Padrela, BE;
Tecelão, S;
Kirsebom, BE;
Geier, O;
Tranfa, M;
Masserini, F;
Sneve, MH;
... Mutsaerts, HJMM; + view all
(2026)
Blood-brain barrier water exchange in relation to amyloid, cognition and cerebrovascular burden.
NeuroImage: Clinical
, 49
, Article 103926. 10.1016/j.nicl.2025.103926.
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Abstract
Blood-brain barrier (BBB) water exchange may serve as a sensitive early biomarker for Alzheimer’s disease and age-related cognitive decline. This study applied a non-invasive multi-echo arterial spin labeling (ASL) technique to measure BBB water exchange time (Tex), cerebral blood flow (CBF), and arterial transit time (ATT) in 160 adults aged 50 years and older. Participants were classified as cognitively normal (CN), having subjective cognitive decline (SCD), or mild cognitive impairment (MCI). They were assessed for amyloid status and cerebrovascular burden. Compared to CN participants, Tex was significantly lower in both SCD (−9.5 %) and MCI (−14.5 %) groups, suggesting that reductions in BBB water exchange emerge early in the course of cognitive decline. In contrast, CBF was reduced only in MCI participants (−20.8 % compared to CN), and ATT was significantly increased only in individuals with severe cerebrovascular burden (Fazekas score 3). Notably, Tex showed a stepwise decrease with increasing Fazekas scores (1–2), supporting its sensitivity to moderate small vessel disease. No associations were found between Tex and amyloid positivity after adjusting for age and sex. These findings indicate that Tex alterations may precede changes in traditional perfusion markers and are more closely related to vascular and early cognitive changes than to amyloid pathology. BBB water exchange mapping may therefore provide a promising, non-invasive tool to detect early neurovascular dysfunction that contributes to cognitive decline in aging populations, potentially offering a useful biomarker for early intervention trials targeting vascular contributions to dementia.
| Type: | Article |
|---|---|
| Title: | Blood-brain barrier water exchange in relation to amyloid, cognition and cerebrovascular burden |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.nicl.2025.103926 |
| Publisher version: | https://doi.org/10.1016/j.nicl.2025.103926 |
| Language: | English |
| Additional information: | Copyright © 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Blood-brain barrier water exchange; Arterial spin labeling; Cerebral blood flow; Amyloid; Cognition; Cerebrovascular damage |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10219460 |
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