Water exchange across blood-brain barrier in neuromyelitis optica spectrum disorder measured by vascular-water-exchange MRI

Motivation: Limited information exists regarding the spatial characteristics of blood-brain barrier (BBB) disruption at the whole-brain level for neuromyelitis optica spectrum disorder (NMOSD). Goal(s): We explored spatial features of BBB changes in NMOSD using noninvasive, quantitative MRI technique. Approach: Vascular-water-exchange MRI was applied for quantitative analysis. Results: In the white matter, the apparent exchange rate across the BBB (AXRBBB) was significantly higher in acute-phase patients than in healthy controls, especially in some lesion-prone areas. In the gray matter, acute-phase patients had significantly higher AXRBBB values in the frontal and parietal lobes. AXRBBB was also significantly correlated with clinical-scale scores. Impact: Exploring the spatial features of BBB disruption will enable better understanding the imaging features of NMOSD and may help clinicians in differentially diagnosing NMOSD from other brain diseases using noninvasive MRI.