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.