Permeability of the blood-brain barrier may provide prognostic information for later multiple sclerosis in patients with optic neuritis, according to Dr. Stig P. Cramer of Rigshospitalet in Glostrup, Denmark.
In a study of 39 patients with monosymptomatic optic neuritis and 18 controls, investigators used dynamic contrast-enhanced MRI to measure blood-brain barrier permeability. MRI and lumbar puncture were performed within 4 weeks of onset, and information on multiple sclerosis (MS) conversion was acquired from hospital records 2 years later.
A multivariate logistic regression analysis found that baseline white matter permeability significantly improved prediction of MS, compared with T2 lesion count alone (P = .007). A receiver operating characteristic curve analysis of permeability in normal-appearing white matter gave a cut-off of 0.13 mL/100 g per min, which predicted conversion to MS with a sensitivity of 88% and specificity of 72%, the authors reported (Brain 2015:138;2571-83).
The findings suggest that “a new marker of low-grade multiple sclerosis disease activity could have many useful applications, i.e. subclinical disease activity monitoring or identification of inadequate treatment response before the next relapse occurs,” Dr. Cramer and his colleagues wrote.
“Quantification of [blood-brain barrier] permeability may constitute an early prognostic factor in the pathogenesis of multiple sclerosis,” they added.
The Research Foundation of the Capital Region of Denmark, Foundation for Health Research, Biogen Idec, and the Danish Multiple Sclerosis Society funded the work.
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