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Blood-brain barrier impairment is functionally correlated with clinical severity in patients of multiple system atrophy

 Sook K. Song  ;  Seung-Koo Lee  ;  Jae Jung Lee  ;  Ji E. Lee  ;  Hyun Seok Choi  ;  Young H. Sohn  ;  Phil Hyu Lee 
 NEUROBIOLOGY OF AGING, Vol.32(12) : 2183-2189, 2011 
Journal Title
Issue Date
Aged ; Blood-Brain Barrier/pathology* ; Blood-Brain Barrier/physiology* ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Multiple System Atrophy/cerebrospinal fluid* ; Multiple System Atrophy/pathology* ; Prospective Studies ; Severity of Illness Index*
Blood–brain barrier impairment ; Multiple system atrophy ; Dynamic contrast-enhanced MRI
Multiple system atrophy (MSA) has been regarded as a unique entity within the spectrum of oligodendrogliopathy. However, the pathomechanisms underlying the initial trigger and aggravating factors responsible for disease progression remain unknown. Even though the implication of blood-brain barrier (BBB) dysfunction has not been fully elucidated, this dysfunction may act as a modifier of disease progression in neurodegenerative disease. We evaluated the integrity of the BBB and its functional significance in patients with MSA using the CSF/serum albumin index (CSF-AI) and the volume transfer coefficient (K(trans)) in dynamic contrast-enhanced MRI (DCE-MRI). CSF-AI and K(trans) values increased significantly in patients with MSA compared to the control (5.1 μg vs 3.6 μg, p=0.02; 0.16/mim(-1) vs 0.05/mim(-1), p=0.001, respectively). There were positive relationships between both CSF-AI and K(trans) and unified MSA rating scale (UMSARS). K(trans) in the periventricular white matter was significantly correlated with the volume of white matter hyperintensities among all subjects (r=0.58, p=0.001) and within patients with MSA (r=0.58, p=0.019), but not within controls (r=0.42, p>0.05). In addition, a significant positive correlation was detected between CSF-AI and K(trans) (r=0.81, p=0.002). Multiple linear regression analysis showed that only UMSARS score was a significantly independent predisposing factor for CSF-AI (β=0.193, p=0.04). Our data suggest that BBB dysfunction is related to the underlying nature of MSA and its dysfunction is closely coupled to disease severity
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Song, Sook Keun(송숙근)
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Lee, Ji Eun(이지은)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Choi, Hyun Seok(최현석)
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