Prognostic utility of the IgM oligoclonal bands against myelin lipids in multiple sclerosis

AbstractTorticollis refers to a condition in which the head is persistently tilted to one side, sometimes associated with pain. Torticollis in a child can be congenital or acquired. Torticollis as an initial manifestation of an underlying demyelinating syndrome is quite rare in children. Here, we report a 7-year-old girl who presented with persistent torticollis. Neuroimaging of the brain revealed features of a demyelinating disease. Further studies did not show any evidence of multiple sclerosis. Cerebrospinal fluid was negative for antiaquaporin-4 antibodies, antimyelin oligodendrocyte glycoprotein antibodies, and oligoclonal bands. A seronegative demyelinating disorder was considered. She was treated with pulsed methylprednisolone therapy. She responded well to steroids with no progression of illness during follow-up. Torticollis was partially improved.

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Oligoclonal bands in the cerebrospinal fluid and increased brain atrophy in early stages of relapsing-remitting multiple sclerosis

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2012000800003 ◽

2012 ◽

Vol 70 (8) ◽

pp. 574-577 ◽

Cited By ~ 4

Author(s):

Juan Ignacio Rojas ◽

Liliana Patrucco ◽

Santiago Tizio ◽

Edgardo Cristiano

Keyword(s):

Multiple Sclerosis ◽

Cerebrospinal Fluid ◽

Brain Atrophy ◽

Disease Onset ◽

Oligoclonal Bands ◽

Matter Volume ◽

Early Stages ◽

Relapsing Remitting ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis

OBJECTIVE: To determine if the presence of oligoclonal bands (OB) at early stages of multiple sclerosis was associated with higher brain atrophy, when compared with patients without OB. METHODS: Relapsing-remitting multiple sclerosis (RRMS) patients with less than two years of disease onset and OB detection in cerebrospinal fluid (CSF) were included. SIENAX was used for total brain volume (TBV), gray matter volume (GMV), and white matter volume (WMV). RESULTS: Forty patients were included, 29 had positive IgG-OB. No differences were found between positive and negative patients in gender, expanded disability status scale (EDSS), treatment received, and T2/T1 lesion load. TBV in positive IgG-OB patients was 1.5 mm³ x 10(6) compared with 1.64 mm³ x 10(6) in the negative ones (p=0.02). GMV was 0.51 mm³ x 10(6) in positive IgG-OB compared with 0.62 mm³ x 10(6) in negative ones (p=0.002). No differences in WMV (p=0.09) were seen. CONCLUSIONS: IgG-OB in the CSF was related to neurodegeneration magnetic resonance (MR) markers in early RRMS.

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Presence of CSF oligoclonal bands (OCB) is associated with the HLA-DRB1 genotype in a West Australian multiple sclerosis cohort

Journal of the Neurological Sciences ◽

10.1016/j.jns.2009.10.005 ◽

2010 ◽

Vol 288 (1-2) ◽

pp. 63-67 ◽

Cited By ~ 21

Author(s):

Jing-Shan Wu ◽

Wei Qiu ◽

Alison Castley ◽

Ian James ◽

Joyce Joseph ◽

...

Keyword(s):

Multiple Sclerosis ◽

Oligoclonal Bands ◽

Csf Oligoclonal Bands

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Antiparasitic antibodies occur with similar frequency in patients with clinically established multiple sclerosis with or without oligoclonal bands in the cerebrospinal fluid

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130079 ◽

2013 ◽

Vol 71 (8) ◽

pp. 512-515 ◽

Cited By ~ 1

Author(s):

Fabiana Cruz Gomes da Fonseca-Papavero ◽

Dagoberto Callegaro ◽

Paulo Diniz da Gama ◽

Jose Antonio Livramento ◽

Adelaide Jose Vaz ◽

...

Keyword(s):

Multiple Sclerosis ◽

Molecular Weight ◽

High Molecular Weight ◽

Hygiene Hypothesis ◽

Oligoclonal Bands ◽

Parasitic Infections ◽

Low Molecular Weight ◽

Serum Samples ◽

Similar Frequency ◽

Electrophoresis Of Proteins

The "hygiene hypothesis" postulates an inverse relationship between the prevalence of parasitic infections and the frequency of multiple sclerosis (MS). Objective: It was to study whether antibodies against parasites could be demonstrated more frequently in blood serum from MS patients with oligoclonal bands (OCB) than from MS patients without OCB. Methods: We studied serum samples from 164 patients who had previously been analyzed to investigate OCB. Parasitic antibodies were studied through unidimensional electrophoresis of proteins on polyacrylamide gel against Taenia antigens, searching for antiparasitic specific low molecular weight antibodies and also for antiparasitic nonspecific high molecular weight antibodies. Results: Two of the 103 patients with no evidence of OCB had antibodies of low molecular weight and 59 of them had antibodies of high molecular weight. Of the 61 patients with evidence of OCB, one showed antibodies of low molecular weight and 16 showed antibodies of high molecular weight. Conclusion: Antiparasitic antibodies are detected with similar frequency in MS patients with OCB and in MS patients without OCB.

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Pediatric Multiple Sclerosis in Portugal: A Multicentre Study

Acta Médica Portuguesa ◽

10.20344/amp.6346 ◽

2016 ◽

Vol 29 (7-8) ◽

pp. 425 ◽

Cited By ~ 1

Author(s):

Ana Sofia Correia ◽

Luís Augusto ◽

Joana Meireles ◽

Joana Pinto ◽

Ana Paula Sousa

Keyword(s):

Multiple Sclerosis ◽

Cerebrospinal Fluid ◽

Brain Magnetic Resonance Imaging ◽

Oligoclonal Bands ◽

Childhood Onset ◽

Multicentric Study ◽

Pediatric Multiple Sclerosis ◽

Adolescent Groups ◽

Reported Data ◽

Cerebrospinal Fluid Pleocytosis

Introduction: Multiple sclerosis is most often diagnosed among young adults but less frequently it may present during childhood or adolescence. In Portugal, there has been only one previous single-center, pediatric multiple sclerosis study. The main objective was the evaluation of the demographic, clinical, laboratorial and neuroradiological characteristics of patients with pediatric-onset multiple sclerosis in Portugal. The secondary objectives were to compare the characteristics of childhood-onset multiple sclerosis and adolescent-onset multiple sclerosis and to characterize the treatments prescribed.Material and Methods: We performed a retrospective observational, multicentric study. We reviewed data of all patients with multiple sclerosis younger than 18 years at the onset of their first multiple sclerosis symptoms.Results: There were 46 patients (72% female) included with a mean age at diagnosis of 16.1 years. Six cases had childhood-onset and 40 cases had adolescence-onset. The median value of Expanded Disability Status Scale was two. Relapsing-remitting multiple sclerosis was most prevalent (98% of cases). In the cerebrospinal fluid study, 74% of patients had positive oligoclonal bands. Brain magnetic resonance imaging studies showed a predominant supratentorial involvement (98% of cases), whereas the cervical segment was the most frequently affected in the spinal cord. All the patients enrolled in the study underwent immunomodulatory therapy, 75% ofpatients with beta-interferon. Concerning differences between the childhood and the adolescent groups, we found a greater proportion of male patients and of individuals with cerebrospinal fluid pleocytosis among the childhood-onset group.Discussion: This study provides new data on pediatric multiple sclerosis characteristics in Portugal and our results are similar to previously reported data in other parts of the worldConclusion: This is the first multicentric study characterizing pediatric multiple sclerosis in Portugal. The mechanisms underlying the particularities of pediatric multiple sclerosis remain largely unknown and further studies are required.

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Integrative biochemical, proteomics, and metabolomics cerebrospinal fluid biomarkers predict clinical conversion to multiple sclerosis

Brain Communications ◽

10.1093/braincomms/fcab084 ◽

2021 ◽

Author(s):

Fay Probert ◽

Tianrong Yeo ◽

Yifan Zhou ◽

Megan Sealey ◽

Siddharth Arora ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cerebrospinal Fluid ◽

Predictive Accuracy ◽

Personalised Medicine ◽

Clinically Isolated Syndrome ◽

Oligoclonal Bands ◽

Protein Biomarkers ◽

Glucose Levels ◽

Prognostic Accuracy ◽

New Biomarkers

Abstract Eighty-five percent of multiple sclerosis cases begin with a discrete attack termed clinically isolated syndrome, but 37% of clinically isolated syndrome patients do not experience a relapse within 20 years of onset. Thus, the identification of biomarkers able to differentiate between individuals who are most likely to have a second clinical attack from those who remain in the clinically isolated syndrome stage is essential to apply a personalised medicine approach. We sought to identify biomarkers from biochemical, metabolic, and proteomic screens that predict clinically defined conversion from clinically isolated syndrome to multiple sclerosis and generate a multi-omics-based algorithm with higher prognostic accuracy than any currently available test. An integrative multi-variate approach was applied to the analysis of cerebrospinal fluid samples taken from 54 individuals at the point of clinically isolated syndrome with 2–10 years of subsequent follow-up enabling stratification into clinical converters and non-converters. Leukocyte counts were significantly elevated at onset in the clinical converters and predict occurrence of a second attack with 70% accuracy. Myo-inositol levels were significantly increased in clinical converters while glucose levels were decreased, predicting transition to multiple sclerosis with accuracies of 72% and 63%, respectively. Proteomics analysis identified 89 novel gene products related to conversion. The identified biochemical and protein biomarkers were combined to produce an algorithm with predictive accuracy of 83% for the transition to clinically defined multiple sclerosis, outperforming any individual biomarker in isolation including oligoclonal bands. The identified protein biomarkers are consistent with an exaggerated immune response, perturbed energy metabolism, and multiple sclerosis pathology in the clinical converter group. The new biomarkers presented provide novel insight into the molecular pathways promoting disease while the multi-omics algorithm provides a means to more accurately predict whether an individual is likely to convert to clinically defined multiple sclerosis.

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Early predictors of multiple sclerosis after a typical clinically isolated syndrome

Multiple Sclerosis Journal ◽

10.1177/1352458514533397 ◽

2014 ◽

Vol 20 (13) ◽

pp. 1721-1726 ◽

Cited By ~ 24

Author(s):

Aurélie Ruet ◽

Georgina Arrambide ◽

Bruno Brochet ◽

Cristina Auger ◽

Eva Simon ◽

...

Keyword(s):

Multiple Sclerosis ◽

At Risk ◽

High Specificity ◽

Clinically Isolated Syndrome ◽

Oligoclonal Bands ◽

Mcdonald Criteria ◽

Early Predictors ◽

Patients At Risk ◽

Magnetic Resonance Imaging Mri ◽

Periventricular Lesions

Background: The 2010 McDonald criteria allow diagnosing multiple sclerosis (MS) with one magnetic resonance imaging (MRI) scan. Nevertheless, not all patients at risk fulfil criteria at baseline. Other predictive factors (PFs) are: age ≤40 years, positive oligoclonal bands (OBs), and ≥3 periventricular lesions. Objective: The purpose of this study was to evaluate the 2010 McDonald criteria performance and to assess other PFs in patients without dissemination in space (DIS). Methods: Patients with clinically isolated syndrome (CIS) underwent baseline MRI and OB determination with clinical and radiological follow-up. Adjusted hazard ratios (aHRs) for clinically definite MS were estimated for DIS, dissemination in time (DIT), and DIS+DIT. Diagnostic properties at two years were calculated. In cases without DIS, combinations of ≥2 PFs were assessed. Results: A total of 652 patients were recruited; aHRs were 3.8 (2.5–5.8) for DIS, 4.2 (1.9–9.2) for DIT, and 8.6 (5.4–13.8) for DIS+DIT. Sensitivities were 69.6%, 42.3%, and 36.4%, and specificities were 67.3%, 87.9%, and 90.2%, respectively. In patients without DIS, aHRs varied between 2.7–5.5 and specificities ranged from 73.5–89.7% for PF combinations. Conclusion: The high specificity of the 2010 McDonald criteria is confirmed. In patients without DIS, PF combinations could be helpful in identifying those at risk for MS.

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