Cramer S P, Simonsen H, Frederiksen J L, Rostrup E, Larsson H B W
Functional Imaging Unit, Dept. of Diagnostics, Glostrup Hospital, University of Copenhagen, Denmark ; Dept. of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.
Functional Imaging Unit, Dept. of Diagnostics, Glostrup Hospital, University of Copenhagen, Denmark.
Neuroimage Clin. 2013 Dec 10;4:182-9. doi: 10.1016/j.nicl.2013.12.001. eCollection 2014.
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 K(trans) 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.
与健康对照相比，研究多发性硬化症（MS）患者正常外观白质中的血脑屏障（BBB）通透性是否被破坏，以及它是否与MS临床特征相关。
采用动态对比增强MRI测量27例MS患者的BBB通透性，并与24例匹配的健康对照进行比较。
与健康对照相比，MS患者脑室周围正常外观白质（NAWM）和丘脑灰质中以K（trans）衡量的通透性显著更高，脑室周围NAWM表现出最明显的差异。近期复发与脑室周围NAWM、丘脑灰质和MS病灶中显著更高的通透性一致。免疫调节治疗和近期复发是MS病灶和脑室周围NAWM通透性的显著预测因素。我们的结果表明，MS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，我们发现在脑室周围NAWM中最为突出，该区域易于发生MS病灶。近期复发似乎会导致广泛的BBB破坏以及免疫调节治疗似乎会减弱这种效应这两个事实均表明，BBB通透性与MS复发活动的存在密切相关。这可能会揭示对MS病理生理学的进一步见解。
