PMID- 30867275
OWN - NLM
STAT- MEDLINE
DCOM- 20191216
LR  - 20191217
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Linking)
VI  - 92
IP  - 15
DP  - 2019 Apr 9
TI  - Blood-brain barrier impairment and hypoperfusion are linked in cerebral small 
      vessel disease.
PG  - e1669-e1677
LID - 10.1212/WNL.0000000000007263 [doi]
AB  - OBJECTIVE: To investigate the link between blood-brain-barrier (BBB) permeability 
      and cerebral blood flow (CBF) and the relation with white matter hyperintensities 
      (WMH) in cerebral small vessel disease (cSVD). METHODS: Twenty-seven patients 
      with cSVD received dynamic susceptibility contrast and dynamic contrast-enhanced 
      MRI to determine CBF and BBB permeability (expressed as leakage rate and volume), 
      respectively. Structural MRI were segmented into normal-appearing white matter 
      (NAWM) and WMH, for which a perilesional zone was defined. In these regions, we 
      investigated the BBB permeability, CBF, and their relation using Pearson 
      correlation r. RESULTS: We found a decrease in CBF of 2.2 mL/min/100 g (p < 0.01) 
      and an increase in leakage volume of 0.7% (p < 0.01) per mm closer to the WMH in 
      the perilesional zones. Lower CBF values correlated with higher leakage measures 
      in the NAWM and WMH (-0.53 < r < -0.40, p < 0.05). This relation was also 
      observed in the perilesional zones, which became stronger in the proximity of WMH 
      (p = 0.03). CONCLUSION: BBB impairment and hypoperfusion appear in the WMH and 
      NAWM, which increase in the proximity of the WMH, and are linked. Both BBB and 
      CBF are regulated in the neurovascular unit (NVU) and the observed link might be 
      due to the physiologic regulation mechanism of the NVU. This link may suggest an 
      early overall deterioration of this unit.
CI  - (c) 2019 American Academy of Neurology.
FAU - Wong, Sau May
AU  - Wong SM
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands.
FAU - Jansen, Jacobus F A
AU  - Jansen JFA
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands.
FAU - Zhang, C Eleana
AU  - Zhang CE
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands.
FAU - Hoff, Erik I
AU  - Hoff EI
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands.
FAU - Staals, Julie
AU  - Staals J
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands.
FAU - van Oostenbrugge, Robert J
AU  - van Oostenbrugge RJ
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands.
FAU - Backes, Walter H
AU  - Backes WH
AD  - From the Departments of Radiology and Nuclear Medicine (S.M.W., J.F.A.J., 
      W.H.B.), Neurology (C.E.Z., J.S., R.J.v.O.), School for Mental Health and 
      Neuroscience (MHeNs) (S.M.W., J.F.A.J., C.E.Z., R.J.v.O., W.H.B.), and 
      Cardiovascular Research Institute Maastricht (CARIM) (C.E.Z., J.S., R.J.v.O.), 
      Maastricht University Medical Centre; and the Department of Neurology (E.I.H.), 
      Zuyderland Medical Centre, Heerlen, the Netherlands. w.backes@mumc.nl.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190313
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - Neurology. 2019 Apr 9;92(15):687-688. PMID: 30867267
MH  - Aged
MH  - Blood-Brain Barrier/diagnostic imaging/*pathology
MH  - Cerebral Small Vessel Diseases/diagnostic imaging/*pathology
MH  - Cerebrospinal Fluid Leak/pathology
MH  - Cerebrovascular Circulation
MH  - Cerebrovascular Disorders/diagnostic imaging/*pathology
MH  - Contrast Media
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - White Matter/diagnostic imaging
EDAT- 2019/03/15 06:00
MHDA- 2019/12/18 06:00
CRDT- 2019/03/15 06:00
PHST- 2018/03/21 00:00 [received]
PHST- 2018/11/28 00:00 [accepted]
PHST- 2019/03/15 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2019/03/15 06:00 [entrez]
AID - WNL.0000000000007263 [pii]
AID - 10.1212/WNL.0000000000007263 [doi]
PST - ppublish
SO  - Neurology. 2019 Apr 9;92(15):e1669-e1677. doi: 10.1212/WNL.0000000000007263. Epub 
      2019 Mar 13.