Higher Blood-brain barrier permeability in patients with major depressive disorder identified by DCE-MRI imaging

Background: Studies from animal models and clinical trials of blood and cerebrospinal fluid have proposed that blood-brain barrier (BBB) dysfunction in depression (MDD). But there are no In vivo proves focused on BBB dysfunction in MDD patients. The present study aimed to identify whether there was abnormal BBB permeability, as well as the association with clinical status in MDD patients using dynamic contrast-enhanced magnetic resonance (DCE-MRI) imaging.

Methods: Patients with MDD and healthy adults were recruited and underwent DCE-MRI and structural MRI scans. The mean volume transfer constant (K^trans) values were calculated for a quantitative assessment of BBB leakage. For each subject, the mean K^trans values were calculated for the whole gray matter, white matter, and 90 brain regions of the anatomical automatic labeling template (AAL). The differences in K^trans values between patients and controls and between treated and untreated patients were compared.

Results: 23 MDD patients (12 males and 11 females, mean age 28.09 years) and 18 healthy controls (HC, 8 males and 10 females, mean age 30.67 years) were recruited in the study. We found that the K^trans values in the olfactory, caudate, and thalamus were higher in MDD patients compared to healthy controls (p<0.05). The K^trans values in the orbital lobe, anterior cingulate gyrus, putamen, and thalamus in treated patients were lower than the patients never treated. There were positive correlations between HAMD total score with K^trans values in whole brain WM, hippocampus and thalamus. The total HAMA score was positively correlated with the K^trans of hippocampus.

Conclusion: These findings supported a link between blood-brain barrier leakage and depression and symptom severity. The results also suggested a role for non-invasive DCE-MRI in detecting blood-brain barrier dysfunction in depression patients.