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Mult Scler. 2019 Mar;25(3):338-343. doi: 10.1177/1352458517748474. Epub 2017 Dec 11.

Increased cerebrospinal fluid albumin and immunoglobulin A fractions forecast cortical atrophy and longitudinal functional deterioration in relapsing-remitting multiple sclerosis.

Author information

1
Department of Neurology, Focus Program Translational Neuroscience (FTN), Research Center for Immunology (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
2
Department of Neurology, Focus Program Translational Neuroscience (FTN), Research Center for Immunology (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany/Department of Neurology, Institute of Emergency Medicine, Laboratory of Neurobiology and Medical Genetics, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova.
3
Department of Neurology, University of Munster, Munster, Germany.

Abstract

BACKGROUND:

Currently, no unequivocal predictors of disease evolution exist in patients with multiple sclerosis (MS). Cortical atrophy measurements are, however, closely associated with cumulative disability.

OBJECTIVE:

Here, we aim to forecast longitudinal magnetic resonance imaging (MRI)-driven cortical atrophy and clinical disability from cerebrospinal fluid (CSF) markers.

METHODS:

We analyzed CSF fractions of albumin and immunoglobulins (Ig) A, G, and M and their CSF to serum quotients.

RESULTS:

Widespread atrophy was highly associated with increased baseline CSF concentrations and quotients of albumin and IgA. Patients with increased CSFIgA and CSFIgM showed higher functional disability at follow-up.

CONCLUSION:

CSF markers of blood-brain barrier integrity and specific immune response forecast emerging gray matter pathology and disease progression in MS.

KEYWORDS:

Multiple sclerosis; atrophy rate; cerebrospinal fluid albumin; cerebrospinal fluid immunoglobulins; cortical gray matter

PMID:
29226779
DOI:
10.1177/1352458517748474

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