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. 2019 Apr;13(2):389-395.
doi: 10.1007/s11682-018-9855-7.

Blood-brain Barrier Leakage in Relation to White Matter Hyperintensity Volume and Cognition in Small Vessel Disease and Normal Aging

Free PMC article

Blood-brain Barrier Leakage in Relation to White Matter Hyperintensity Volume and Cognition in Small Vessel Disease and Normal Aging

C Eleana Zhang et al. Brain Imaging Behav. .
Free PMC article


Blood-brain barrier (BBB) leakage increases with age and is involved in the pathophysiology of cerebral small vessel disease (cSVD). We examined the relationship between BBB leakage and white matter hyperintensity (WMH) volume and cognition, in cSVD patients and healthy controls. Seventy-seven patients with clinically overt cSVD and thirty-nine age matched healthy controls underwent dynamic contract-enhanced and structural brain MRI and neuropsychological assessment. We quantified BBB leakage volume and rate in normal appearing white matter (NAWM), WMH and cortical grey matter (CGM). Larger leakage volume and lower leakage rate in WMH were associated with larger WMH volume in cSVD but not in controls. Higher leakage rate in NAWM was associated with lower scores on executive function and information processing speed in healthy controls, whereas no relation with cognition was found in cSVD patients. Our findings support the involvement of BBB leakage in cSVD and aging. They also suggest that the mechanism of cognitive dysfunction in cSVD is more complex and multifactorial in cSVD compared with normal aging.

Keywords: Blood–brain barrier; Cerebral small vessel disease; Cognition; MRI; White matter hyperintensities.

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Medical Ethical Committee of the Maastricht University Medical Centre approved the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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