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. 2021 Apr 15;21(1):159.
doi: 10.1186/s12883-021-02189-6.

Increase of blood-brain barrier leakage is related to cognitive decline in vascular mild cognitive impairment

Man Li  1 , Yue Li  2 , Long Zuo  3 , Wenli Hu  2 , Tao Jiang  3
Affiliations

Increase of blood-brain barrier leakage is related to cognitive decline in vascular mild cognitive impairment

Man Li et al. BMC Neurol. .

Abstract

Background: Blood-brain barrier (BBB) breakdown, as an early biomarker for vascular mild cognitive impairment (vMCI), has only been validated by a few studies. The aim of this study was to investigate whether compromised BBB integrity is involved in vMCI patients, and detect the relationship between BBB breakdown and cognitive function. BBB leakage in vMCI was explored, and the relationship between BBB leakage and cognitive function was discussed in this study.

Methods: This is a cross-sectional study involving 26 vMCI patients and 21 sex- and age-matched healthy controls. Dynamic contrast-enhanced-magnetic resonance imaging was performed for all participants, to determine BBB leakage. Leakage volume, leakage rate, and fractional blood plasma volume (Vp) in the grey and white matter were evaluated. Neuropsychological tests were used to determine cognitive function. Leakage rate, leakage volume, and Vp in different brain locations, including deep grey matter, cortical grey matter, white matter hyperintensity, and normal-appearing white matter were compared between the two groups.

Results: Multivariable linear regression analyses revealed that in all regions of interest, the leakage rate was significantly higher in vMCI patients relative to controls. Leakage volume in normal-appearing white matter and white matter hyperintensity were significantly higher, while Vp in normal-appearing white matter, deep grey matter, and cortical grey matter were significantly lower in vMCI patients. Moreover, Montreal Cognitive Assessment scores decreased with the increase of leakage rate in white matter hyperintensity.

Conclusion: Increased BBB permeability was detected in vMCI patients and was related to cognitive decline, which suggested that BBB breakdown might be involved in cognitive dysfunction pathogenesis.

Keywords: Blood-brain barrier; Cognitive function; Dynamic contrast-enhanced-magnetic resonance imaging; Vascular mild cognitive impairment.

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Conflict of interest statement

All authors state that there is no competing interest.

Figures

Fig. 1
Fig. 1
An example map. a Axial fluid-attenuated inversion recovery (FLAIR) image of a79-year-old man; b BBB leak (Ktrans) map; c Area under the leakage curve (AUC) map; d Fractional blood plasma volume (Vp) map
Fig. 2
Fig. 2
Regions of interest (ROIs). Example of the template for sampling ROIs (red circles) in normal-appearing white matter (NAWM), white matter hyperintensities (WMH), cortical gray matter (CGM), and deep gray matter (DGM). CSF, cerebrospinal fluid
See this image and copyright information in PMC

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