Blood–brain barrier alterations in both focal and diffuse abnormalities on postmortem MRI in multiple sclerosis
Open accessAbstract
Postmortem MRI-guided tissue sampling significantly enhances the yield of MS lesions in autopsy material, but so far it is unknown whether abnormalities concur with blood-brain barrier alterations. Here we sampled MS lesions with focal and diffuse abnormalities (diffusely abnormal white matter; DAWM) on MRI; both were coupled to the presence of MS lesions upon neuropathological examination. Extravascular distribution of fibrinogen, indicating BBB disturbance, was observed in so-called (p)reactive lesions that reflect discrete areas of microglial activation without demyelination within an otherwise normal appearing white matter. Leakage became more extensive in active demyelinating MS lesions to chronic inactive lesions. An enlargement of the perivascular (Virchow-Robin) space containing infiltrated leukocytes was associated with both DAWM and focal abnormalities on postmortem MRI. This study shows for the first time that in MS brain changes in the vasculature take place not only in focal lesions but also in DAWM as detected by postmortem MRI.
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MRI changes suggestive of blood-brain barrier disruption were found in normally appearing white matter before enhancing lesions and in nonenhancing areas.
“Furthermore, MRI changes suggestive of BBB disruption were also found in normally appearing white matter before enhancing lesions (176), and in nonenhancing areas (626)”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [626]
Fibrinogen perivascular deposition occurs in developing multiple sclerosis lesions.
“This is supported by evidence of fibrinogen perivascular deposition in the developing lesions (317, 626).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [626]
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Multiple Sclerosis and the Blood-Central Nervous System Barrier
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- Authors
- Vos, C. M. P., Geurts, J. J. G., Montagne, L., van Haastert, E. S., Bö, L., van der Valk, P., Barkhof, F., & de Vries, H. E.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- Neurobiology of Disease
- Publisher
- Elsevier BV
- Published
- 2005-12
- Volume
- 20
- Issue
- 3
- Pages
- 953-960
- ISSN
- 0969-9961 (ISSN-L)
- OpenAlex
- W2065524737
- Cited by
- 188
- References
- 35
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 7 · 2023: 10 · 2022: 12 · 2021: 20 · 2020: 15 · 2019: 7 · 2018: 11 · 2017: 6 · 2016: 6 · 2015: 10 · 2014: 7 · 2013: 7 · 2012: 10
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- green
- research.vumc.nl
- Licence
- Locations
- Neurobiology of Disease (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Stichting MS Research
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- multiple sclerosis, blood-brain barrier, postmortem MRI, reactive lesion, demyelinating lesions, perivascular spaces, leukocyte infiltration, microglial activation
- MeSH terms
- Aged, Aged, 80 and over, Autopsy, Blood-Brain Barrier, Brain, Cerebral Arteries, Chemotaxis, Leukocyte, Extracellular Space, Fibrinogen, Gliosis, Humans, Leukocytes, Magnetic Resonance Imaging, Microcirculation, Middle Aged, Multiple Sclerosis, Nerve Fibers, Myelinated, Postmortem Changes, Microglia
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