Increase in blood–brain barrier leakage in healthy, older adults

GeroScience - Tập 42 Số 4 - Trang 1183-1193 - 2020
Inge C.M. Verheggen1, Joost J.A. de Jong2, Martin P.J. van Boxtel1, E. H. B. M. Gronenschild1, Walter M. Palm3, Alida A. Postma2, Jacobus F.A. Jansen2, Frans R.J. Verhey2, Walter H. Backes2
1Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
2School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
3Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands

Tóm tắt

AbstractBlood–brain barrier (BBB) breakdown can disrupt nutrient supply and waste removal, which affects neuronal functioning. Currently, dynamic contrast-enhanced (DCE) MRI is the preferred in-vivo method to quantify BBB leakage. Dedicated DCE MRI studies in normal aging individuals are lacking, which could hamper value estimation and interpretation of leakage rate in pathological conditions. Therefore, we applied DCE MRI to investigate the association between BBB disruption and age in a healthy sample. Fifty-seven cognitively and neurologically healthy, middle-aged to older participants (mean age: 66 years, range: 47–91 years) underwent MRI, including DCE MRI with intravenous injection of a gadolinium-based contrast agent. Pharmacokinetic modeling was applied to contrast concentration time-curves to estimate BBB leakage rate in each voxel. Subsequently, leakage rate was calculated in the white and gray matter, and primary (basic sensory and motor functions), secondary (association areas), and tertiary (higher-order cognition) brain regions. A difference in vulnerability to deterioration was expected between these regions, with especially tertiary regions being affected by age. Higher BBB leakage rate was significantly associated with older age in the white and gray matter, and also in tertiary, but not in primary or secondary brain regions. Even in healthy individuals, BBB disruption was stronger in older persons, which suggests BBB disruption is a normal physiologically aging phenomenon. Age-related increase in BBB disruption occurred especially in brain regions most vulnerable to age-related deterioration, which may indicate that BBB disruption is an underlying mechanism of normal age-related decline.Netherlands Trial Register number: NL6358, date of registration: 2017-03-24.

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Tài liệu tham khảo

Andrews-Hanna JR, Snyder AZ, Vincent JL, Lustig C, Head D, Raichle Marcus E, et al. Disruption of large-scale brain systems in advanced aging. Neuron. 2007;56:924–35. https://doi.org/10.1016/j.neuron.2007.10.038.

Bonkowski MS, Sinclair DA. Slowing ageing by design: the rise of NAD+ and sirtuin-activating compounds. Nat Rev Mol Cell Biol. 2016;17:679–90.

Burgmans S, van de Haar HJ, Verhey FR, Backes WH. Amyloid-β interacts with blood-brain barrier function in dementia: a systematic review. J Alzheimers Dis. 2013;35:859–73.

Casey BJ, Tottenham N, Liston C, Durston S. Imaging the developing brain: what have we learned about cognitive development? Trends Cogn Sci. 2005;9:104–10. https://doi.org/10.1016/j.tics.2005.01.011.

Cramer SP, Larsson HB. Accurate determination of blood–brain barrier permeability using dynamic contrast-enhanced T1-weighted MRI: a simulation and in vivo study on healthy subjects and multiple sclerosis patients. J Cereb Blood Flow Metab. 2014;34:1655–65.

Csiszar A, et al. Role of endothelial NAD+ deficiency in age-related vascular dysfunction. Am J Phys Heart Circ Phys. 2019;316:H1253–66.

Desikan RS, et al. An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest. Neuroimage. 2006;31:968–80.

DiBattista AM, Sierra F, Masliah E. NIA workshop on senescence in brain aging and Alzheimer’s disease and its related dementias. 2020. Springer.

Farkas E, Luiten PG. Cerebral microvascular pathology in aging and Alzheimer’s disease. Prog Neurobiol. 2001;64:575–611.

Farrall AJ, Wardlaw JM. Blood–brain barrier: ageing and microvascular disease—systematic review and meta-analysis. Neurobiol Aging. 2009;30:337–52.

Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F, et al. Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology. 1993;43:1683–9.

Fernando MS, et al. White matter lesions in an unselected cohort of the elderly. Stroke. 2006;37:1391–8.

Fischl B, Sereno MI, Dale AM. Cortical surface-based analysis: II: inflation, flattening, and a surface-based coordinate system. NeuroImage. 1999;9:195–207. https://doi.org/10.1006/nimg.1998.0396.

Fjell AM, McEvoy L, Holland D, Dale AM, Walhovd KB. Brain changes in older adults at very low risk for Alzheimer’s sisease. J Neurosci. 2013;33:8237–42. https://doi.org/10.1523/jneurosci.5506-12.2013.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

Fulop GA, et al. Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice. Geroscience. 2019;41:575–89. https://doi.org/10.1007/s11357-019-00110-1.

Gaillard C, Jolles J, van Boxtel MP, van Es PN, de Leeuw PW. Repeated automatic versus ambulatory blood pressure measurement: the effects of age and sex in a normal ageing population. J Hypertens. 1996;14:31–40.

Gélinas I, Gauthier L, McIntyre M, Gauthier S. Development of a functional measure for persons with Alzheimer’s disease: the disability assessment for dementia. Am J Occup Ther. 1999;53:471–81.

Gomes AP, et al. Declining NAD+ induces a pseudohypoxic state disrupting nuclear-mitochondrial communication during aging. Cell. 2013;155:1624–38.

Gustafson D, Karlsson C, Skoog I, Rosengren L, Lissner L, Blennow K. Mid-life adiposity factors relate to blood–brain barrier integrity in late life. J Intern Med. 2007;262:643–50.

Hainsworth A. White matter lesions in cerebral small vessel disease: underperfusion or leaky vessels? Neurology. 2019; 92:https://doi.org/10.1212/WNL.0000000000007258.

Iadecola C, et al. SOD1 rescues cerebral endothelial dysfunction in mice overexpressing amyloid precursor protein. Nat Neurosci. 1999;2:157. https://doi.org/10.1038/5715.

Iturria-Medina Y, et al. Early role of vascular dysregulation on late-onset Alzheimer’s disease based on multifactorial data-driven analysis. Nat Commun. 2016;7:11934. https://doi.org/10.1038/ncomms11934https://www.nature.com/articles/ncomms11934#supplementary-information.

Jacobs HI, Clerx L, Gronenschild EH, Aalten P, Verhey FR. White matter hyperintensities are positively associated with cortical thickness in Alzheimer's disease. J Alzheimers Dis. 2014;39:409–22.

Jelescu IO, Leppert IR, Narayanan S, Araújo D, Arnold DL, Pike GB. Dual-temporal resolution dynamic contrast-enhanced MRI protocol for blood–brain barrier permeability measurement in enhancing multiple sclerosis lesions. J Magn Reson Imaging. 2011;33:1291–300. https://doi.org/10.1002/jmri.22565.

Jolles J, Houx P, Van Boxtel M, Ponds R. Maastricht aging study: determinants of cognitive aging. Neuropsych Publishers Maastricht. 1995.

Kiss T, et al. Nicotinamide mononucleotide (NMN) treatment attenuates oxidative stress and rescues angiogenic capacity in aged cerebromicrovascular endothelial cells: a potential mechanism for the prevention of vascular cognitive impairment. GeroScience. 2019;41:619–30.

Larsson HB, Courivaud F, Rostrup E, Hansen AE. Measurement of brain perfusion, blood volume, and blood-brain barrier permeability, using dynamic contrast-enhanced T1-weighted MRI at 3 tesla. Magn Reson Med. 2009;62:1270–81.

Levit A, Hachinski V, Whitehead SN. Neurovascular unit dysregulation, white matter disease, and executive dysfunction: the shared triad of vascular cognitive impairment and Alzheimer disease. GeroScience. 2020;1–21.

Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008;451:716–9.

Maniega SM, Valdés Hernández MC, Clayden JD, Royle NA, Murray C, Morris Z, et al. White matter hyperintensities and normal-appearing white matter integrity in the aging brain. Neurobiol Aging. 2015;36:909–18.

Martin AJ, Friston KJ, Colebatch JG, Frackowiak RS. Decreases in regional cerebral blood flow with normal aging. J Cereb Blood Flow Metab. 1991;11:684–9.

Mazzone P, Tierney W, Hossain M, Puvenna V, Janigro D, Cucullo L. Pathophysiological impact of cigarette smoke exposure on the cerebrovascular system with a focus on the blood-brain barrier: expanding the awareness of smoking toxicity in an underappreciated area. Int J Environ Res Public Health. 2010;7:4111–26.

Mills KF, et al. Long-term administration of nicotinamide mononucleotide mitigates age-associated physiological decline in mice. Cell Metab. 2016;24:795–806.

Montagne A, Barnes SR, Sweeney MD, Halliday MR, Sagare AP, Zhao Z, et al. Blood-brain barrier breakdown in the aging human hippocampus. Neuron. 2015;85:296–302.

Montagne A, Nation DA, Pa J, Sweeney MD, Toga AW, Zlokovic BV. Brain imaging of neurovascular dysfunction in Alzheimer’s disease. Acta Neuropathol. 2016;131:687–707.

Montagne A, Zhao Z, Zlokovic BV. Alzheimer’s disease: a matter of blood–brain barrier dysfunction? J Exp Med. 2017;214:3151–69.

Murugesan N, Demarest TG, Madri JA, Pachter JS. Brain regional angiogenic potential at the neurovascular unit during normal aging. Neurobiol Aging. 2012;33:1004. e1001–16.

Nation DA, et al. Blood–brain barrier breakdown is an early biomarker of human cognitive dysfunction. Nat Med. 2019; doi:https://doi.org/10.1038/s41591-018-0297-y.

Niwa K, Kazama K, Younkin L, Younkin SG, Carlson GA, Iadecola C. Cerebrovascular autoregulation is profoundly impaired in mice overexpressing amyloid precursor protein. Am J Phys Heart Circ Phys. 2002a;283:H315–23. https://doi.org/10.1152/ajpheart.00022.2002.

Niwa K, Kazama K, Younkin SG, Carlson GA, Iadecola C. Alterations in Cerebral Blood Flow and Glucose Utilization in Mice Overexpressing the Amyloid Precursor Protein. Neurobiol Dis. 2002b;9:61–8. https://doi.org/10.1006/nbdi.2001.0460.

Norton E, Bridges L, Kenyon L, Esiri M, Bennett D, Hainsworth A. Cell senescence and cerebral small vessel disease in the brains of people aged 80 years and older. J Neuropathol Exp Neurol. 2019;78 doi:https://doi.org/10.1093/jnen/nlz088.

Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. The Lancet Neurology. 2010;9:689–701.

Pasquier F, Leys D, Weerts JG, Mounier-Vehier F, Barkhof F, Scheltens P. Inter-and intraobserver reproducibility of cerebral atrophy assessment on MRI scans with hemispheric infarcts. Eur Neurol. 1996;36:268–72.

Patlak CS, Blasberg RG, Fenstermacher JD. Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. J Cereb Blood Flow Metab. 1983;3:1–7.

Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr. 1997;9:65–9.

Raja R, Rosenberg GA, Caprihan A. MRI measurements of Blood-Brain Barrier function in dementia: a review of recent studies. Neuropharmacology. 2018;134:259–71. https://doi.org/10.1016/j.neuropharm.2017.10.034.

Rapoport SI. Opening of the blood-brain barrier by acute hypertension. Exp Neurol. 1976;52:467–79.

Rapp PR, Amaral DG. Individual differences in the cognitive and neurobiological consequences of normal aging. Trends Neurosci. 1992;15:340–5.

Riphagen JM, et al. Shades of white: diffusion properties of T1- and FLAIR-defined white matter signal abnormalities differ in stages from cognitively normal to dementia. Neurobiol Aging. 2018;68:48–58. https://doi.org/10.1016/j.neurobiolaging.2018.03.029.

Schaie KW. The course of adult intellectual development. Am Psychol. 1994;49:304.

Starr J, Wardlaw J, Ferguson K, MacLullich A, Deary I, Marshall I. Increased blood–brain barrier permeability in type II diabetes demonstrated by gadolinium magnetic resonance imaging. J Neurol Neurosurg Psychiatry. 2003;74:70–6.

Tarantini S, et al. Treatment with the poly (ADP-ribose) polymerase inhibitor PJ-34 improves cerebromicrovascular endothelial function, neurovascular coupling responses and cognitive performance in aged mice, supporting the NAD+ depletion hypothesis of neurovascular aging. GeroScience. 2019;41:533–42.

Thambisetty M, Wan J, Carass A, An Y, Prince JL, Resnick SM. Longitudinal changes in cortical thickness associated with normal aging. Neuroimage. 2010;52:1215–23.

Ungvari Z, Tarantini S, Donato AJ, Galvan V, Csiszar A. Mechanisms of vascular aging. Circ Res. 2018;123:849–67.

Ungvari Z, et al. Aging-induced dysregulation of dicer1-dependent microRNA expression impairs angiogenic capacity of rat cerebromicrovascular endothelial cells. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2013;68:877–91.

van de Haar HJ, Burgmans S, Jansen JFA, van Osch MJP, van Buchem MA, Muller M, et al. Blood-brain barrier leakage in patients with early Alzheimer disease. Radiology. 2016a;281:527–35.

van de Haar HJ, et al. Neurovascular unit impairment in early Alzheimer’s disease measured with magnetic resonance imaging. Neurobiol Aging. 2016b;45:190–6.

van de Haar HJ, et al. Subtle blood-brain barrier leakage rate and spatial extent: considerations for dynamic contrast-enhanced. MRI Medical Physics. 2017;44:4112–25. https://doi.org/10.1002/mp.12328.

Verdecchia P, Staessen JA, White W, Imai Y, O'Brien E. Properly defining white coat hypertension. Eur Heart J. 2002;23:106–9.

Wang H, Golob EJ, Su M-Y. Vascular volume and blood-brain barrier permeability measured by dynamic contrast enhanced MRI in hippocampus and cerebellum of patients with MCI and normal controls. J Magn Reson Imaging. 2006;24:695–700. https://doi.org/10.1002/jmri.20669.

Wang L, Swank JS, Glick IE, Gado MH, Miller MI, Morris JC, et al. Changes in hippocampal volume and shape across time distinguish dementia of the Alzheimer type from healthy aging☆. Neuroimage. 2003;20:667–82.

Wong SM, Jansen JF, Zhang CE, Hoff EI, Staals J, van Oostenbrugge RJ, et al. Blood-brain barrier impairment and hypoperfusion are linked in cerebral small vessel disease. Neurology. 2019;92:e1669–77.

Woodruff-Pak DS. The neuropsychology of aging. 1997. Blackwell Publishing.

Yoshino J, Baur JA, Imai S-I. NAD+ intermediates: the biology and therapeutic potential of NMN and NR. Cell Metab. 2018;27:513–28.

Zhang CE, Wong SM, van de Haar HJ, Staals J, Jansen JFA, Jeukens CRLPN, et al. Blood–brain barrier leakage is more widespread in patients with cerebral small vessel disease. Neurology. 2017;88:426–32.

Zhang H, et al. NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science. 2016;352:1436–43.

Zhao Z, Nelson AR, Betsholtz C, Zlokovic BV. Establishment and dysfunction of the blood-brain barrier. Cell. 2015;163:1064–78.

Zlokovic BV. The blood-brain barrier in health and chronic neurodegenerative disorders. Neuron. 2008;57:178–201.

Zlokovic BV. Neurovascular pathways to neurodegeneration in Alzheimer’s disease and other disorders. Nat Rev Neurosci. 2011;12:723. https://doi.org/10.1038/nrn3114.