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Updated: Feb 7, 2026
Evaluation of Blood-Brain Barrier Breakdown in a Mouse Model of Mild Traumatic Brain Injury
Published on: October 18, 2024
Quantitative dynamic contrast-enhanced MR imaging shows widespread blood-brain barrier disruption in mild traumatic
Roh-Eul Yoo1, Seung Hong Choi2,3,4, Byung-Mo Oh5
1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
Objectives:
To explore the utility of dynamic contrast-enhanced (DCE) MR imaging for quantitative analysis of blood-brain barrier disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS).
Methods:
Forty-four consecutive patients with PCS after mTBI and 32 controls were included in this retrospective study. Ktrans and ve from DCE MR imaging were analyzed at contrast-enhancing lesions, T2 hyperintense white matter (WM) lesions, normal-appearing white matter (NAWM), and predilection sites for diffuse axonal injury (LocationDAI). The Mann-Whitney U-test was performed to compare the parameters between mTBI patients and controls and the parameters were correlated with neuropsychological tests using Mann-Whitney U-test and Spearman rank correlation.
Results:
The median ve of the T2 hyperintense WM lesions in mTBI patients (n=21) was higher than that of NAWM in controls (p=.027). Both median Ktrans and ve at NAWM were also significantly higher in mTBI patients than in controls (p=.023 and p=.029, respectively). In addition, mTBI patients had higher Ktrans and ve at LocationDAI than controls (p=.008 and p=.015, respectively). VLT (delayed recall) scores were significantly correlated with ve values at T2 hyperintense WM lesions (p=-0.767, p=.044). The median ve at LocationDAI was significantly higher in patients with atypical performance in the digit span test (forward) than in those with average or good performance (p=.043).
Conclusions:
mTBI patients with PCS had higher Ktrans and ve values than controls not only at T2 hyperintense WM lesions but also at NAWM and LocationDAI. BBB disruption may be implicated in development of PCS in mTBI patients.
Key Points:
• mTBI patients with PCS had higher permeability than controls at T2 hyperintense WM lesions on DCE MR imaging. • mTBI patients with PCS had higher permeability than controls also at NAWM and predilection sites for DAI. • BBB disruption may be implicated in the development of PCS in mTBI patients.
Insights
Mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) show increased blood-brain barrier permeability in white matter lesions and normal-appearing white matter. This suggests blood-brain barrier disruption contributes to PCS development after mTBI.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Mild traumatic brain injury (mTBI) can lead to persistent post-concussion syndrome (PCS).
- The role of blood-brain barrier (BBB) disruption in PCS development is not fully understood.
- Dynamic contrast-enhanced (DCE) MR imaging offers quantitative analysis of BBB integrity.
Purpose of the Study:
- To assess BBB disruption in mTBI patients with PCS using DCE MR imaging.
- To quantitatively analyze permeability parameters (Ktrans and ve) in various brain regions.
- To correlate imaging findings with neurocognitive test performance.
Main Methods:
- Retrospective analysis of 44 mTBI patients with PCS and 32 controls.
- DCE MR imaging to measure Ktrans and ve in T2 hyperintense WM lesions, normal-appearing white matter (NAWM), and diffuse axonal injury (DAI) predilection sites.
- Comparison between groups using Mann-Whitney U-test and correlation with neuropsychological tests via Spearman rank correlation.
Main Results:
- mTBI patients with PCS exhibited significantly higher ve in T2 hyperintense WM lesions compared to controls.
- Elevated Ktrans and ve were observed in NAWM and DAI predilection sites in mTBI patients.
- Higher ve at DAI sites correlated with poorer performance in digit span tests.
Conclusions:
- mTBI patients with PCS demonstrate increased BBB permeability beyond focal lesions, affecting NAWM and DAI sites.
- DCE MR imaging reveals widespread BBB disruption in mTBI-related PCS.
- BBB disruption is a potential mechanism underlying the development of PCS after mTBI.
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