Increased cerebrospinal fluid albumin and immunoglobulin A fractions forecast cortical atrophy and longitudinal functional deterioration in relapsing-remitting multiple sclerosis

Mult Scler. 2019 Mar;25(3):338-343. doi: 10.1177/1352458517748474. Epub 2017 Dec 11.


Background: Currently, no unequivocal predictors of disease evolution exist in patients with multiple sclerosis (MS). Cortical atrophy measurements are, however, closely associated with cumulative disability.

Objective: Here, we aim to forecast longitudinal magnetic resonance imaging (MRI)-driven cortical atrophy and clinical disability from cerebrospinal fluid (CSF) markers.

Methods: We analyzed CSF fractions of albumin and immunoglobulins (Ig) A, G, and M and their CSF to serum quotients.

Results: Widespread atrophy was highly associated with increased baseline CSF concentrations and quotients of albumin and IgA. Patients with increased CSFIgA and CSFIgM showed higher functional disability at follow-up.

Conclusion: CSF markers of blood-brain barrier integrity and specific immune response forecast emerging gray matter pathology and disease progression in MS.

Keywords: Multiple sclerosis; atrophy rate; cerebrospinal fluid albumin; cerebrospinal fluid immunoglobulins; cortical gray matter.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albumins / cerebrospinal fluid*
  • Atrophy / pathology
  • Biomarkers / cerebrospinal fluid
  • Cerebral Cortex / pathology*
  • Female
  • Humans
  • Immunoglobulin A / cerebrospinal fluid*
  • Longitudinal Studies
  • Male
  • Multiple Sclerosis, Relapsing-Remitting* / cerebrospinal fluid
  • Multiple Sclerosis, Relapsing-Remitting* / diagnosis
  • Multiple Sclerosis, Relapsing-Remitting* / pathology
  • Multiple Sclerosis, Relapsing-Remitting* / physiopathology
  • Prognosis
  • Young Adult


  • Albumins
  • Biomarkers
  • Immunoglobulin A