背景:主要目的是通过动态对比增强磁共振成像(DCE-MRI)评估神经衰弱病患者的局部血脑屏障(BBB)功能。次要目的是研究BBB功能与生化指标的相关性,临床,和认知参数。
方法:区域伦理委员会批准了这项前瞻性单中心病例对照研究。在诊断为神经性伯氏症后1个月内,55例患者行DCE-MRI检查。患者组由25名男性和30名女性组成,平均年龄58岁,对照组为8名男性和7名女性,平均年龄57岁。应用Patlak拟合的药代动力学隔室建模,提供毛细血管渗漏率和血液体积分数的估计。用自动生成的二元掩模对9个解剖脑区域进行采样。疲劳,临床症状和发现的严重程度,在急性期和治疗后6个月评估认知功能。
结果:与对照组相比,患者的丘脑泄漏率和血液体积分数较低(分别为p=0.027和p=0.018),尾状核(两者p=0.009),和海马(p=0.054和p=0.009)。泄漏率与疲劳无相关性,发现临床疾病严重程度或认知功能。
结论:在神经性伯氏症中,丘脑的渗漏率和血液体积分数,尾状核,与对照组相比,患者的海马区更低。DCE-MRI为神经性伯氏症的病理生理学提供了新的见解,并可作为感染和炎症中BBB功能和神经血管单元调节机制的生物标志物。
结论:DCE-MRI为神经性贝类病的病理生理学提供了新的见解,并且可以作为感染和炎症中血脑屏障功能和神经血管单元调节机制的生物标志物。
结论:•神经衰弱病是一种BBB功能紊乱的感染。•微血管渗漏可以用DCE-MRI进行研究。•前瞻性病例对照研究显示丘脑微血管特性改变,尾状,和海马体。
Main aim was assessment of regional blood-brain barrier (BBB) function by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with neuroborreliosis. Secondary aim was to study the correlation of BBB function with biochemical, clinical, and cognitive parameters.
Regional ethical committee approved this prospective single-center
case-control study. Within 1 month after diagnosis of neuroborreliosis, 55 patients underwent DCE-MRI. The patient group consisted of 25 males and 30 females with mean age 58 years, and the controls were 8 males and 7 females with mean age 57 years. Pharmacokinetic compartment modelling with Patlak fit was applied, providing estimates for capillary leakage rate and blood volume fraction. Nine anatomical brain regions were sampled with auto-generated binary masks. Fatigue, severity of clinical symptoms and findings, and cognitive function were assessed in the acute phase and 6 months after treatment.
Leakage rates and blood volume fractions were lower in patients compared to controls in the thalamus (p = 0.027 and p = 0.018, respectively), caudate nucleus (p = 0.009 for both), and hippocampus (p = 0.054 and p = 0.009). No correlation of leakage rates with fatigue, clinical disease severity or cognitive function was found.
In neuroborreliosis, leakage rate and blood volume fraction in the thalamus, caudate nucleus, and hippocampus were lower in patients compared to controls. DCE-MRI provided new insight to pathophysiology of neuroborreliosis, and can serve as biomarker of BBB function and regulatory mechanisms of the neurovascular unit in infection and inflammation.
DCE-MRI provided new insight to pathophysiology of neuroborreliosis, and can serve as biomarker of blood-brain barrier function and regulatory mechanisms of the neurovascular unit in infection and inflammation.
• Neuroborreliosis is an infection with disturbed BBB function. • Microvessel leakage can be studied with DCE-MRI. • Prospective
case-control study showed altered microvessel properties in thalamus, caudate, and hippocampus.