Regional Differences in Blood-Brain Barrier Permeability in Cognitively Normal Elderly Subjects: A Dynamic Contrast-Enhanced MRI-Based Study.
Regional Differences in Blood-Brain Barrier Permeability in Cognitively Normal Elderly Subjects: A Dynamic Contrast-Enhanced MRI-Based Study.
复制标题
认知正常老年受试者血脑屏障渗透性的区域差异：基于动态对比增强的MRI研究。
DOI：
10.3348/kjr.2020.0816
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发表时间：
2021-07
影响因子：
4.8
通讯作者：
Moon WJ
中科院分区：
文献类型：
--
作者：
Ha IH;Lim C;Kim Y;Moon Y;Han SH;Moon WJ
本研究旨在确定认知正常的老年参与者的血脑屏障 (BBB) 通透性是否存在区域差异，并通过临床可行的 10 分钟动态对比增强 (DCE) MRI 方案确定影响 BBB 通透性的因素。这项 IRB 批准的前瞻性研究招募了 35 名认知正常的成年人（26 名女性；平均年龄为 64.5 ± 5.6 岁），他们接受了 DCE T1 加权成像。渗透率图 (Ktrans) 与掩模共同配准以计算平均区域值。采用配对t检验和Friedman检验来比较不同地区之间的Ktrans。使用 Pearson 相关性和 Spearman 等级检验评估 Ktrans 与年龄、性别、教育程度、认知评分、血管风险负担、影像学血管因素和内侧颞叶萎缩等因素之间的关系。通过自动分割评估，左右海马的平均渗透率分别为 0.529 ± 0.472 和 0.585 ± 0.515 (Ktrans，× 10−3 min−1)。对于深部灰质，丘脑的 Ktrans 显着大于壳核和海马的 Ktrans（p = 0.007，p = 0.041）。关于白质，枕叶白质的 Ktrans 值显着大于额叶、扣带回和颞叶白质的 Ktrans 值 (p < 0.0001，p = 0.0007，p = 0.0002)。研究组中各脑区 Ktrans 的变化与年龄、认知评分、血管风险负担、影像学血管危险因素或内侧颞叶萎缩无关。我们的研究使用临床上可接受的 10 分钟 DCE 成像方案，证明了认知正常老年人的 BBB 通透性 (Ktrans) 存在区域差异。区域差异表明，认知正常的老年人大脑中血脑屏障的完整性存在差异。我们建议在评估神经退行性疾病患者的 BBB 通透性时考虑 Ktrans 值的区域差异。
This study aimed to determine whether there are regional differences in the blood-brain barrier (BBB) permeability of cognitively normal elderly participants and to identify factors influencing BBB permeability with a clinically feasible, 10-minute dynamic contrast-enhanced (DCE) MRI protocol. This IRB-approved prospective study recruited 35 cognitively normal adults (26 women; mean age, 64.5 ± 5.6 years) who underwent DCE T1-weighted imaging. Permeability maps (Ktrans) were coregistered with masks to calculate the mean regional values. The paired t test and Friedman test were used to compare Ktrans between different regions. The relationships between Ktrans and the factors of age, sex, education, cognition score, vascular risk burden, vascular factors on imaging, and medial temporal lobar atrophy were assessed using Pearson correlation and the Spearman rank test. The mean permeability rates of the right and left hippocampi, as assessed with automatic segmentation, were 0.529 ± 0.472 and 0.585 ± 0.515 (Ktrans, × 10−3 min−1), respectively. Concerning the deep gray matter, the Ktrans of the thalamus was significantly greater than those of the putamen and hippocampus (p = 0.007, p = 0.041). Regarding the white matter, the Ktrans value of the occipital white matter was significantly greater than those of the frontal, cingulate, and temporal white matter (p < 0.0001, p = 0.0007, p = 0.0002). The variations in Ktrans across brain regions were not related to age, cognitive score, vascular risk burden, vascular risk factors on imaging, or medial temporal lobar atrophy in the study group. Our study demonstrated regional differences in BBB permeability (Ktrans) in cognitively normal elderly adults using a clinically acceptable 10-minutes DCE imaging protocol. The regional differences suggest that the integrity of the BBB varies across the brains of cognitively normal elderly adults. We recommend considering regional differences in Ktrans values when evaluating BBB permeability in patients with neurodegenerative diseases.
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