Blood-Brain Barrier Leakage: A New Biomarker in Transient Ischemic Attacks.

Autor:	Serlin Y; From the Neurology Residency Training Program (Y.S.), McGill University, Montreal, QC, Canada., Ofer J; Department of Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel (J.O., R.V., A.F.), Soroka Medical Center, Beer-Sheva, Israel., Ben-Arie G; Department of Medical Imaging (G.B.-A., I.S.), Soroka Medical Center, Beer-Sheva, Israel., Veksler R; Department of Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel (J.O., R.V., A.F.), Soroka Medical Center, Beer-Sheva, Israel., Ifergane G; Department of Neurology (G.I., A.H.), Soroka Medical Center, Beer-Sheva, Israel., Shelef I; Department of Medical Imaging (G.B.-A., I.S.), Soroka Medical Center, Beer-Sheva, Israel., Minuk J; Department of Neurology and Neurosurgery, Jewish General Hospital (J.M.), McGill University, Montreal, QC, Canada., Horev A; Department of Neurology (G.I., A.H.), Soroka Medical Center, Beer-Sheva, Israel., Friedman A; Department of Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel (J.O., R.V., A.F.), Soroka Medical Center, Beer-Sheva, Israel.; Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (A.F.).
Jazyk:	angličtina
Zdroj:	Stroke [Stroke] 2019 May; Vol. 50 (5), pp. 1266-1269.
DOI:	10.1161/STROKEAHA.119.025247
Abstrakt:	Background and Purpose- The diagnosis of transient ischemic attack is challenging. Evidence of acute ischemia on MRI diffusion-weighted imaging is highly variable and confirmed in only about one-third of patients. This study investigated the significance of blood-brain barrier dysfunction (BBBD) mapping in patients with transient neurological deficits, as a diagnostic and prognostic biomarker required for risk stratification and stroke prevention. Methods- We used dynamic contrast-enhanced MRI to quantitatively map BBBD in a prospective cohort study of 57 patients diagnosed with transient ischemic attack/minor stroke and 50 healthy controls. Results- Brain volume with BBBD was significantly higher in patients compared with controls ( P=0.002). BBBD localization corresponded with the clinical presentation in 41 patients (72%) and was more extensive in patients with acute infarct on diffusion-weighted imaging ( P=0.05). Patients who developed new stroke during follow-up had a significantly greater BBBD at the initial presentation ( P=0.03) with a risk ratio of 5.35 for recurrent stroke. Conclusions- This is the first description of the extent and localization of BBBD in patients with transient ischemic attack/minor stroke. We propose BBBD mapping as a valuable tool for detection of subtle brain ischemia and a promising predictive biomarker required for risk stratification and stroke prevention.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu