Thrippleton, M. | Search bioRxiv

bioRxiv2026

APOE4 genotype, blood-brain barrier leakage and ischaemic stroke subtype and location

BackgroundApolipoprotein E (APOE) has been implicated in blood-brain barrier (BBB) dysfunction and may influence ischaemic cerebrovascular disease and cerebral small-vessel disease (cSVD). This study examined associations between APOE genotype, BBB permeability, and infarct distribution in patients with mild ischemic stroke. MethodsWe recruited patients with mild ischemic stroke who underwent structural and dynamic contrast-enhanced MRI (DCE-MRI) and APOE genotyping. Infarct type and location, white matter hyperintensities (WMH), and perivascular spaces (PVS) were assessed. BBB-related metrics were quantified using fractional plasma volume (vP) and permeability-surface area product (PS) across five brain regions of interest: deep grey matter (DGM), hippocampus, thalamus, normal-appearing white matter (NAWM), and WMH. Associations between genotype, BBB metrics, vascular risk factors, and age were evaluated using linear mixed-effects models. Binary logistic regression was also applied to assess the association between APOE status and infarct location by vascular territory (anterior vs posterior circulation). ResultsAmong 147 patients with APOE genotype and BBB measures, APOE4 carriers (n=44) demonstrated a greater proportion of posterior circulation infarcts than E3/E3 individuals (n=80; 56.4% versus 32.9%), including higher frequencies of posterior cerebral artery cortical, posterior borderzone, and thalamic infarcts. Mean PS and vP did not differ significantly by genotype. Increasing age was associated with lower PS across multiple regions and lower vP in WMH, while higher vascular risk burden was associated with lower vP in NAWM and WMH. Inclusion of regional BBB metrics did not substantially alter APOE4 effect estimates in infarct-location models. ConclusionsAPOE4 carriers showed a posterior-predominant infarct distribution despite similar BBB permeability and vascularity measures. Age and vascular risk burden were more strongly associated with BBB-related imaging metrics than APOE genotype. These findings add to evidence suggesting that APOE genotype may influence regional cerebrovascular vulnerability and that this effect is unlikely to be fully explained by DCE-MRI-derived measures of BBB permeability and vascularity alone.

neuroscience↗

bioRxiv2017

Evaluation of MRI sequences for quantitative T1 brain mapping

T1 mapping constitutes a quantitative MRI technique finding significant application in brain imaging. It allows improved evaluation of contrast uptake, blood perfusion, volume, and provides more specific biomarkers of disease progression compared to conventional T1-weighted images. While there are many techniques for T1-mapping, there is also a wide range of reported T1-values in tissues, raising the issue of protocols reproducibility and standardization. The gold standard for obtaining T1-maps is based on acquiring IR-SE sequence. Widely used alternative sequences are IR-SE-EPI, VFA (DESPOT), DESPOT-HIFI and MP2RAGE that speed up scanning and fitting procedures. A custom MRI phantom was used to assess the reproducibility and accuracy of the different methods. All scans were performed using a 3T Siemens Prisma scanner. The acquired data were processed using two different codes. The main difference was observed for VFA (DESPOT) which grossly overestimated T1 relaxation time by 214 ms [CI: 126 270 ms] compared to the IR-SE sequence. MP2RAGE and DESPOT-HIFI sequences gave slightly shorter T1 than IR-SE ([~]20 to 30ms) and can be considered as alternative and time-efficient methods for acquiring accurate T1 maps of the human brain, while IR-SE-EPI gave identical results, at a cost of a lower image quality.

biophysics↗