Abnormal blood-brain barrier permeability in normal appearing white matter in multiple sclerosis investigated by MRI.
Abnormal blood-brain barrier permeability in normal appearing white matter in multiple sclerosis investigated by MRI.
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DOI：
10.1016/j.nicl.2013.12.001
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发表时间：
2014
影响因子：
4.2
通讯作者：
Larsson, H. B. W.
中科院分区：
文献类型：
--
作者：
Cramer, S. P.;Simonsen, H.;Frederiksen, J. L.;Rostrup, E.;Larsson, H. B. W.
旨在研究与健康对照相比，多发性硬化症患者的正常白质中血脑屏障 (BBB) 通透性是否受到破坏，以及其是否与多发性硬化症临床特征相关。使用动态对比增强 MRI 测量 27 名 MS 患者的血脑屏障通透性，并与 24 名匹配的健康对照者进行比较。与健康对照相比，多发性硬化症患者的脑室周围正常白质 (NAWM) 和丘脑灰质的通透性（以 Ktrans 测量）显着较高，其中脑室周围 NAWM 显示出最明显的差异。最近的复发与脑室周围 NAWM、丘脑灰质和 MS 病变的通透性显着升高同时发生。免疫调节治疗和近期复发是 MS 病变和脑室周围 NAWM 通透性的重要预测因素。我们的结果表明，多发性硬化症复发后，通透性逐渐降低，这可能是免疫调节治疗的作用。我们的结果强调了 BBB 病理学在 MS 中的重要性，我们发现 BBB 病理在脑室周围 NAWM 中最为突出，这是一个容易发生 MS 病变的区域。最近的复发似乎会导致广泛的 BBB 破坏，而免疫调节治疗似乎会减弱这种影响，这两个事实都表明 BBB 通透性与 MS 复发活动的存在有着复杂的联系。这可能进一步揭示多发性硬化症的病理生理学。与对照组相比，MS 正常白质的 BBB 通透性更高。 BBB 通透性与临床 MS 复发后的天数相关。 BBB 通透性似乎受到治疗的影响。我们提出 BBB 缺陷在 MS 病因学中发挥更重要的作用。
To investigate whether blood–brain barrier (BBB) permeability is disrupted in normal appearing white matter in MS patients, when compared to healthy controls and whether it is correlated with MS clinical characteristics. Dynamic contrast-enhanced MRI was used to measure BBB permeability in 27 patients with MS and compared to 24 matched healthy controls. Permeability measured as Ktrans was significantly higher in periventricular normal appearing white matter (NAWM) and thalamic gray matter in MS patients when compared to healthy controls, with periventricular NAWM showing the most pronounced difference. Recent relapse coincided with significantly higher permeability in periventricular NAWM, thalamic gray matter, and MS lesions. Immunomodulatory treatment and recent relapse were significant predictors of permeability in MS lesions and periventricular NAWM. Our results suggest that after an MS relapse permeability gradually decreases, possibly an effect of immunomodulatory treatment. Our results emphasize the importance of BBB pathology in MS, which we find to be most prominent in the periventricular NAWM, an area prone to development of MS lesions. Both the facts that recent relapse appears to cause widespread BBB disruption and that immunomodulatory treatment seems to attenuate this effect indicate that BBB permeability is intricately linked to the presence of MS relapse activity. This may reveal further insights into the pathophysiology of MS. BBB permeability is higher in MS Normal Appearing White matter compared to controls. BBB permeability is correlated with the number of days since clinical MS relapse. BBB permeability seems to be affected by treatment. We propose a more central role of BBB defects in the etiology of MS.
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