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A Commentary on Correlates Between Cerebrospinal Fluid γ-Globulins and Magnetic Resonance Imaging in Multiple Sclerosis

Robert W. Baumhefner, MD; Karl Syndulko, PhD; Wallace W. Tourtellotte, MD, PhD
Arch Neurol. 1990;47(8):841-842. doi:10.1001/archneur.1990.00530080023003
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To the Editor.  —The results of Müller et al1 in the April 1989 issue of the Archives, showing a significant correlation between cerebrospinal fluid γ-globulin (IgG) concentration and a nonparametric estimate of magnetic resonance imaging as well as slowed visual-evoked potentials, are in general agreement with our data despite significant differences in the methods employed.2-4 However, their conclusion that cerebrospinal fluid IgG primarily originates from periventricular lesions implies a less statistically significant correlation between the cerebrospinal fluid IgG concentration and their global magnetic resonance imaging score (not shown by their data), since inclusion of nonperiventricular plaque area should dilute the periventricular relationship. Second, their method for quantifying IgG in the cerebrospinal fluid and serum is not specific for IgG, but includes other proteins and is no longer used by advanced cerebrospinal fluid laboratories. Our laboratory measures IgG directly,5 utilizing monoclonal or affinity purified antibody to IgG heavy

REFERENCES

Müller FAJ, Hanny PE, Wichmann W, Fierz W, Dursteler MR.  Cerebrospinal fluid immunoglobulins and multiple sclerosis: correspondence with magnetic resonance imaging and visually evoked potential changes . Arch Neurol . 1989;;46:367-371.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Multiple sclerosis (MS): correlation of periventricular MRI-quantified lesion area with blood-brain-barrier (BBB) leakage, CSF IgG concentration, and intra-BBB IgG synthesis rate . Neurology 1989;;39:417.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Correlation of quantified magnetic resonance imaged plaque area with clinical disability, instrumented neurologic function measurement (QENF), evoked potentials, and intra-BBB IgG synthesis . Neurology . 1987;;37:231.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Size of multiple sclerosis (MS) plaque volume in cerebrum correlated directly with intra-BBB IgG synthesis rate in vivo . J Neuroimmunol . 1988;;17:253-254.
Tourtellotte WW, Baumhefner RW, Syndulko K, et al.  The long march of the cerebrospinal fluid profile indicative of clinical definite multiple sclerosis; and still marching . J Neuroimmunol . 1988;;20:217-227.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Quantitative multiple sclerosis plaque assessment with magnetic resonance imaging and its correlation with clinical parameters, evoked potentials, and intra-blood brain barrier IgG synthesis . Arch Neurol . 1990;;47:19-26.
Koopmans RA, Li DKB, Oger JJF, et al.  Chronic progressive multiple sclerosis: serial magnetic resonance brain imaging over 6 months . Ann Neurol . 1989;;26:248-256.
Prineas JW, Wright RG.  Macrophages, lymphocytes, and plasma cells in the perivascular compartment in chronic multiple sclerosis . Lab Invest . 1978;;38:409-421.
Tourtellotte WW.  The cerebrospinal fluid in multiple sclerosis . In: Vinken PJ, Bruyn GW, eds. Handbook of Clinical Neurology . Amsterdam the Netherlands: Elsevier Science Publishers; 1985;.

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Müller FAJ, Hanny PE, Wichmann W, Fierz W, Dursteler MR.  Cerebrospinal fluid immunoglobulins and multiple sclerosis: correspondence with magnetic resonance imaging and visually evoked potential changes . Arch Neurol . 1989;;46:367-371.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Multiple sclerosis (MS): correlation of periventricular MRI-quantified lesion area with blood-brain-barrier (BBB) leakage, CSF IgG concentration, and intra-BBB IgG synthesis rate . Neurology 1989;;39:417.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Correlation of quantified magnetic resonance imaged plaque area with clinical disability, instrumented neurologic function measurement (QENF), evoked potentials, and intra-BBB IgG synthesis . Neurology . 1987;;37:231.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Size of multiple sclerosis (MS) plaque volume in cerebrum correlated directly with intra-BBB IgG synthesis rate in vivo . J Neuroimmunol . 1988;;17:253-254.
Tourtellotte WW, Baumhefner RW, Syndulko K, et al.  The long march of the cerebrospinal fluid profile indicative of clinical definite multiple sclerosis; and still marching . J Neuroimmunol . 1988;;20:217-227.
Baumhefner RW, Tourtellotte WW, Syndulko K, et al.  Quantitative multiple sclerosis plaque assessment with magnetic resonance imaging and its correlation with clinical parameters, evoked potentials, and intra-blood brain barrier IgG synthesis . Arch Neurol . 1990;;47:19-26.
Koopmans RA, Li DKB, Oger JJF, et al.  Chronic progressive multiple sclerosis: serial magnetic resonance brain imaging over 6 months . Ann Neurol . 1989;;26:248-256.
Prineas JW, Wright RG.  Macrophages, lymphocytes, and plasma cells in the perivascular compartment in chronic multiple sclerosis . Lab Invest . 1978;;38:409-421.
Tourtellotte WW.  The cerebrospinal fluid in multiple sclerosis . In: Vinken PJ, Bruyn GW, eds. Handbook of Clinical Neurology . Amsterdam the Netherlands: Elsevier Science Publishers; 1985;.

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