Blood-brain barrier impairment is functionally correlated with clinical severity in patients of multiple system atrophy
Blood-brain barrier impairment is functionally correlated with clinical severity in patients of multiple system atrophy
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DOI：
10.1016/j.neurobiolaging.2009.12.017
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发表时间：
2011-12-01
影响因子：
4.2
通讯作者：
Lee, Phil Hyu
中科院分区：
文献类型：
--
作者：
Song, Sook K.;Lee, Seung-Koo;Lee, Phil Hyu
多系统萎缩（MSA）被认为是少突神经胶质病谱系中的一个独特实体。然而，导致疾病进展的最初触发因素和加重因素的病理机制仍然未知。尽管血脑屏障（BBB）功能障碍的影响尚未完全阐明，但这种功能障碍可能作为神经退行性疾病疾病进展的调节剂。我们使用脑脊液/血清白蛋白指数 (CSF-AI) 和动态对比增强 MRI (DCE-MRI) 中的体积转移系数 (K-trans) 评估了 MSA 患者 BBB 的完整性及其功能意义。与对照组相比，MSA 患者的 CSF-AI 和 K-trans 值显着增加（分别为 5.1 μg vs 3.6 μg，p = 0.02；0.16/mim(-1) vs 0.05/mim(-1)，p = 0.001）。 CSF-AI 和 K-trans 与统一 MSA 评分量表 (UMSARS) 之间存在正相关关系。在所有受试者中（r = 0.58，p = 0.001）和 MSA 患者中（r = 0.58，p = 0.019），脑室周围白质中的 K-trans 与白质高信号体积显着相关，但在对照组中则不然（r = 0.42，p > 0.05）。此外，CSF-AI 和 K-trans 之间检测到显着的正相关（r = 0.81，p = 0.002）。多元线性回归分析显示，仅UMSARS评分是CSF-AI的显着独立诱发因素（β = 0.193，p = 0.04）。我们的数据表明，BBB 功能障碍与 MSA 的根本性质有关，其功能障碍与疾病严重程度密切相关。 (C) 2010 Elsevier Inc. 保留所有权利。
Multiple system atrophy (MSA) has been regarded as a unique entity within the spectrum of oligodendrogliopathy. However, the pathomechanisms underlying the initial trigger and aggravating factors responsible for disease progression remain unknown. Even though the implication of blood-brain barrier (BBB) dysfunction has not been fully elucidated, this dysfunction may act as a modifier of disease progression in neurodegenerative disease. We evaluated the integrity of the BBB and its functional significance in patients with MSA using the CSF/serum albumin index (CSF-AI) and the volume transfer coefficient (K-trans) in dynamic contrast-enhanced MRI (DCE-MRI). CSF-AI and K-trans values increased significantly in patients with MSA compared to the control (5.1 mu g vs 3.6 mu g, p = 0.02; 0.16/mim(-1) vs 0.05/mim(-1), p = 0.001, respectively). There were positive relationships between both CSF-AI and K-trans and unified MSA rating scale (UMSARS). K-trans in the periventricular white matter was significantly correlated with the volume of white matter hyperintensities among all subjects (r = 0.58, p = 0.001) and within patients with MSA (r = 0.58, p = 0.019), but not within controls (r = 0.42, p > 0.05). In addition, a significant positive correlation was detected between CSF-AI and K-trans (r = 0.81, p = 0.002). Multiple linear regression analysis showed that only UMSARS score was a significantly independent predisposing factor for CSF-AI (beta = 0.193, p = 0.04). Our data suggest that BBB dysfunction is related to the underlying nature of MSA and its dysfunction is closely coupled to disease severity. (C) 2010 Elsevier Inc. All rights reserved.