Blood-brain barrier permeability and long term clinical and imaging outcomes in cerebral small vessel disease
Open accessAbstract
Background and Purpose—: Increased blood–brain barrier (BBB) permeability occurs in cerebral small vessel disease. It is not known if BBB changes predate progression of small vessel disease. Methods—: We followed-up patients with nondisabling lacunar or cortical stroke and BBB permeability magnetic resonance imaging after their original stroke. Approximately 3 years later, we assessed functional outcome (Oxford Handicap Score, poor outcome defined as 3–6), recurrent neurological events, and white matter hyperintensity (WMH) progression on magnetic resonance imaging. Results—: Among 70 patients with mean age of 68 (SD±11) years, median time to clinical follow-up was 39 months (interquartile range, 30–45) and median Oxford Handicap Score was 2 (interquartile range, 1–3); poor functional outcome was associated with higher baseline WMH score ( P <0.001) and increased basal ganglia BBB permeability ( P =0.046). Among 48 patients with follow-up magnetic resonance imaging, WMH progression at follow-up was associated with baseline WMH (ANCOVA P <0.0001) and age (ANCOVA P =0.032). Conclusions—: Further long-term studies to evaluate the role of BBB dysfunction in progression of small vessel disease are required in studies that are large enough to account for key prognostic influences such as baseline WMH and age.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Evidence for endothelial dysfunction in SVD comes from CADASIL, a hereditary SVD caused by Notch3 mutations, where extensive WMH are associated with increased brain volume on MRI suggesting increased brain water content, and CSF/plasma albumin ratios are increased, consistent with BBB failure.
“Evidence for endothelial dysfunction in SVD also comes from CADASIL, a hereditary SVD caused by Notch3 mutations,146 where extensive WMH were associated with increased brain volume on MRI suggesting an increase of brain water content147 and CSF/plasma albumin ratios were increased,148 in keeping with BBB failure.”
From Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging (2013) · cites this paper as [147]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Interobserver agreement for the assessment of handicap in stroke patients
van Swieten, J. C., Koudstaal, P. J., Visser, M. C., Schouten, H. J., & van Gijn, J. (1988) · Stroke · doi:10.1161/01.str.19.5.604 · Cited by 6,512 · see citing works
Blood–brain barrier: Ageing and microvascular disease – systematic review and meta-analysis
Farrall, A. J., & Wardlaw, J. M. (2009) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2007.07.015 · Cited by 882 · see citing works
Self-citationInterobserver agreement for the assessment of handicap in stroke patients.
Bamford, J., Sandercock, P. A., Warlow, C. P., & Slattery, J. (1989) · Stroke · doi:10.1161/01.str.20.6.828 · Cited by 694 · see citing works
Blood brain barrier: ageing and microvascular disease-systematic review and meta-analysis
Farrall, A., & Wardlaw, J. M. (2009) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2009.02.089 · Cited by 639 · see citing works
Self-citationLacunar stroke is associated with diffuse blood-brain barrier dysfunction
Wardlaw, J. M., Doubal, F., Armitage, P., Chappell, F., Carpenter, T., Muñoz Maniega, S., Farrall, A., Sudlow, C., Dennis, M., & Dhillon, B. (2009) · Annals of Neurology · doi:10.1002/ana.21549 · Cited by 364 · see citing works
Self-citationTopakian, R., Barrick, T. R., Howe, F. A., & Markus, H. S. (2010) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2009.172072 · Cited by 281 · see citing works
Blood-brain barrier permeability abnormalities in vascular cognitive impairment
Taheri, S., Gasparovic, C., Huisa, B. N., Adair, J. C., Edmonds, E., Prestopnik, J., Grossetete, M., Shah, N. J., Wills, J., Qualls, C., et al. (2011) · Stroke · doi:10.1161/strokeaha.110.611731 · Cited by 248 · see citing works
Fazekas, F. (2008) · European Neurology · doi:10.1159/000116401 · Cited by 217 · see citing works
Measuring progression of cerebral white matter lesions on MRI
Prins, N. D., van Straaten, E. C. W., van Dijk, E. J., Simoni, M., van Schijndel, R. A., Vrooman, H. A., Koudstaal, P. J., Scheltens, P., Breteler, M. M. B., & Barkhof, F. (2004) · Neurology · doi:10.1212/01.wnl.0000123264.40498.b6 · Cited by 186 · see citing works
Hernández, M. D. C. V., Ferguson, K. J., Chappell, F. M., & Wardlaw, J. M. (2010) · European Radiology · doi:10.1007/s00330-010-1718-6 · Cited by 152 · see citing works
Self-citationUse of dynamic contrast-enhanced MRI to measure subtle blood–brain barrier abnormalities
Armitage, P. A., Farrall, A., Carpenter, T. K., Doubal, F., & Wardlaw, J. M. (2010) · Magnetic Resonance Imaging · doi:10.1016/j.mri.2010.09.002 · Cited by 86 · see citing works
Self-citationWindham, B. G., Griswold, M. E., Shibata, D., Penman, A., Catellier, D. J., & Mosley, T. H. (2012) · Stroke · doi:10.1161/strokeaha.111.643379 · Cited by 41 · see citing works
Silencing of meiosis-critical genes for engineering male sterility in plants
Wang, X., Singer, S. D., & Liu, Z. (2011) · Plant Cell Reports · doi:10.1007/s00299-011-1193-9 · Cited by 11 · see citing works
Self-citationNew development in diagnosis of vascular cognitive impairment
Cavalieri, M., & Schmidt, R. (2010) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2010.08.031 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Small vessel disease: mechanisms and clinical implications
Wardlaw, J. M., Smith, C., & Dichgans, M. (2019) · The Lancet Neurology · doi:10.1016/s1474-4422(19)30079-1 · Cited by 1,777 · see citing works
Self-citationMechanisms of sporadic cerebral small vessel disease: insights from neuroimaging
Wardlaw, J. M., Smith, C., & Dichgans, M. (2013) · The Lancet Neurology · doi:10.1016/s1474-4422(13)70060-7 · Cited by 1,657 · see citing works
Self-citationMicrobiome–host systems interactions: protective effects of propionate upon the blood–brain barrier
Hoyles, L., Snelling, T., Umlai, U.-K., Nicholson, J. K., Carding, S. R., Glen, R. C., & McArthur, S. (2018) · Microbiome · doi:10.1186/s40168-018-0439-y · Cited by 591 · see citing works
Thrippleton, M. J., Backes, W. H., Sourbron, S., Ingrisch, M., van Osch, M. J. P., Dichgans, M., Fazekas, F., Ropele, S., Frayne, R., van Oostenbrugge, R. J., et al. (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2019.01.013 · Cited by 252 · see citing works
Self-citationXu, M., Feng, T., Liu, B., Qiu, F., Xu, Y., Zhao, Y., & Zheng, Y. (2021) · Theranostics · doi:10.7150/thno.62330 · Cited by 229 · see citing works
Staffaroni, A., Elahi, F., McDermott, D., Marton, K., Karageorgiou, E., Sacco, S., Paoletti, M., Caverzasi, E., Hess, C., Rosen, H., et al. (2017) · Seminars in Neurology · doi:10.1055/s-0037-1608808 · Cited by 91 · see citing works
- Authors
- Wardlaw, J. M., Doubal, F. N., Valdes-Hernandez, M., Wang, X., Chappell, F. M., Shuler, K., Armitage, P. A., Carpenter, T. C., & Dennis, M. S.
- Affiliations
- University of Edinburgh (GB)
- From the Brain Research Imaging Center (J.M.W., F.N.D., M.V.H., X.W., F.M.C., K.S., P.A.A., T.C.C.), and Stroke Medicine (J.M.W., F.N.D.,M.S.D.), Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, United Kingdom (J.M.W., M.V.H., X.W., F.M.C., K.S., P.A.A., T.C.C.); and Center for Cognitive Aging and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United...
- ORCID
- Venue
- Stroke
- Published
- 2013-02
- Volume
- 44
- Issue
- 2
- Pages
- 525-527
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC3843346
- OpenAlex
- W2167086724
- Cited by
- 183
- References
- 14
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 18 · 2023: 22 · 2022: 15 · 2021: 15 · 2020: 11 · 2019: 14 · 2018: 14 · 2017: 18 · 2016: 13 · 2015: 11 · 2014: 11 · 2013: 1
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (075611)
- Mrs Gladys Row Fogo Charitable Trust
- Research Councils UK
- Centre for Cognitive Ageing and Cognitive Epidemiology
- Medical Research Council (MR/K026992/1)
- Topics
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Keywords
- blood-brain barrier permeability, cerebral small vessel disease, white matter hyperintensities, white matter hyperintensity progression, lacunar stroke, cortical stroke, functional outcome, basal ganglia, prognostic factors
- MeSH terms
- Aged, Aged, 80 and over, Blood-Brain Barrier, Capillary Permeability, Female, Follow-Up Studies, Humans, Male, Middle Aged, Time Factors, Treatment Outcome, Diffusion Magnetic Resonance Imaging, Cerebral Small Vessel Diseases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
