期刊
ALZHEIMERS & DEMENTIA
卷 13, 期 6, 页码 634-643出版社
WILEY
DOI: 10.1016/j.jalz.2016.09.006
关键词
Blood brain barrier; Small vessel disease; Stroke; White matter hyperintensities; Dementia
资金
- Wellcome Trust [WT088134/Z/09/A]
- Row Fogo Charitable Trust
- Scottish Funding Council Scottish Imaging Network A Platform for Scientific Excellence collaboration
- Age-UK Disconnected Mind Study
- NHS Lothian R1D Department
- Brain Research Imaging Centre Edinburgh
- Wellcome Trust [WT088134/Z/09/A]
- Row Fogo Charitable Trust
- Scottish Funding Council Scottish Imaging Network A Platform for Scientific Excellence collaboration
- Age-UK Disconnected Mind Study
- NHS Lothian R1D Department
- Brain Research Imaging Centre Edinburgh
- Medical Research Council [MR/K026992/1] Funding Source: researchfish
Introduction: Small vessel disease (SVD) is a common contributor to dementia. Subtle blood-brain barrier (BBB) leakage may be important in SVD-induced brain damage. Methods: We assessed imaging, clinical variables, and cognition in patients with mild (i.e., nondisabling) ischemic lacunar or cortical stroke. We analyzed BBB leakage, interstitial fluid, and white matter integrity using multimodal tissue-specific spatial analysis around white matter hyperintensities (WMH). We assessed predictors of 1 year cognition, recurrent stroke, and dependency. Results: In 201 patients, median age 67 (range 34-97), BBB leakage, and interstitial fluid were higher in WMH than normal-appearing white matter; leakage in normal-appearing white matter increased with proximity to WMH (P < .0001), with WMH severity (P = .033), age (P = .03), and hypertension (P = .0001). BBB leakage in WMH predicted declining cognition at 1 year. Discussion: BBB leakage increases in normal-appearing white matter withWMHand predicts worsening cognition. Interventions to reduce BBB leakage may prevent SVD-associated dementia. (C) 2016 The Authors. Published by Elsevier Inc.
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