Blood-brain barrier leakage is more widespread in patients with cerebral small vessel disease

C. Eleana Zhang*, Sau May Wong, Harm J. van de Haar, Julie Staals, Jacobus F. A. Jansen, Cecile R. L. P. N. Jeukens, Paul A. M. Hofman, Robert J. van Oostenbrugge, Walter H. Backes

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

103 Citations (Web of Science)
66 Downloads (Pure)

Abstract

Objective: As blood-brain barrier (BBB) dysfunction may occur in normal aging but may also play a pivotal role in the pathophysiology of cerebral small vessel disease (cSVD), we used dynamic contrast-enhanced (DCE)-MRI to quantify the rate and the spatial extent of BBB leakage in patients with cSVD and age-and sex-matched controls to discern cSVD-related BBB leakage from aging-related leakage.

Methods: We performed structural brain MRI and DCE-MRI in 80 patients with clinically overt cSVD and 40 age-and sex-matched controls. Using the Patlak pharmacokinetic model, we calculated the leakage rate. The mean leakage rate and relative leakage volume were calculated using noise-corrected histogram analysis. Leakage rate and leakage volume were compared between patients with cSVD and controls for the normal-appearing white matter (NAWM), white matter hyperintensities (WMH), cortical gray matter (CGM), and deep gray matter.

Results: Multivariable linear regression analyses adjusting for age, sex, and cardiovascular risk factors showed that the leakage volume of the NAWM, WMH, and CGM was significantly larger in patients with cSVD compared with controls. No significant difference was found for leakage rate in any of the tissue regions.

Conclusion: We demonstrated a larger tissue volume with subtle BBB leakage in patients with cSVD than in controls. This was shown in the NAWM, WMH, and CGM, supporting the generalized nature of cSVD.

Original languageEnglish
Pages (from-to)426-432
Number of pages7
JournalNeurology
Volume88
Issue number5
DOIs
Publication statusPublished - 31 Jan 2017

Keywords

  • VASCULAR COGNITIVE IMPAIRMENT
  • WHITE-MATTER HYPERINTENSITIES
  • LACUNAR STROKE
  • PERMEABILITY
  • DEMENTIA
  • ABNORMALITIES
  • BREAKDOWN
  • MRI
  • PATHOPHYSIOLOGY
  • DYSFUNCTION

Cite this