The relationship between blood-brain barrier permeability and enlarged perivascular spaces: a cross-sectional study
The relationship between blood-brain barrier permeability and enlarged perivascular spaces: a cross-sectional study
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DOI：
10.2147/cia.s204269
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发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
Hu, Wenli
中科院分区：
文献类型：
--
作者：
Li, Yue;Li, Man;Hu, Wenli
目的：血管周围间隙扩大（EPVS）已被广泛认为是脑小血管病（cSVD）的特征，但EPVS的发病机制仍不清楚。血脑屏障（BBB）完整性受损可能发挥作用，因为先前的研究表明，BBB破坏是其他cSVD标志物发病机制的关键因素。本研究的目的是探讨在半卵圆中心（CSO）和基底神经节（BG）与BBB permeability.Patients和方法的关联EPVS：连续参与者无症状的中风病史体检参加了这项横断面研究。使用经验证的5分量表对T2加权（T2-W）磁共振成像（MRI）上的CSO和BG-EPVS进行评级。应用动态对比增强（DCE）-MRI和Patlak药代动力学模型来量化CSO和BG中的BBB通透性。结果：共有109名参与者入选，年龄49-90岁（平均年龄69.85岁）。在CSO和BG中表现出高级别（>10）EPVS的参与者比例分别为50.5%和44.0%。经Logistic回归校正潜在混杂因素后，漏率和血浆体积分数与BG-EPVS的严重程度相关（OR：5.33; 95%CI：1.95-14.60和OR：0.93; 95%CI：0.87-0.99）。我们的研究表明BG-EPVS与受损的BBB完整性相关，支持BBB功能障碍可能参与BG-EPVS发病机制的假设。CSO和BG中的EPVS可能具有不同的病理生理学。
Purpose: Enlarged perivascular spaces (EPVS) have been widely considered as a feature of cerebral small vessel disease (cSVD) but the pathogenesis of EPVS remains unclear. Compromised blood-brain barrier (BBB) integrity may play a role since previous studies have shown that BBB breakdown is a critical contributor to the pathogenesis of other cSVD markers. This study aimed to investigate the association of EPVS in the centrum semiovale (CSO) and basal ganglia (BG) with BBB permeability.Patients and methods: Consecutive participants free of symptomatic stroke history presented for physical examination were enrolled in this cross-sectional study. CSO- and BG-EPVS on T2-weighted (T2-W) magnetic resonance imaging (MRI) were rated using a five-point validated scale. Dynamic contrast-enhanced (DCE)-MRI and Patlak pharmacokinetic model were applied to quantify BBB permeability in the CSO and BG.Results: A total of 109 participants aged 49-90 years (mean age of 69.85 years) were enrolled. The proportions of participants presenting high-grade (>10) EPVS in the CSO and BG were 50.5% and 44.0%, respectively. After adjustments for potential confounders by logistic regression, leakage rate and fractional blood plasma volume were correlated with the severity of BG-EPVS (OR: 5.33; 95%CI: 1.95-14.60 and OR: 0.93; 95%CI: 0.87-0.99).Conclusion: Our study demonstrates that BG-EPVS are associated with compromised BBB integrity, supporting the hypothesis that the BBB dysfunction may be involved in the pathogenesis of BG-EPVS. EPVS in the CSO and BG may have distinct pathophysiology.