants without symptomatic stroke history presented for physical examination were enrolled in this cross-sectional study. The presence of lacunes, white matter hyperintensities (WMH), cerebral microbleeds, and enlarged perivascular spaces was recorded in an ordinal score (range 0–4). We used dynamic contrast-enhanced-MRI and Patlak pharmacokinetic model to quantify BBB permeability in the normal-appearing white matter (NAWM), WMH, cortical gray matter (CGM), and deep gray matter (DGM).ResultsAll 99 participants averaged 70.33 years old (49–90 years). Multivariable linear regression analyses adjusted for age, sex, and vascular risk factors showed that leakage rate and area under the leakage curve in the NAWM, WMH, CGM, and DGM were positively associated with total MRI cSVD burden (all P < 0.01). Moreover, fractional blood plasma volumes in the NAWM, CGM, and DGM were negatively associated with total MRI cSVD burden (all P < 0.05).ConclusionThis study verified that compromised BBB integrity is associated with total MRI cSVD burden, suggesting that BBB dysfunction may be a critical contributor to the pathogenesis of cSVD. Longitudinal studies are required to determine whether there is a causal relationship between BBB permeability and total MRI cSVD burden.

【 授权许可】

Unknown