caa a22 4500 445808462 CHVBK 20180317145204.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00415-011-6086-x doi (NATIONALLICENCE)springer-10.1007/s00415-011-6086-x Cerebrospinal fluid/serum gradient of IgG is associated with disability at acute attacks of neuromyelitis optica [Elektronische Daten] [Sung-Min Kim, Patrick Waters, Angela Vincent, Min Go, Kyung Park, Jung-Joon Sung, Kwang-Woo Lee] Increased blood-brain barrier (BBB) disruption can be found in patients with neuromyelitis optica (NMO); however, its clinical implication and association with disability at acute attack remains obscure. The purpose of the study was to evaluate the clinical significance of BBB disruption and the subsequent cerebrospinal fluid (CSF)/serum IgG gradient in NMO. Retrospective analysis was made of acute-stage CSF samples from NMO (n=40) and multiple sclerosis (MS; n=26) patients. The CSF/serum IgG gradient (QIgG), albumin ratio (Qalb), and IgG index were calculated. Multivariate regression analysis was used to identify clinical and CSF variables associated with disability at acute attacks (extended disability scale score, EDSS) in both groups. The EDSS was significantly associated with the QIgG (p<0.001), Qalb (p=0.012), and number of cumulative attacks (p=0.012) in NMO but not in MS with univariate analysis. Length of spinal cord involvement was also associated with EDSS in NMO (p=0.030). However, multivariate analysis revealed that the QIgG was only significantly associated with EDSS in NMO (0.580; 95% CI −0.257, 0.961; p=0.002). The QIgG was also highly associated with the Qalb in NMO (p<0.001). The QIgG may reflect systemic IgG leakage into the CNS and is strongly associated with disability at acute attacks in NMO, suggesting that BBB disruption can aggravate disease activity by facilitating systemic IgG infiltration into the CNS. Springer-Verlag, 2011 Neuromyelitis optica nationallicence Multiple sclerosis nationallicence Albumin ratio nationallicence Cerebrospinal fluid nationallicence Blood-brain barrier nationallicence Kim Sung-Min Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut Waters Patrick Neuroscience Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK aut Vincent Angela Neuroscience Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK aut Go Min Center for Genome Science, Korea National Institute of Health, Osong, Korea aut Park Kyung Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut Sung Jung-Joon Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut Lee Kwang-Woo Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut Journal of Neurology Springer-Verlag 258/12(2011-12-01), 2176-2180 0340-5354 258:12<2176 2011 258 415 https://doi.org/10.1007/s00415-011-6086-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-6086-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Sung-Min Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut NATIONALLICENCE 700 1- Waters Patrick Neuroscience Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK aut NATIONALLICENCE 700 1- Vincent Angela Neuroscience Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK aut NATIONALLICENCE 700 1- Go Min Center for Genome Science, Korea National Institute of Health, Osong, Korea aut NATIONALLICENCE 700 1- Park Kyung Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut NATIONALLICENCE 700 1- Sung Jung-Joon Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Kwang-Woo Department of Neurology, College of Medicine, Seoul National University, 28 Yon-Gun Dong, Chong-Ro, Seoul, Korea aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/12(2011-12-01), 2176-2180 0340-5354 258:12<2176 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer