Increased Blood-Brain Barrier Permeability in White Matter Lesions of Binswanger’s Disease Evaluated by Contrast-Enhanced MRI

We investigated blood-brain barrier (BBB) permeability in white matter lesions of Binswanger’s disease (BD) with contrast-enhanced MRI. Three subject groups were studied: 17 patients with BD and periventricular hyperintensities (PVH) on MRI, 10 patients with ischemic cerebrovascular events and with PVH but no dementia, and 14 age-matched control subjects without PVH. BBB permeability was quantified by calculation of T 1 change defined as [(T 1post – T 1pre )/T 1pre ] ×100, where T 1pre and T 1post represent the T 1 relaxation times before and after Gd-DTPA administration. T 1 change in PVH of BD patients significantly decreased in comparison with that observed in PVH of the nondemented patients and in normal white matter of the control subjects, but no significant T 1 change was observed between the PVH of the nondemented patients and normal white matter of the controls. There was a significant correlation between the Mini-Mental State Examination score and T 1 change for areas of PVH in BD. These results suggest that BBB permeability increases in areas of PVH in BD and that a BBB dysfunction is related to a progression of cognitive impairment.