Investigation of cerebral microbleeds in multiple sclerosis as a potential marker of blood-brain barrier dysfunction

Mult Scler Relat Disord. 2016 May;7:61-4. doi: 10.1016/j.msard.2016.03.010. Epub 2016 Mar 21.


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.

Conclusion: 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.

Keywords: Blood-brain-barrier; MRI; Microbleeds; Multiple sclerosis; Small vessel disease; White matter lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood-Brain Barrier / diagnostic imaging*
  • Blood-Brain Barrier / physiopathology
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / diagnostic imaging*
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / physiopathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis, Chronic Progressive / complications
  • Multiple Sclerosis, Chronic Progressive / diagnostic imaging*
  • Multiple Sclerosis, Chronic Progressive / epidemiology
  • Multiple Sclerosis, Chronic Progressive / physiopathology
  • Multiple Sclerosis, Relapsing-Remitting / complications
  • Multiple Sclerosis, Relapsing-Remitting / diagnostic imaging*
  • Multiple Sclerosis, Relapsing-Remitting / epidemiology
  • Multiple Sclerosis, Relapsing-Remitting / physiopathology
  • Prevalence
  • Prospective Studies
  • Young Adult