Danielle Kerkhofs1, Sau May Wong2, Eleana Zhang2, Julie Staals2, Jacobus F A Jansen2, Robert J van Oostenbrugge2, Walter H Backes2. 1. From the Departments of Neurology (D.K., E.Z., J.S., R.J.v.O.) and Radiology and Nuclear Medicine (S.M.W., J.F.A.J., W.H.B.), Maastricht University Medical Center, the Netherlands. danielle.kerkhofs@mumc.nl. 2. From the Departments of Neurology (D.K., E.Z., J.S., R.J.v.O.) and Radiology and Nuclear Medicine (S.M.W., J.F.A.J., W.H.B.), Maastricht University Medical Center, the Netherlands.
Abstract
OBJECTIVE: To investigate the 2-year change in parenchymal diffusivity, a quantitative marker of microstructural tissue condition, and the relationship with baseline blood-brain barrier (BBB) permeability, in tissue at risk, i.e., the perilesional zone surrounding white matter hyperintensities (WMH) in patients with cerebral small vessel disease (cSVD). METHODS: Patients with sporadic cSVD (lacunar stroke or mild vascular cognitive impairment) underwent 3T MRI at baseline, including dynamic contrast-enhanced MRI to quantify BBB permeability (i.e., leakage volume and rate) and intravoxel incoherent motion imaging (IVIM), a diffusion technique that provides parenchymal diffusivity D. After 2 years, IVIM was repeated. We assessed the relation between BBB leakage measures at baseline and change in parenchymal diffusivity (∆D) over 2 years in the perilesional zones (divided in 2-mm contours) surrounding WMH. RESULTS: We analyzed 43 patients (age 68 ± 12 years, 58% male). In the perilesional zones, ∆D increased 0.10% (confidence interval [CI] 0.07-0.013%) (p < 0.01) per 2 mm closer to the WMH. Furthermore, ∆D over 2 years showed a positive correlation with both baseline BBB leakage volume (r = 0.29 [CI 0.06-0.52], p = 0.013) and leakage rate (r = 0.24 [CI 0.02-0.47], p = 0.034). CONCLUSION: BBB leakage at baseline is related to the 2-year change in parenchymal diffusivity in the perilesional zone of WMH. These results support the hypothesis that BBB impairment might play an early role in subsequent microstructural white matter degeneration as part of the pathophysiology of cSVD.
OBJECTIVE: To investigate the 2-year change in parenchymal diffusivity, a quantitative marker of microstructural tissue condition, and the relationship with baseline blood-brain barrier (BBB) permeability, in tissue at risk, i.e., the perilesional zone surrounding white matter hyperintensities (WMH) in patients with cerebral small vessel disease (cSVD). METHODS:Patients with sporadic cSVD (lacunar stroke or mild vascular cognitive impairment) underwent 3T MRI at baseline, including dynamic contrast-enhanced MRI to quantify BBB permeability (i.e., leakage volume and rate) and intravoxel incoherent motion imaging (IVIM), a diffusion technique that provides parenchymal diffusivity D. After 2 years, IVIM was repeated. We assessed the relation between BBB leakage measures at baseline and change in parenchymal diffusivity (∆D) over 2 years in the perilesional zones (divided in 2-mm contours) surrounding WMH. RESULTS: We analyzed 43 patients (age 68 ± 12 years, 58% male). In the perilesional zones, ∆D increased 0.10% (confidence interval [CI] 0.07-0.013%) (p < 0.01) per 2 mm closer to the WMH. Furthermore, ∆D over 2 years showed a positive correlation with both baseline BBB leakage volume (r = 0.29 [CI 0.06-0.52], p = 0.013) and leakage rate (r = 0.24 [CI 0.02-0.47], p = 0.034). CONCLUSION: BBB leakage at baseline is related to the 2-year change in parenchymal diffusivity in the perilesional zone of WMH. These results support the hypothesis that BBB impairment might play an early role in subsequent microstructural white matter degeneration as part of the pathophysiology of cSVD.
Authors: Maaike P Cliteur; Lotte Sondag; Axel Wolsink; Ingeborg Rasing; F J A Meijer; Wilmar M T Jolink; Marieke J H Wermer; Catharina J M Klijn; Floris H B M Schreuder Journal: Front Neurol Date: 2022-07-29 Impact factor: 4.086
Authors: Maria Luz Alonso-Alonso; Ana Sampedro-Viana; Sabela Fernández-Rodicio; Marcos Bazarra-Barreiros; Alberto Ouro; Tomás Sobrino; Francisco Campos; José Castillo; Pablo Hervella; Ramón Iglesias-Rey Journal: Int J Mol Sci Date: 2022-08-22 Impact factor: 6.208