Vascular-water-exchange MRI (VEXI) enables the detection of subtle AXR alterations in Alzheimer's disease without MRI contrast agent, which may relate to BBB integrity

Yifan Zhang; Yue Wang; Zhaoqing Li; Zejun Wang; Juange Cheng; Xiaoyan Bai; Yi-Cheng Hsu; Yi Sun; Shiping Li; Jiong Shi; Binbin Sui; Ruiliang Bai

doi:10.1016/j.neuroimage.2023.119951

Vascular-water-exchange MRI (VEXI) enables the detection of subtle AXR alterations in Alzheimer's disease without MRI contrast agent, which may relate to BBB integrity

Neuroimage. 2023 Apr 15:270:119951. doi: 10.1016/j.neuroimage.2023.119951. Epub 2023 Feb 18.

Authors

Yifan Zhang¹, Yue Wang², Zhaoqing Li¹, Zejun Wang¹, Juange Cheng³, Xiaoyan Bai⁴, Yi-Cheng Hsu⁵, Yi Sun⁵, Shiping Li⁶, Jiong Shi⁷, Binbin Sui⁸, Ruiliang Bai⁹

Affiliations

¹ Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Shaw Hospital AND Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.
² National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Shaw Hospital AND Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China.
⁴ Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China; Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China.
⁵ MR Collaboration, Siemens Healthcare, Shanghai, China.
⁶ National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
⁷ National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. Electronic address: jiongshi@ncrcnd.org.cn.
⁸ National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: reneesui@163.com.
⁹ Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Shaw Hospital AND Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China; MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University. Electronic address: ruiliangbai@zju.edu.cn.

PMID: 36805091
DOI: 10.1016/j.neuroimage.2023.119951

Abstract

Blood-brain barrier (BBB) impairment is an important pathophysiological process in Alzheimer's disease (AD) and a potential biomarker for early diagnosis of AD. However, most current neuroimaging methods assessing BBB function need the injection of exogenous contrast agents (or tracers), which limits the application of these methods in a large population. In this study, we aim to explore the feasibility of vascular water exchange MRI (VEXI), a diffusion-MRI-based method proposed to assess the BBB permeability to water molecules without using a contrast agent, in the detection of the BBB breakdown in AD. We tested VEXI on a 3T MRI scanner on three groups: AD patients (AD group), mild cognitive impairment (MCI) patients due to AD (MCI group), and the age-matched normal cognition subjects (NC group). Interestingly, we find that the apparent water exchange across the BBB (AXR_BBB) measured by VEXI shows higher values in MCI compared with NC, and this higher AXR_BBB happens specifically in the hippocampus. This increase in AXR_BBB value gets larger and extends to more brain regions (medial orbital frontal cortex and thalamus) from MCI group to the AD group. Furthermore, we find that the AXR_BBB values of these three regions is correlated significantly with the impairment of respective cognitive domains independent of age, sex and education. These results suggest VEXI is a promising method to assess the BBB breakdown in AD.

Keywords: Alzheimer's disease; Blood-brain barrier; contrast-agent-free; permeability; water exchange.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alzheimer Disease*
Blood-Brain Barrier / diagnostic imaging
Cognitive Dysfunction* / diagnostic imaging
Contrast Media
Humans
Magnetic Resonance Imaging / methods
Water

Substances

Contrast Media
Water