Changes in the blood-brain barrier status closely correlate with the rate of disease progression in patients with multiple system atrophy: A longitudinal study

Background: The pathomechanisms responsible for disease progression in multiple system atrophy are unknown. The blood brain barrier status may act as a modifier of disease progression in neurodegenerative diseases. Methods: We evaluated the 12-month longitudinal change of the blood brain barrier in 16 multiple system atrophy patients and analyzed its correlation with changes in clinical severity. Results: The baseline blood brain barrier index did not correlate significantly with change in disease severity. However, changes in the blood brain barrier indices over 12 months had significant positive correlations with changes in total unified multiple system atrophy rating scale (r = 0.56, p = 0.024) and part II scores (r = 0.56, p = 0.025). These correlation coefficients were higher after adjusting for baseline neurological deficits. Conclusions: These data suggest that changes in the blood brain barrier status are closely coupled with the rate of disease progression in multiple system atrophy, potentially acting as a contributor to disease progression. (C) 2012 Elsevier Ltd. All rights reserved.