Format

Send to

Choose Destination
Alzheimers Dement. 2019 Apr 25. pii: S1552-5260(19)30045-7. doi: 10.1016/j.jalz.2019.01.013. [Epub ahead of print]

Quantifying blood-brain barrier leakage in small vessel disease: Review and consensus recommendations.

Author information

1
Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK; Dementia Research Institute, University of Edinburgh, Edinburgh, UK; Edinburgh Imaging, University of Edinburgh, Edinburgh, UK. Electronic address: m.j.thrippleton@ed.ac.uk.
2
Department of Radiology & Nuclear Medicine, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
3
Leeds Imaging Biomarkers group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK.
4
Department of Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
5
Department of Radiology, C. J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands.
6
Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University München & Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
7
Department of Neurology, Medical University of Graz, Graz, Austria.
8
Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Seaman Family MR Research Centre, Foothills Medical Centre, Calgary, Alberta, Canada.
9
Department of Neurology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
10
Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
11
Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK; Dementia Research Institute, University of Edinburgh, Edinburgh, UK; Edinburgh Imaging, University of Edinburgh, Edinburgh, UK.

Abstract

Cerebral small vessel disease (cSVD) comprises pathological processes of the small vessels in the brain that may manifest clinically as stroke, cognitive impairment, dementia, or gait disturbance. It is generally accepted that endothelial dysfunction, including blood-brain barrier (BBB) failure, is pivotal in the pathophysiology. Recent years have seen increasing use of imaging, primarily dynamic contrast-enhanced magnetic resonance imaging, to assess BBB leakage, but there is considerable variability in the approaches and findings reported in the literature. Although dynamic contrast-enhanced magnetic resonance imaging is well established, challenges emerge in cSVD because of the subtle nature of BBB impairment. The purpose of this work, authored by members of the HARNESS Initiative, is to provide an in-depth review and position statement on magnetic resonance imaging measurement of subtle BBB leakage in clinical research studies, with aspects requiring further research identified. We further aim to provide information and consensus recommendations for new investigators wishing to study BBB failure in cSVD and dementia.

KEYWORDS:

Blood-brain barrier; Cerebral small vessel disease; DCE-MRI; Dementia; Endothelial dysfunction; MRI; Permeability

PMID:
31031101
DOI:
10.1016/j.jalz.2019.01.013
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center