Abstract
Oligoclonal IgG bands (OCB) in cerebrospinal fluid (CSF) are important in diagnosis of multiple sclerosis (MS). We evaluated the MRI features of clinically definite MS subjects with and without CSF-OCB. Relapsing MS subjects were recruited from a prospective registry in a university center. CSF-OCB were detected using isoelectric focusing and lgG-specific immunofixation. MRI metrics including brain volumes, lesion volumes and microstructural measures, were analyzed by FMRIB Software Library (FSL) and Statistical Parametric Mapping (SPM). Seventy-five subjects with relapsing MS were analyzed. Forty-four (59%) subjects had an interval MRI at around 1 year. CSF-OCB were detected in 46 (61%) subjects. The OCB-positive group had a higher proportion of cerebellar lesions than the OCB-negative group (23.9% vs. 3.4%, p = 0.057). Except for amygdala volumes which were lower in the OCB-positive group (p = 0.034), other regional brain volumes including the subcortical deep gray matter and corpus callosum were similar. The two groups also showed comparable brain atrophy rate. For DTI, the OCB-positive group showed significantly higher mean diffusivity (MD) value in perilesional normal-appearing white matter (p = 0.043). Relapsing MS patients with and without CSF-OCB shared similar MRI features regarding volumetric analyses and DTI microstructural integrity.
Highlights
Oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) are one of the most sensitive biomarkers in the diagnostic work-up of multiple sclerosis (MS), and inclusion of their presence into the updated McDonald criteria has improved clinical diagnosis[1]
All subjects had volumetric T1 and FLAIR brain scans; spinal cord Magnetic resonance imaging (MRI) scans were available for 72 patients (95%) and diffusion tensor imaging (DTI) scans were successfully acquired for 67 (89%) patients
There were no significant differences between the two groups in terms of sex, age at disease onset, annual relapse rate (ARR) before baseline, Expanded Disability Status Scale (EDSS) scores and disease modifying treatments (DMT) usage at baseline
Summary
Oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) are one of the most sensitive biomarkers in the diagnostic work-up of multiple sclerosis (MS), and inclusion of their presence into the updated McDonald criteria has improved clinical diagnosis[1]. The relationship between CSF-OCB status and disease characteristics, such as clinical course, disease progression, responses to disease modifying therapies, remain u nclear[3,5]. Diffusion in normal myelinated axons tends to be anisotropic and parallel to tracts; in contrast, damaged white matter will return lower fractional anisotropy (FA) and higher mean diffusivity (MD). Such changes in these DTI metrics reflect histologic injury but may shed light on mechanisms responsible. In this study, we explored the association between CSF-OCB status and advanced MRI metrics that are related to disease prognosis. Given the variability of MS phenotypes, we focused on relapsing–remitting multiple sclerosis (RRMS) patients
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