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In vivo imaging methods, particularly translocator protein positron emission tomography (TSPO-PET) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), have advanced our understanding of glial activation and BBB permeability in conditions such as Alzheimer\u2019s disease, Parkinson\u2019s disease, epilepsy, multiple sclerosis, Huntington\u2019s disease, schizophrenia, and depression. We present key findings from the clinical application of these imaging modalities and highlight critical methodological challenges\u2014including variability in study protocols, tracer selection, input function derivation, and parameter estimation\u2014that currently limit cross-study comparability and clinical translation. TSPO-PET and DCE-MRI provide valuable clinical insights on the inflammatory mechanisms contributing to CNS disease at various disease stages. Future methodological standardization, co-localization studies, and longitudinal multi-modal applications will be crucial for using these tools as markers of disease in the context of immune interventions in at-risk populations.<\/jats:p>","DOI":"10.1186\/s12974-025-03598-x","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T10:22:39Z","timestamp":1763547759000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Imaging brain inflammation and blood brain barrier permeability in neurological and psychiatric diseases: a review"],"prefix":"10.1186","volume":"22","author":[{"given":"Zanetta","family":"Kovbasyuk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eden","family":"Tefera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven H.","family":"Baete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude","family":"Steriade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"issue":"7","key":"3598_CR1","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1080\/00207454.2016.1212854","volume":"127","author":"T Shabab","year":"2017","unstructured":"Shabab T, Khanabdali R, Moghadamtousi SZ, Kadir HA, Mohan G. 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All participants provided written informed consent. Study protocols and consent forms were approved by New York University School of Medicine Institutional Review Board. All procedures were conducted in accordance with the ethical standards of the New York University School of Medicine and with the 1964 Helsinki Declaration and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Claude Steriade reported salary support from the Epilepsy Study Consortium given to New York University for work provided to Biohaven Pharmaceuticals, Cerevel, Longboard Pharmaceuticals, Marinus, Neurocrine, Ono Pharmaceutical Co., Praxis, SK Life Sciences, Supernus, UCB Inc, uniQure, Xenon Pharmaceuticals as well as grants from National Institute of Neurological Disorders and Stroke and American Epilepsy Society, consulting fees from Jazz Pharmaceuticals, Xenon Pharmaceuticals, Dynamed, and the Department of Justice, and speaker\u2019s bureau fees from SK Life Sciences and Neurelis outside the submitted work.Steven Baete reports equity ownership of Magnitend, IP, and a research grant from Q-Bio unrelated to the submitted work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"275"}}