Risk of cognitive decline progression is associated to increased blood‐brain‐barrier permeability: A longitudinal study in a memory unit clinical cohort

Abstract

INTRODUCTIONThis study examined the relationship between blood‐brain‐barrier permeability (BBBp), measured by cerebrospinal fluid/serum albumin ratio (QAlb), and cognitive decline progression in a clinical cohort.METHODSThis prospective observational study included 334 participants from the BIODEGMAR cohort. Cognitive decline progression was defined as an increase in Global Deterioration Scale and/or Clinical Dementia Rating scores. Associations between BBBp, demographics, and clinical factors were explored.RESULTSMale sex, diabetes mellitus, and cerebrovascular burden were associated with increased log‐QAlb. Vascular cognitive impairment patients had the highest log‐QAlb levels. Among the 273 participants with valid follow‐up data, 154 (56.4%) showed cognitive decline progression. An 8% increase in the hazard of clinical worsening was observed for each 10% increase in log‐QAlb.DISCUSSIONThese results suggest that increased BBBp in individuals with cognitive decline may contribute to clinical worsening, pointing to potential targeted therapies. QAlb could be a useful biomarker for identifying patients with a worse prognosis.

Constitutive NOS Production Is Modulated by Alzheimer’s Disease Pathology Depending on APOE Genotype

“…The NVU constitutes the blood-brain barrier (BBB) and regulates the cerebral blood flow (CBF) to guarantee the supply of oxygen and nutrients and to ensure the clearance of toxic metabolites produced by neurons and glial cells, which are both necessary to support brain health and to meet energy demands. Solid neuropathological evidence demonstrates that both macrostructural and microstructural vascular 2 of 11 alterations are linked to diminished CBF and defective BBB permeability, conditions that both weigh on the progression of AD [6,7].…”