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[Comparison between PVHIS on the MRI and the permeability of brain blood vessels in elderly patients]
Abstract:
The degree of PVHIS (periventricular high intensity signal) on the MRI was composed with the permeability of brain blood vessels using the cerebrospinal fluid (CSF)/serum ratio for albumin, and the CSF/serum ratio for IgG in elderly patients. The 47 elderly patients (mean age = 79.9) were divided into three groups: (1) Mild group (20 cases, M:6, F:14, mean age = 75.8), (2) Moderate group (18 cases, M:7, F:11, mean age = 82.6), (3) Severe group (9 cases, M:2, F:7, mean age = 82.9), in accordance with the degree of PVHIS on the MRI. The MRI was operated at a field strength of 0.22 tesla. The pulse sequence (used on all patients) had a repetition times (TR) of 2,000 msec and a time to echo (TE) of 40 msec. The levels of albumin and IgG in the serum and CSF were measured. The CSF/serum ratio for albumin was used of analyze the permeability of the brain blood vessels in each group. There was no significant difference in the level of the serum albumin, the CSF albumin, the serum IgG, the CSF IgG and the CSF/serum ratio for IgG among the three groups. The same was found to be true for the IgG index which indicates the synthesis of immunoglobulin in the central nervous system. However, there was a statistically significant difference (p less than 0.05) in the CSF/serum ratio for albumin between groups (1) and (3). The increased CSF/serum ratio for albumin in the severe group indicated there were confluent lesions involving the entire extent of the periventricular white matter on the MRI. This suggested an increased permeability of brain blood vessels which revealed the dysfunction of the blood brain barrier due to affected cerebral endothelial cells in capillaries.
Insights
In elderly patients, increased periventricular high intensity signal (PVHIS) on MRI correlates with higher albumin levels in cerebrospinal fluid, indicating impaired blood-brain barrier function and potential capillary endothelial cell damage.
Area of Science:
- Neurology
- Neuroimaging
- Biochemistry
Background:
- Periventricular high intensity signal (PVHIS) on MRI is a common finding in elderly individuals.
- The integrity of the blood-brain barrier (BBB) is crucial for maintaining brain health.
- Understanding the relationship between PVHIS and BBB permeability can provide insights into age-related neurological changes.
Purpose of the Study:
- To investigate the association between the degree of PVHIS on MRI and the permeability of brain blood vessels in elderly patients.
- To evaluate the utility of cerebrospinal fluid (CSF)/serum ratios of albumin and IgG as markers of BBB dysfunction in relation to PVHIS severity.
Main Methods:
- A cohort of 47 elderly patients (mean age 79.9) was categorized into mild, moderate, and severe PVHIS groups based on MRI findings.
- Cerebrospinal fluid (CSF) and serum levels of albumin and IgG were measured.
- The CSF/serum albumin ratio was used to assess brain blood vessel permeability.
Main Results:
- No significant differences were observed in serum albumin, CSF albumin, serum IgG, CSF IgG, or CSF/serum IgG ratio among the PVHIS groups.
- A statistically significant increase in the CSF/serum albumin ratio was found in the severe PVHIS group compared to the mild group (p < 0.05).
- The elevated CSF/serum albumin ratio in severe PVHIS suggests increased blood-brain barrier permeability.
Conclusions:
- Increased CSF/serum albumin ratio in elderly patients with severe PVHIS indicates compromised blood-brain barrier function.
- This finding suggests that severe PVHIS may be associated with dysfunction of cerebral endothelial cells in capillaries.
- The CSF/serum albumin ratio serves as a valuable indicator of BBB permeability in the context of PVHIS.