Subtle blood-brain barrier leakage quantification using DCE-MRI in subjective and mild cognitive impairment: A pilot sub-study of the Cognitive Ageing, Nutrition & Neurogenesis (CANN) trial

The pathophysiology of dementia relates to leakage of the aging blood-brain barrier (BBB). Dynamic contrast-enhanced (DCE)-MRI quantifies this leakage and may facilitate early diagnosis and treatment monitoring. Here, we present preliminary work comparing BBB leakage and T₁ between mild and subjective cognitive impairment (MCI and SCI) participants (n = 6 and 17, respectively) after year-long consumption of a combined omega-3 fatty acid (fish oil capsules) and cocoa flavanol-3-ol (chocolate drops) dietary supplement or matched-control (n = 1/5 MCI and 9/8 SCI). DCE-MRI data from white matter, grey matter, hippocampus, thalamus, and amygdala were fitted with the Patlak model to obtain the permeability-surface-area product (PS), and pre-contrast T₁ was calculated. No differences were observed between intervention groups. After combining control and active groups, we observed greater leakage (PS) in the MCI hippocampus (p = 0.019) and thalamus (p = 0.042) versus SCI, and longer T₁ values in MCI white matter (p = 0.042) and thalamus (p = 0.023). This preliminary study indicates the potential utility of BBB leakage and T₁ in differentiating MCI and SCI. This should be investigated further in larger trials.