Relationships between blood-brain barrier permeability and WMH severity and cognitive function in elderly patients with ischemic white matter hyperintensity
XU Yanjie1, CHEN Weiqi2, YANG Zhiqiang1, WANG Rui1, GUO Jiangtao1, WANG Yilong2
1. Department of Neurology, Beijing Longfu Hospital, Beijing 100000, China, 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
Abstract：Objective To explore the relationships between blood-brain barrier permeability and WMH severity and cognitive function in elderly patients with ischemic white matter hyperintensity (WMH). Methods One hundred and twenty elderly patients with ischemic WMH and 120 elderly healthy people were selected between January 2018 and January 2021, who were randomly divided into the observation group and control group. According to results of magnetic resonance imaging (MRI), the indexes of blood-brain barrier permeability were compared between the two groups. According to Fazekas scores, elderly patients with ischemic WMH were divided into three groups:mild (Fazekas score of 0-2), moderate (Fazekas score of 3-4) and severe (Fazekas score of 5-6). The cognitive function of these patients was evaluated. The blood-brain barrier permeability indexes and cognitive function indexes of patients with different levels of severity of WMH were compared. Results The osmotic transport rate and the area under the osmotic curve in normal areas of the white matter of the brain were significantly higher in the observation group than in the control group (P<0.05). The difference in the osmotic transport rate and areas under osmotic curves were statistically significant between mild, moderate and severe WMH groups (P<0.05), which were the highest in the severe WMH group. MMSE scores and MoCA scores were significantly different between the three groups (P<0.05), and they were the highest in the mild WMH group, followed by the moderate WMH group and severe WMH group. According to correlation analysis, the osmotic transport rate and the area under the osmotic curve of elderly patients with ischemic WMH were positively correlated with the severity of WMH (P<0.05), but were negatively correlated with MMSE scores and MoCA scores (P<0.05). Conclusions The permeability of blood-brain barriers increases with the severity of WMH. The stronger the permeability of blood-brain barriers is, the more serious the cognitive impairment becomes.
许研杰, 陈玮琪, 杨志强, 王锐, 郭江涛, 王伊龙. 老年人血脑屏障通透性、缺血性脑白质高信号严重程度与认知功能的关系[J]. 武警医学, 2021, 32(10): 864-867.
XU Yanjie, CHEN Weiqi, YANG Zhiqiang, WANG Rui, GUO Jiangtao, WANG Yilong. Relationships between blood-brain barrier permeability and WMH severity and cognitive function in elderly patients with ischemic white matter hyperintensity. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(10): 864-867.
Scott J A, Braskie M N, Tosun D,et al. Cerebral amyloid is associated with greater white-matter hyperintensity accrual in cognitively normal older adults[J]. Neurobiol Aging, 2016, 48:48-52.
[2]
Ogama N, Yoshida M, Nakai T,et al. Frontal white matter hyperintensity predicts lower urinary tract dysfunction in older adults with amnestic mild cognitive impairment and Alzheimer's disease[J]. Geriatr Gerontol Int, 2016, 16(2):167-174.
[3]
Havenon A, Wong K H, Elkhetali A,et al. Carotid artery stiffness accurately predicts white matter hyperintensity volume 20 years later: a secondary analysis of the atherosclerosis risk in the community study[J]. AJNR Am J Neuroradiol, 2019, 40(8):1369-1373.
Bahrani A A, Powell D K, Yu G,et al. White matter hyperintensity associations with cerebral blood flow in elderly subjects stratified by cerebrovascular risk[J]. J Stroke Cerebrovasc Dis, 2017, 26(4):779-786.
[7]
Dalen J W, Mutsaerts H, Nederveen A J,et al. White matter hyperintensity volume and cerebral perfusion in older individuals with hypertension using arterial spin-labeling[J]. AJNR Am J Neuroradiol, 2016, 37(10):1824-1830.
[8]
Aljondi R, Szoeke C, Steward C,et al. The effect of midlife cardiovascular risk factors on white matter hyperintensity volume and cognition two decades later in normal ageing women[J]. Brain Imaging Behav,2020,14(1):51-61.
2021, Vol. 32 
