title: Investigation of cerebral microbleeds in multiple sclerosis as a potential marker of blood-brain barrier dysfunction.
abstract: OBJECTIVE
  In multiple sclerosis (MS) lesions blood-brain-barrier (BBB) breakdown is a common phenomenon delineating the phase of focal inflammation in developing MS lesions. In other pathologies like cerebral amyloid angiopathy or arteriosclerotic cerebral small vessel disease permanent cerebral microbleeds (CMB) have been shown to be sensitive markers indicating BBB dysfunction. We were interested in the potential role of T(2)*-weighted MRI and CMBs as BBB integrity markers in MS.
  
  
  METHODS
  A large cohort of 189 MS patients (179 relapsing remitting MS and 10 secondary progressive MS) was investigated on a 3T MRI system with conventional and T(2)*-weighted gradient echo MRI (T(2)*w) sequences. T(2)*w images were analysed for CMBs by experienced raters.
  
  
  RESULTS
  None of the MS patients showed a CMB.
  
  
  CONCLUSIONS
  On T(2)*w MRI the prevalence of CMBs is not higher in MS patients than what is to be expected in young healthy people. In contrast to pathologies with structural vascular changes like small vessel disease or cerebral amyloid angiopathy, CMBs are not seen in MS where the immune reaction is causing a functional change in the BBB.
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: eisele@neuro.ma.uni-heidelberg.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Eisele
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: alonso@neuro.ma.uni-heidelberg.de.
authors.forename: Angelika
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: griebe@neuro.ma.uni-heidelberg.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Griebe
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: szabo@neuro.ma.uni-heidelberg.de.
authors.forename: Kristina
authors.initials: K
authors.lastname: Szabo
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: hennerici@neuro.ma.uni-heidelberg.de.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hennerici
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: achim.gass@medma.uni-heidelberg.de.
authors.forename: Achim
authors.initials: A
authors.lastname: Gass
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
keywords: Blood-brain-barrier; MRI; Microbleeds; Multiple sclerosis; Small vessel disease; White matter lesions