Evolution of blood-brain-barrier permeability after acute ischemic stroke

PLoS One. 2017 Feb 16;12(2):e0171558. doi: 10.1371/journal.pone.0171558. eCollection 2017.


The dynamics of BBB permeability after AIS in humans are not well understood. In the present study we measured the evolution of BBB permeability after AIS in humans using MRI. Patients presenting to our institution with a diagnosis of AIS underwent a single dynamic contrast-enhanced MRI (DCE-MRI) sequence to measure BBB permeability during their initial workup. Forty-two patients were included in the final analysis. The patient sample underwent DCE-MRI at a mean time of 23.8hrs after the onset of AIS symptoms (range: 1.3-90.7hrs). At all time-points the BBB permeability within the infarct region of the brain as defined on DWI/ADC was higher compared to the homologous region of the contralateral hemisphere (p<0.005). BBB permeability, expressed as a ratio of infarct permeability to contralateral permeability, was greatest at 6-48hrs after the onset of AIS. Although the data was not acquired longitudinally, these findings suggest that the permeability of the BBB is continually elevated following AIS, which contradicts previous assertions that BBB permeability after AIS follows a biphasic course. Knowledge of BBB dynamics following AIS may provide insight into future treatments for AIS, especially BBB stabilizing agents.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Evolution*
  • Blood-Brain Barrier / physiopathology*
  • Brain Ischemia / physiopathology*
  • Cell Membrane Permeability*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Stroke / physiopathology*

Grant support

This study was funded by The Heart and Stroke Foundation of Canada (NA 7035) and the Canada Research Chairs Program (950-220786). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.