Blood-CSF barrier integrity in multiple sclerosis

In about 20% of MS patients an increased CSF/serum albumin quotient (Q(Alb)) has been observed. The reason for this blood-CSF barrier dysfunction is yet unclear. Subjects and methods -Q(Alb) values from 48 MS patients in relapse were correlated with parameters of active CNS lesions as measured by gadolinium-DTPA MRIs. Q(Alb) values from 20 MS patients without relapse served as controls. Results - Mean Q(Alb) values (x10(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). Q(Alb) values of patients with a spinal lesion tended to decrease with increasing time intervals between onset of relapse and lumbar puncture. Conclusions - The data is in consent with the present knowledge on now dynamics of both extracellular fluid and CSF. As a clinical consequence, increased Q(Alb) values in MS patients may hint at an active spinal or, less likely, infratentorial lesion.