Abstract
BackgroundBlood-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.MethodsThis 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.ResultsMultivariable 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.ConclusionIncreased 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.
Highlights
Blood-brain barrier (BBB) breakdown, as an early biomarker for vascular mild cognitive impairment, has only been validated by a few studies
Increased BBB leakage in white matter was found in patients with Vascular cognitive impairment (VCI) using Dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) [13], there were scarce studies focusing on vascular mild cognitive impairment (vMCI) patients, and understanding of the relationship between cognitive function and BBB leakage was deficient
Participants were recruited into the vMCI group if they met the following criteria: (1) complaints of cognitive function, activities of daily living may be normal or mildly impaired, (2) objective cognitive impairment in at least one cognitive domain, (3) MRI findings suggest that cognitive impairment is associated with vascular diseases [14, 15]
Summary
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. Neuropathological, cerebrospinal fluid (CSF) biomarker, and non-quantitative neuroimaging studies have revealed the increase of BBB permeability in cognitively declining patients [8,9,10]. Increased BBB leakage in white matter was found in patients with VCI using DCE-MRI [13], there were scarce studies focusing on vMCI patients, and understanding of the relationship between cognitive function and BBB leakage was deficient. The matter whether the cognitive function was independently associated with BBB leakage change was tentatively examined
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