McLean B N, Zeman A Z, Barnes D, Thompson E J
Department of Neurology, National Hospitals for Neurology and Neurosurgery, London.
J Neurol Neurosurg Psychiatry. 1993 Apr;56(4):356-60. doi: 10.1136/jnnp.56.4.356.
Seventy four patients with clinically definite multiple sclerosis were studied by using polyacrylamide gel electrophoresis of cerebrospinal fluid to assess blood-brain barrier function. Blood-brain barrier impairment was associated with recent clinical relapses of multiple sclerosis and worsened across a spectrum from the relapsing-remitting type of multiple sclerosis to secondary and primary progressive disease. The association between blood-brain barrier impairment and primary progressive disease is particularly interesting in the light of recent evidence that focal gadolinium enhancement on MRI is relatively unusual in patients with this disease.