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Cerebral Microbleeds Are Associated with Widespread Blood-Brain Barrier Leakage
1Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 9119yueyue@sina.com.
Introduction:
The pathogenesis of cerebral microbleeds (CMBs) is incompletely understood, but blood-brain barrier (BBB) leakage may play a key role. This study aimed to investigate the relationship between compromised BBB integrity and CMBs as well as cognitive function.
Methods:
Ninety-seven participants were enrolled in this cross-sectional study, involving 24 CMB patients. Dynamic contrast-enhanced-magnetic resonance imaging was used to measure BBB permeability, and cognitive function was assessed by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).
Results:
Compared with participants without CMBs, CMB patients had higher volume transfer constant (Ktrans, all p < 0.01) and area under the concentration curve (AUC, all p < 0.05) in normal-appearing white matter (NAWM), white matter hyperintensities (WMH), cortical gray matter (CGM), and deep gray matter (DGM). Multivariable linear regression analyses revealed that CMB patients had significantly higher Ktrans in NAWM and AUC in NAWM, WMH, and CGM after adjustment for age, sex, vascular risk factors, and cognitive scores. MMSE and MoCA scores decreased with increasing Ktrans in WMH and DGM as well as AUC in WMH after adjustment for age, sex, CMB group, and education length.
Conclusion:
This study demonstrated that widespread BBB leakage was prevalent in CMB patients, suggesting that compromised BBB integrity may play a key role in the pathogenesis of CMBs and could lead to cognitive impairment.
Insights
This study found that blood-brain barrier (BBB) leakage is common in individuals with cerebral microbleeds (CMBs). This BBB dysfunction is linked to both the presence of CMBs and a decline in cognitive function.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Cerebral microbleeds (CMBs) pathogenesis is not fully understood.
- Blood-brain barrier (BBB) leakage is a potential key factor in CMB development.
- Investigating the link between BBB integrity, CMBs, and cognitive decline is crucial.
Purpose of the Study:
- To explore the association between compromised BBB integrity and the presence of CMBs.
- To examine the relationship between BBB permeability and cognitive function in individuals with and without CMBs.
Main Methods:
- A cross-sectional study included 97 participants, with 24 diagnosed with CMBs.
- Dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) quantified BBB permeability.
- Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).
Main Results:
- CMB patients exhibited significantly higher BBB permeability (Ktrans and AUC) in various brain regions, including normal-appearing white matter (NAWM), white matter hyperintensities (WMH), cortical gray matter (CGM), and deep gray matter (DGM).
- Higher BBB permeability (Ktrans in NAWM, AUC in NAWM, WMH, and CGM) persisted in CMB patients after adjusting for confounding factors.
- Cognitive scores (MMSE and MoCA) were inversely correlated with BBB permeability (Ktrans in WMH and DGM, AUC in WMH), indicating cognitive decline with increased leakage.
Conclusions:
- Widespread BBB leakage is a common finding in individuals with CMBs.
- Compromised BBB integrity appears to be a significant factor in the pathogenesis of CMBs.
- BBB dysfunction is associated with cognitive impairment in patients with CMBs.
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