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Oligoclonal bands and periventricular lesions in multiple sclerosis will not increase blood-brain barrier

Tetsuya Akaishi1, Toshiyuki Takahashi1, Ichiro Nakashima2

  • 1Department of Neurology, Tohoku University Graduate School of Medicine, Japan; Department of Neurology, National Hospital Organization Yonezawa Hospital, Japan.

Journal of the Neurological Sciences
|March 25, 2018
PubMed
Abstract

Insights

Oligoclonal bands (OB) and periventricular lesions (PVLs) in multiple sclerosis (MS) are linked but do not worsen clinical outcomes or blood-brain barrier permeability. However, more PVLs correlate with faster brain atrophy.

Area of Science:

  • Neuroimmunology
  • Neurology
  • Radiology

Background:

  • Periventricular lesions (PVLs) and oligoclonal bands (OB) are common findings in multiple sclerosis (MS).
  • The precise etiological and clinical significance of these markers in MS remains an area of active investigation.
  • Understanding their relationship is crucial for prognostic assessments and therapeutic strategies.

Purpose of the Study:

  • To investigate the association between periventricular lesions (PVLs) and oligoclonal bands (OB) in multiple sclerosis (MS).
  • To determine the clinical significance of PVLs and OB regarding disease severity, relapse rates, and cerebral atrophy.
  • To explore the impact of PVLs and OB on blood-brain barrier (BBB) permeability using biomarkers like the albumin quotient (QAlb).

Main Methods:

  • A cohort of 97 MS patients, negative for anti-aquaporin-4 (AQP4) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, were analyzed.
  • Data collected included clinical information, laboratory results, and magnetic resonance imaging (MRI) findings.
  • Statistical analyses were performed to correlate OB status and the number of PVLs with clinical and MRI parameters, including QAlb and cerebrospinal fluid (CSF) protein levels.

Main Results:

  • A significant association was found between OB-positivity and the number of PVLs in MS patients.
  • Neither OB-positivity nor the presence of PVLs directly impacted clinical severity or relapse rates.
  • Patients with three or more PVLs exhibited accelerated cerebral atrophy compared to those with fewer than three PVLs.
  • Patients with OB or three or more PVLs demonstrated lower QAlb values and CSF protein levels, suggesting potential alterations in BBB function or disease activity, though causality was not established.

Conclusions:

  • Oligoclonal bands and periventricular lesions are associated in multiple sclerosis.
  • These markers do not appear to influence the clinical course or increase blood-brain barrier permeability in the studied MS cohort.
  • The number of PVLs may be a predictor of cerebral atrophy progression in MS.
Keywords:
Barkhof's criteriaBlood-brain barrierMultiple sclerosisOligoclonal bandsPeriventricular lesions

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