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Blood-CSF barrier integrity in multiple sclerosis
R Liebsch1, M E Kornhuber, D Dietl
1Department of Neurology, Technische Universität München, Germany.
Introduction:
In about 20% of MS patients an increased CSF/serum albumin quotient (QAlb) has been observed. The reason for this blood-CSF barrier dysfunction is yet unclear.
Subjects And Methods:
QAlb values from 48 MS patients in relapse were correlated with parameters of active CNS lesions as measured by gadolinium-DTPA MRIs. QAlb values from 20 MS patients without relapse served as controls.
Results:
Mean QAlb values (x 10(3) of a group with spinal cord lesions (7.6 +/- 3.6; n = 16) differed significantly from those of a control group (4.6 +/- 1.5; n = 20; p < 0.005) as well as from those of a group with supratentorial lesions (5.0 +/- 1.8; n = 18; p < 0.05), and were higher than those of a group with infratentorial lesions (5.8 +/- 2.8; n = 14). QAlb values of patients with a spinal lesion tended to decrease with increasing time intervals between onset of relapse and lumbar puncture.
Conclusion:
The data is in consent with the present knowledge on flow dynamics of both extracellular fluid and CSF. As a clinical consequence, increased QAlb values in MS patients may hint at an active spinal or, less likely, infratentorial lesion.