Blood-CSF barrier integrity in multiple sclerosis

Abstract

Introduction - In about 20% of MS patients an increased CSF/serum albumin quotient (Q_Alb) has been observed. The reason for this blood-CSF barrier dysfunction is yet unclear. Subjects and methods - Q_Alb values from 48 MS patients in relapse were correlated with parameters of active CNS lesions as measured by gadolinium-DTPA MRIs. Q_Alb values from 20 MS patients without relapse served as controls. Results - Mean Q_Alb values (×10³) 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; pAlb values of patients with a spinal lesion tended to decrease with increasing time intervals between onset of relapse and lumbar puncture. Conclusions - The data is in consent with the present knowledge on flow dynamics of both extracellular fluid and CSF. As a clinical consequence, increased Q_Alb values in MS patients may hint at an active spinal or, less likely, infratentorial lesion.