title: Breakdown of the blood-brain barrier precedes symptoms and other MRI signs of new lesions in multiple sclerosis. Pathogenetic and clinical implications.
abstract: From an extensive serial magnetic resonance imaging (MRI) study in multiple sclerosis (MS) we have identified 4 cases in which disruption of the blood-brain barrier, as detected by gadolinium-DTPA enhancement, preceded other MRI abnormalities and in 1 case clinical evidence of the new lesion. This supports the view that a defect in the blood-brain barrier, and therefore inflammation, is an early and possibly crucial event in the pathogenesis of the new lesion in MS. These cases showed a marked discrepancy between MRI abnormality and symptoms. The mechanisms contributing to this disparity are discussed, and it is concluded that far from being surprising it is to be expected.
authors: Multiple Sclerosis NMR Research Group, Institute of Neurology, London, UK.
authors: A G
authors: AG
authors: Kermode
authors: A J
authors: AJ
authors: Thompson
authors: P
authors: P
authors: Tofts
authors: D G
authors: DG
authors: MacManus
authors: B E
authors: BE
authors: Kendall
authors: D P
authors: DP
authors: Kingsley
authors: I F
authors: IF
authors: Moseley
authors: P
authors: P
authors: Rudge
authors: W I
authors: WI
authors: McDonald
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier; D001921:Brain / Q000473:pathology; D003287:Contrast Media; D004185:Disability Evaluation; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D009942:Organometallic Compounds; D004369:Pentetic Acid
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA