Dynamic contrast-enhanced MRI shows altered blood–brain barrier function of deep gray matter structures in neuroborreliosis: a case–control study

European Radiology Experimental

Original Article

Anne Marit Solheim¹  Åslaug R. Lorentzen²  Robin Bugge³  Elisabeth S. Lindland⁴  Atle Bjørnerud⁵  Mona K. Beyer⁶  Hanne F. Harbo⁷  Silje Andreassen⁸  Harald Reiso⁹  Randi Eikeland^1,10 

[1] Department of Neurology, Sorlandet Hospital, Kristiansand, Norway;Institute of Clinical Medicine, University of Bergen, Bergen, Norway;Department of Neurology, Sorlandet Hospital, Kristiansand, Norway;The Norwegian National Advisory Unit On Tick-Borne Diseases, Sorlandet Hospital, Kristiansand, Norway;Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway;Department of Radiology, Sorlandet Hospital, Sykehusveien 1, N-4809, Arendal, Norway;Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;Department of Physics, University of Oslo, Oslo, Norway;Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Neurology, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Pediatrics, Sorlandet Hospital, Arendal, Norway;The Norwegian National Advisory Unit On Tick-Borne Diseases, Sorlandet Hospital, Kristiansand, Norway;The Norwegian National Advisory Unit On Tick-Borne Diseases, Sorlandet Hospital, Kristiansand, Norway;Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway;

关键词: Blood–brain barrier;    Encephalitis (tick-borne);    Gray matter;    Lyme neuroborreliosis;    Magnetic resonance imaging;   

DOI  :  10.1186/s41747-023-00365-6

 received in 2023-05-04, accepted in 2023-06-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMain aim was assessment of regional blood–brain barrier (BBB) function by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with neuroborreliosis. Secondary aim was to study the correlation of BBB function with biochemical, clinical, and cognitive parameters.MethodsRegional ethical committee approved this prospective single-center case–control study. Within 1 month after diagnosis of neuroborreliosis, 55 patients underwent DCE-MRI. The patient group consisted of 25 males and 30 females with mean age 58 years, and the controls were 8 males and 7 females with mean age 57 years. Pharmacokinetic compartment modelling with Patlak fit was applied, providing estimates for capillary leakage rate and blood volume fraction. Nine anatomical brain regions were sampled with auto-generated binary masks. Fatigue, severity of clinical symptoms and findings, and cognitive function were assessed in the acute phase and 6 months after treatment.ResultsLeakage rates and blood volume fractions were lower in patients compared to controls in the thalamus (p = 0.027 and p = 0.018, respectively), caudate nucleus (p = 0.009 for both), and hippocampus (p = 0.054 and p = 0.009). No correlation of leakage rates with fatigue, clinical disease severity or cognitive function was found.ConclusionsIn neuroborreliosis, leakage rate and blood volume fraction in the thalamus, caudate nucleus, and hippocampus were lower in patients compared to controls. DCE-MRI provided new insight to pathophysiology of neuroborreliosis, and can serve as biomarker of BBB function and regulatory mechanisms of the neurovascular unit in infection and inflammation.Relevance statementDCE-MRI provided new insight to pathophysiology of neuroborreliosis, and can serve as biomarker of blood–brain barrier function and regulatory mechanisms of the neurovascular unit in infection and inflammation.Key points• Neuroborreliosis is an infection with disturbed BBB function.• Microvessel leakage can be studied with DCE-MRI.• Prospective case–control study showed altered microvessel properties in thalamus, caudate, and hippocampus.Graphical Abstract

【 授权许可】

CC BY   
© European Society of Radiology (ESR) 2023

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