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Journal of Neurology

, Volume 265, Issue 4, pp 966–967 | Cite as

The cortical blood–brain barrier in multiple sclerosis: a gateway to progression?

  • Jack S. Bell
  • Jonathan I. Spencer
  • Richard L. Yates
  • Gabriele C. DeLuca
Letter to the Editors

Dear Sirs,

Despite the historical focus on white matter pathology, it is now increasingly recognised that cortical tissue injury is critical to disease outcome. Cortical pathology occurs from the earliest disease stages, predominates in progressive MS, and correlates with physical and cognitive disability [1]. However, our understanding of disease processes operative in the MS cortex remains poor and, in particular, the contribution of BBB dysfunction has been relatively overlooked. A recent radiological study and pathological findings from our group make steps to address these shortcomings and provide fresh insight into the role of BBB dysfunction in cortical pathology.

Maranzano et al. undertook a retrospective analysis of serial MRI scans from an early MS cohort. Over a 2-year period, 36% of MS patients had cortical gadolinium (Gd)-enhancing lesions, of which 95% were leukocortical [2]. While MRI studies are limited in their ability to detect cortical lesions, these findings...

Notes

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

Ethical standard statement

For this type of study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jack S. Bell
    • 1
  • Jonathan I. Spencer
    • 1
  • Richard L. Yates
    • 1
    • 2
  • Gabriele C. DeLuca
    • 2
  1. 1.University of Oxford Medical School, Level 2 Academic CentreJohn Radcliffe HospitalOxfordUK
  2. 2.Nuffield Department of Clinical Neurosciences, Level 1 West WingJohn Radcliffe HospitalOxfordUK

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