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MR shows blood-brain barrier leakage in Alzheimer's patients

by Lauren Dubinsky, Senior Reporter | June 01, 2016
Alzheimers/Neurology MRI
Courtesy of RSNA
Contrast-enhanced MR images have revealed that people with early Alzheimer's disease have leakages in their blood-brain barrier (BBB). A new study published online in the journal, Radiology, sugggests that increased BBB permeability might be a key mechanism in the early stages of the disease.

"BBB leakage means that the brain has lost its protective means, the homeostasis of brain cells is disrupted and the neuronal environment becomes ill-conditioned," Walter H. Backes, the study's author from the Maastricht University Medical Center in the Netherlands, told HCB News. "These mechanisms could eventually lead to neuronal dysfunction."

The BBB keeps the brain tissue healthy by circulating blood from the brain. It regulates the delivery of important nutrients, blocks the passage of neurotoxins and removes overabundant substances from the brain.
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The researchers used contrast-enhanced MR to compare 16 patients with early-stage Alzheimer's disease and 17 healthy control patients of the same age. They generated a map called a histogram to find out the amount of brain tissue that was leaking.

They found that the BBB leakage rate was significantly higher in the patient with Alzheimer's. The leakage was distributed throughout the cerebrum, which is the largest part of the brain.

The Alzheimer's patients also had a significantly higher percentage of leaking brain tissue in the gray matter including the cortex. The measurements from the histogram showed very slight BBB impairment in the brain's white matter.

"For Alzheimer's research this means that a novel tool has become available to study the contribution of BBB impairment in the brain to disease onset and progression in early stages or pre-stages of dementia," said Backes.

This research suggests that a compromised BBB is part of the early pathology of Alzheimer's and may be part of a series of events that eventually lead to cognitive decline and dementia.

The main advantage of detecting BBB leakage with contrast-enhanced MR is that it can detect microvascular changes in Alzheimer's even when no directly visible cerebrovascular abnormalities are seen.

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