Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Regional Differences in Blood-Brain Barrier Permeability in Cognitively Normal Elderly Subjects: A Dynamic Contrast-Enhanced MRI-Based Study

  • Il Heon Ha (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Changmok Lim (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Yeahoon Kim (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Yeonsil Moon (Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Seol-Heui Han (Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Won-Jin Moon (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine)
  • Received : 2020.03.16
  • Accepted : 2020.09.27
  • Published : 2021.07.01
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Abstract

Objective: 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. Materials and Methods: 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. Results: 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, x 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. Conclusion: 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.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant, funded by the Korean government (MSIP) (no. 2017R1A2B4010634) and no. 2020R1A2C1102896 and a grant from the Korea Health Technology R&D Project through the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (no. HI18C1038).

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