Correlation of blood-brain barrier leakage with cerebral small vessel disease including cerebral microbleeds in Alzheimer's disease.
Level 4 - case-series / case-control
Cross-sectional case-control study
PubMed 36873442 · doi:10.3389/fneur.2023.1077860
What was done
A cross-sectional study evaluated 139 individuals divided into probable Alzheimer's disease (18F-florbetapir PET positive, n = 101) and cognitively normal controls (n = 38). Blood-brain barrier (BBB) integrity was assessed by measuring the CSF/plasma albumin ratio (Qalb). CSF and plasma total tau, p-tau181, Aβ40, and Aβ42 were quantified via commercial assay kits. Cerebral small vessel disease (CSVD) burden and cerebral microbleeds (CMBs) were evaluated using brain MRI.
What was found
Patients with Alzheimer's disease had significantly higher Qalb (p = 0.0024), higher CMB counts (p = 0.03), and greater CSVD burden (p < 0.0001) than controls. Within the Alzheimer's group, higher Qalb correlated with CMBs and CSVD (p = 0.03), and CMB counts negatively correlated with CSF Aβ42 (p = 0.02). Absolute values, effect sizes, and correlation coefficients were not reported in the abstract.
Why it matters
This study provides biomarker evidence linking blood-brain barrier dysfunction to cerebral microvascular damage and amyloid pathology in patients with Alzheimer's disease.
Limits
The study is cross-sectional and cannot establish causal direction. The control group is small (n = 38), and the abstract does not report effect sizes, correlation magnitudes, or adjustments for shared vascular risk factors.
Cited by
- supports Alzheimer's disease and small vessel disease both exhibit microbleeds on brain MRI caused by blood-brain barrier breakdown allowing red blood cells into the brain.