Exploring the Brain’s Protective Barrier: A Clinical Perspective

Published on April 17, 2023

Imagine you have a bubble wrap protecting something important. Well, the blood-brain barrier is like that bubble wrap for your brain. It’s made up of special cells that control what goes in and out of the brain, keeping it safe and sound. But sometimes, this barrier can start to break down, which can cause all sorts of trouble in the brain. That’s where imaging comes in! By using advanced imaging techniques, doctors can see if there are any problems with the blood-brain barrier and predict how it might affect the brain. This review article gives an in-depth look at how imaging can help diagnose and monitor neurological diseases by studying the blood-brain barrier. The authors also discuss some exciting new imaging methods that could make this process easier and more accessible, especially in places with limited resources. So, if you’re curious about how scientists are protecting our brains, take a dive into this article and learn all about it!

The blood-brain barrier (BBB) consists of specialized cells that tightly regulate the in- and outflow of molecules from the blood to brain parenchyma, protecting the brain’s microenvironment. If one of the BBB components starts to fail, its dysfunction can lead to a cascade of neuroinflammatory events leading to neuronal dysfunction and degeneration. Preliminary imaging findings suggest that BBB dysfunction could serve as an early diagnostic and prognostic biomarker for a number of neurological diseases. This review aims to provide clinicians with an overview of the emerging field of BBB imaging in humans by answering three key questions: (1. Disease) In which diseases could BBB imaging be useful? (2. Device) What are currently available imaging methods for evaluating BBB integrity? And (3. Distribution) what is the potential of BBB imaging in different environments, particularly in resource limited settings? We conclude that further advances are needed, such as the validation, standardization and implementation of readily available, low-cost and non-contrast BBB imaging techniques, for BBB imaging to be a useful clinical biomarker in both resource-limited and well-resourced settings.

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