AUTHOR=Al-Bachari Sarah , Naish Josephine H. , Parker Geoff J. M. , Emsley Hedley C. A. , Parkes Laura M. 

TITLE=Blood–Brain Barrier Leakage Is Increased in Parkinson’s Disease

JOURNAL=Frontiers in Physiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.593026

DOI=10.3389/fphys.2020.593026

ISSN=1664-042X

ABSTRACT=<sec><title>Background</title><p>Blood–brain barrier (BBB) disruption has been noted in animal models of Parkinson’s disease (PD) and forms the basis of the vascular hypothesis of neurodegeneration, yet clinical studies are lacking.</p></sec><sec><title>Objective</title><p>To determine alterations in BBB integrity in PD, with comparison to cerebrovascular disease.</p></sec><sec><title>Methods</title><p>Dynamic contrast enhanced magnetic resonance images were collected from 49 PD patients, 15 control subjects with cerebrovascular disease [control positive (CP)] and 31 healthy control subjects [control negative (CN)], with all groups matched for age. Quantitative maps of the contrast agent transfer coefficient across the BBB (<italic>K</italic><sup>trans</sup>) and plasma volume (v<sub><italic>p</italic></sub>) were produced using Patlak analysis. Differences in <italic>K</italic><sup>trans</sup> and v<sub><italic>p</italic></sub> were assessed with voxel-based analysis as well as in regions associated with PD pathophysiology. In addition, the volume of white matter lesions (WMLs) was obtained from T<sub>2</sub>-weighted fluid attenuation inversion recovery (FLAIR) images.</p></sec><sec><title>Results</title><p>Higher <italic>K</italic><sup>trans</sup>, reflecting higher BBB leakage, was found in the PD group than in the CN group using voxel-based analysis; differences were most prominent in the posterior white matter regions. Region of interest analysis confirmed <italic>K</italic><sup>trans</sup> to be significantly higher in PD than in CN, predominantly driven by differences in the substantia nigra, normal-appearing white matter, WML and the posterior cortex. WML volume was significantly higher in PD compared to CN. <italic>K</italic><sup>trans</sup> values and WML volume were similar in PD and CP, suggesting a similar burden of cerebrovascular disease despite lower cardiovascular risk factors.</p></sec><sec><title>Conclusion</title><p>These results show BBB disruption in PD.</p></sec>