TY - JOUR
T1 - Abnormal blood-brain barrier water exchange in chronic multiple sclerosis lesions
T2 - A preliminary study
AU - Wengler, Kenneth
AU - Ha, Jason
AU - Syritsyna, Olga
AU - Bangiyev, Lev
AU - Coyle, Patricia K.
AU - Duong, Tim Q.
AU - Schweitzer, Mark E.
AU - He, Xiang
N1 - Funding Information:
The authors thank Stony Brook University Departments of Radiology, Psychology, and Psychiatry for providing pilot grant funding for this study. Special thanks are given to Dr. Danny JJ Wang from University of Southern California for discussion and inspiration. Special thanks are given to Dr. Christine DeLorenzo for interest and discussion. This work was partly supported by a RSNA Research Scholar grant.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/7
Y1 - 2020/7
N2 - Relapsing-remitting multiple sclerosis (RRMS) is associated with persistent blood-brain barrier (BBB) dysfunction. The impact of this persistent dysfunction in both active and chronic MS lesions has yet to be investigated due to technological challenges associated with invasive assessment of BBB water transportation (e.g. 15O-PET). The purpose of this study was to test if persistent BBB dysfunction in RRMS manifests as lower BBB water exchange in chronic lesions using a recently developed noninvasive MRI paradigm. Patients with relapsing-remitting MS and healthy subjects were recruited for this prospective study. The novel Intrinsic Diffusivity Encoding of Arterial Labeled Spins (IDEALS) MRI method was used to map BBB water extraction fraction (Ew) and water permeability surface area product (PSw), as well as cerebral blood flow (CBF). Regional differences in BBB water exchange were evaluated between MS patients (normal appearing white matter [NAWM] and normal appearing gray matter [NAGM]) and healthy subjects (white matter [WM] and gray matter [GM]) and within MS subjects in non gadolinium-based contrast-agent (GBCA) enhancing chronic lesions, perilesional areas, and NAWM. Significantly lower PSw and Ew were observed in NAWM compared to WM (ΔPSw: −11.9 mL/100 g/min, p < .05; ΔEw: −4.3%, p < .01). Significantly lower Ew was observed in NAGM compared to GM (ΔEw: −12.1%, p < .01). Significantly lower PSw and CBF were observed in non-GBCA contrast enhancing lesions compared to NAWM (ΔPSw = −11.5 mL/100 g/min, p < .05; ΔCBF = −8.1 mL/100 g/min, p < .05). Ew was significantly higher in non-GBCA enhancing chronic MS lesions compared to NAWM (ΔEw = 1.6%, p < .05). The lower BBB water exchange in chronic MS lesions is consistent with previously reported observations and may demonstrate metabolic changes associated with MS.
AB - Relapsing-remitting multiple sclerosis (RRMS) is associated with persistent blood-brain barrier (BBB) dysfunction. The impact of this persistent dysfunction in both active and chronic MS lesions has yet to be investigated due to technological challenges associated with invasive assessment of BBB water transportation (e.g. 15O-PET). The purpose of this study was to test if persistent BBB dysfunction in RRMS manifests as lower BBB water exchange in chronic lesions using a recently developed noninvasive MRI paradigm. Patients with relapsing-remitting MS and healthy subjects were recruited for this prospective study. The novel Intrinsic Diffusivity Encoding of Arterial Labeled Spins (IDEALS) MRI method was used to map BBB water extraction fraction (Ew) and water permeability surface area product (PSw), as well as cerebral blood flow (CBF). Regional differences in BBB water exchange were evaluated between MS patients (normal appearing white matter [NAWM] and normal appearing gray matter [NAGM]) and healthy subjects (white matter [WM] and gray matter [GM]) and within MS subjects in non gadolinium-based contrast-agent (GBCA) enhancing chronic lesions, perilesional areas, and NAWM. Significantly lower PSw and Ew were observed in NAWM compared to WM (ΔPSw: −11.9 mL/100 g/min, p < .05; ΔEw: −4.3%, p < .01). Significantly lower Ew was observed in NAGM compared to GM (ΔEw: −12.1%, p < .01). Significantly lower PSw and CBF were observed in non-GBCA contrast enhancing lesions compared to NAWM (ΔPSw = −11.5 mL/100 g/min, p < .05; ΔCBF = −8.1 mL/100 g/min, p < .05). Ew was significantly higher in non-GBCA enhancing chronic MS lesions compared to NAWM (ΔEw = 1.6%, p < .05). The lower BBB water exchange in chronic MS lesions is consistent with previously reported observations and may demonstrate metabolic changes associated with MS.
KW - Blood-brain barrier (BBB)
KW - IDEALS
KW - Relapsing-remitting multiple sclerosis (RRMS)
KW - Water extraction fraction
KW - Water permeability surface area product
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U2 - 10.1016/j.mri.2020.04.017
DO - 10.1016/j.mri.2020.04.017
M3 - Article
C2 - 32353529
AN - SCOPUS:85084241788
SN - 0730-725X
VL - 70
SP - 126
EP - 133
JO - Magnetic Resonance Imaging
JF - Magnetic Resonance Imaging
ER -