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Publications

Journal Article Ahead of print

PubMed: 42644376 DOI: 10.1177/0271678X261485415

EXPRESS: Disentangling MRI-derived blood-brain barrier leakage into vascular permeability and surface area.

J Cereb Blood Flow Metab

Authors: Damon Verstappen, Joost J A de Jong, Paulien H Voorter, Maud van Dinther, Robert J van Oostenbrugge, Julie Staals, Jacobus F A F A Jansen, Walter H Backes

Affiliations

  • Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands.
  • Mental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, Netherlands.
  • Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands.
  • Department of Neurology, Maastricht University Medical Centre+, Maastricht, Netherlands.
  • Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.
  • Mental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, Netherlands.
  • Department of Neurology, Maastricht University Medical Centre+, Maastricht, Netherlands.
  • Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.

Abstract

BACKGROUND

In neurovascular and neurodegenerative diseases, blood-brain barrier (BBB) disruption can be subtle, diffuse, and MRI-derived measures are confounded by microvascular architecture. Therefore, we aimed to disentangle MRI-derived blood-brain barrier leakage rate (K i) into intrinsic vascular permeability (P) and surface area (S).

METHODS

In this cross-sectional study, 45 patients with cSVD and 26 elderly controls underwent dynamic contrast-enhanced (DCE) MRI to determine K i and vessel architecture imaging (VAI) to estimate S. These measures were used to calculate P.

RESULTS

Compared to normal-appearing white matter (NAWM), K i was higher in WMH (β=0.297, p<0.001) and deep gray matter (DGM) (β=0.210, p=0.007). P was higher in WMH (β=0.410, p<0.001) and similar between NAWM and DGM. S was smaller in WMH (β=-0.467, p<0.001) and larger in DGM (β=0.540, p<0.001). K i (β=0.289, p=0.007) and P (β=0.249, p=0.021) were only higher in patients than controls in concentric shells surrounding WMH. S was smaller in WMH of patients than controls (β=-0.085, p=0.049). With age, K i (β=0.260, p=0.008) and P increased (β=0.273, p<0.001), while S decreased (β=-0.079, p=0.025).

CONCLUSION

Disentangling P and S from the BBB leakage rate provides two biologically more specific and interpretable measures, which have counteracting effects on the BBB leakage in aging and disease.

MeSH

Blood-Brain Barrier, Blood, Aging, Brain, Cerebrovascular Circulation