Blood-brain barrier dysfunction in cerebral amyloid angiopathy is associated with disseminated cortical superficial siderosis

The study examined blood-brain barrier (BBB) dysfunction in 225 participants, including 115 with cerebral amyloid angiopathy (CAA), 72 with Alzheimer's disease, and 38 healthy controls. Researchers measured cerebrospinal fluid to serum albumin quotient (QAlb) levels as a marker of BBB dysfunction. QAlb levels were significantly higher in CAA patients compared to controls (1.43-fold higher) and Alzheimer's disease patients (1.22-fold higher). Within the CAA group, pathological QAlb levels were independently associated with disseminated cortical superficial siderosis, a marker of advanced hemorrhage-prone disease. The findings suggest that neurovascular barrier dysfunction is associated with the hemorrhage-prone phenotype of CAA and may help identify patients at risk for future intracerebral hemorrhage.