Blood-CSF barrier integrity in multiple sclerosis.

INTRODUCTION

In about 20% of MS patients an increased CSF/serum albumin quotient (QAlb) has been observed. The reason for this blood-CSF barrier dysfunction is yet unclear.

SUBJECTS AND

METHODS

QAlb values from 48 MS patients in relapse were correlated with parameters of active CNS lesions as measured by gadolinium-DTPA MRIs. QAlb values from 20 MS patients without relapse served as controls.

RESULTS

Mean QAlb values (x 10(3) 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; p < 0.005) as well as from those of a group with supratentorial lesions (5.0 +/- 1.8; n = 18; p < 0.05), and were higher than those of a group with infratentorial lesions (5.8 +/- 2.8; n = 14). QAlb values of patients with a spinal lesion tended to decrease with increasing time intervals between onset of relapse and lumbar puncture.

CONCLUSION

The data is in consent with the present knowledge on flow dynamics of both extracellular fluid and CSF. As a clinical consequence, increased QAlb values in MS patients may hint at an active spinal or, less likely, infratentorial lesion.