{"doi":"10.1002/alz.13874","title":"Heterogeneous blood‐brain barrier dysfunction in cerebral small vessel diseases","abstract":"Abstract INTRODUCTION We explored how blood‐brain barrier (BBB) leakage rate of gadolinium chelates (K trans ) and BBB water exchange rate (k w ) varied in cerebral small vessel disease (cSVD) subtypes. METHODS Thirty sporadic cSVD, 40 cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and 13 high‐temperature requirement factor A serine peptidase 1 (HTRA) ‐related cSVD subjects were investigated parallel to 40 healthy individuals. Subjects underwent clinical, cognitive, and MRI assessment. RESULTS In CADASIL, no difference in K trans , but lower k w was observed in multiple brain regions. In sporadic cSVD, no difference in k w , but higher K trans was found in the whole brain and normal‐appearing white matter. In HTRA1‐related cSVD, both higher K trans in the whole brain and lower k w in multiple brain regions were observed. In each patient group, the altered BBB measures were correlated with lesion burden or clinical severity. DISCUSSION In cSVD subtypes, distinct alterations of k w and K trans were observed. The combination of K trans and k w can depict the heterogeneous BBB dysfunction. Highlights We measured BBB leakage to gadolinium‐based contrast agent (K trans ) and water exchange rate (k w ) across BBB in three subtypes of cSVD. CADASIL is characterized by lower k w , HTRA1‐related cSVD exhibits both higher K trans and lower k w , while sporadic cSVD is distinguished by higher K trans . There are distinct alterations in k w and K trans among subtypes of cSVD, indicating the heterogeneous nature of BBB dysfunction.","journal":"Alzheimer s & Dementia","year":2024,"id":420082,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":36,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.893,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":685232,"name":"Yingying Li","orcid":"0000-0003-1184-9475","position":1,"is_corresponding":false},{"id":1031207,"name":"Tingyan Yao","orcid":"0009-0007-9736-7050","position":2,"is_corresponding":false},{"id":290778,"name":"Xingfeng Shao","orcid":"0000-0002-4130-6204","position":3,"is_corresponding":false},{"id":663374,"name":"Weijun Tang","orcid":"0000-0002-3726-5243","position":4,"is_corresponding":false},{"id":290780,"name":"Axel Montagne","orcid":"0000-0001-5564-985X","position":5,"is_corresponding":false},{"id":852944,"name":"Hugues Chabriat","orcid":"0000-0001-8436-6074","position":6,"is_corresponding":false},{"id":244996,"name":"Danny J.J. Wang","orcid":"0000-0002-0840-7062","position":7,"is_corresponding":false},{"id":1024550,"name":"Chaodong Wang","orcid":"0000-0001-8784-1002","position":8,"is_corresponding":false},{"id":492520,"name":"Qi Yang","orcid":"0000-0002-5773-0456","position":9,"is_corresponding":false},{"id":1031211,"name":"Xin Cheng","orcid":"0000-0001-7816-0547","position":10,"is_corresponding":false},{"id":1031206,"name":"Yunqing Ying","orcid":"0000-0001-9421-5683","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-19T01:57:25.777459Z","pmid":"38787758","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}