title: Multimodality imaging of blood-brain barrier impairment during epileptogenesis.
abstract: Insult-associated blood-brain barrier leakage is strongly suggested to be a key step during epileptogenesis. In this study, we used three non-invasive translational imaging modalities, i.e. positron emission tomography, single photon emission computed tomography, and magnetic resonance imaging, to evaluate BBB leakage after an epileptogenic brain insult. Sprague-Dawley rats were scanned during early epileptogenesis initiated by status epilepticus. Positron emission tomography and single photon emission computed tomography scans were performed using the novel tracer [68Ga]DTPA or [99mTc]DTPA, respectively. Magnetic resonance imaging included T2 and post-contrast T1 sequence after infusion of Gd-DTPA, gadobutrol, or Gd-albumin. All modalities revealed increased blood-brain barrier permeability 48 h post status epilepticus, mainly in epileptogenesis-associated brain regions like hippocampus, piriform cortex, thalamus, or amygdala. In hippocampus, Gd-DTPA-enhanced T1 magnetic resonance imaging signal was increased by 199%, [68Ga]DTPA positron emission tomography by 37%, and [99mTc]DTPA single photon emission computed tomography by 56%. Imaging results were substantiated by histological detection of albumin extravasation. Comparison with quantitative positron emission tomography and single photon emission computed tomography shows that magnetic resonance imaging sequences successfully amplify the signal from a moderate amount of extravasated DTPA molecules, enabling sensitive detection of blood-brain barrier disturbance in epileptogenesis. Imaging of the disturbed blood-brain barrier will give further pathophysiologic insights, will help to stratify anti-epileptogenic treatment targeting blood-brain barrier integrity, and may serve as a prognostic biomarker.
authors.affiliation: 1 Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.|2 Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover and Center for Systems Neuroscience, Hannover, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Breuer
authors.affiliation: 3 Preclinical Imaging Labs, Central Laboratory Animal Facility & Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Meier
authors.affiliation: 1 Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Sophie
authors.initials: S
authors.lastname: Schneefeld
authors.affiliation: 4 Paul Flechsig Institute for Brain Research, University of Leipzig, Leipzig, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Härtig
authors.affiliation: 1 Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Wittneben
authors.affiliation: 4 Paul Flechsig Institute for Brain Research, University of Leipzig, Leipzig, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Märkel
authors.affiliation: 1 Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Tobias L
authors.initials: TL
authors.lastname: Ross
authors.affiliation: 1 Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Bengel
authors.affiliation: 2 Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover and Center for Systems Neuroscience, Hannover, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Bankstahl
authors.affiliation: 1 Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Jens P
authors.initials: JP
authors.lastname: Bankstahl
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019559:Capillary Leak Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D002199:Capillary Permeability / Q000502:physiology*; D004827:Epilepsy / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D008279:Magnetic Resonance Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D017207:Rats, Sprague-Dawley; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
keywords: Blood–brain barrier; epilepsy; imaging; magnetic resonance imaging; positron emission tomography