Abstract: Objective · To explore association between blood-brain barrier (BBB) permeability and physical disability in patients with neuromyelitis optica spectrum disorders (NMOSD). Methods · Clinical data of 105 patients with NMOSD was retrospectively analyzed in Department of Neurology at Changhai Hospital, Second Military Medical University and Renji Hospital, Shanghai Jiao Tong University School of Medicine June 2009 to June 2016. According to the difference between the expanded disability status scale (EDSS) scores when discharged hospital and when admitted to hospital, NMOSD patients were divided into disability-reduction group and disability-exacerbation group, and their clinical characteristics were compared between the two groups, then association between BBB permeability and physical disability was analyzed. Results · Between the disability-reduction group and the disability-exacerbation group, there was no significant difference in gender, age, disease duration, inducing factor, clinical symptoms, and medication (all P>0.05), and the abnormal rates of thoracic spinal cord in clinical examination were statistically different (P0.023). There was no significant difference in biochemical data between the two groups (P>0.05), and a statistically significant difference was observed in the rate of cerebrospinal/serum albumin ratio (QALB) in the cerebrospinal fluid examination (P0.042). The percentages of exacerbation of disability in the QALB normal and high groups were 27.60% (16/58) and 46.80% (22/47), respectively, and there was a statistically significant difference between the two groups (χ24.150, P0.042). BBB permeability was positively correlated with physical disability (r0.299, P0.042). Conclusion · The higher the BBB permeability of NMOSD patients on admission is, the higher the degree of physical disability is. The difference in BBB permeability provides key clues to the investigation of the immunological mechanisms of physical disability in NMOSD patients.

Key words: neural immune, neuromyelitis optica spectrum disorders, blood-brain barrier permeability, physical disability