Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 20;12(7):e0181431.
doi: 10.1371/journal.pone.0181431. eCollection 2017.

Cerebrospinal fluid humoral immunity in the differential diagnosis of multiple sclerosis

Evanthia Bernitsas  1 , Omar Khan  1 , Sara Razmjou  1 , Alexandros Tselis  1 , Fen Bao  1 , Christina Caon  1 , Scott Millis  2 , Navid Seraji-Bozorgzad  1
Affiliations

Cerebrospinal fluid humoral immunity in the differential diagnosis of multiple sclerosis

Evanthia Bernitsas et al. PLoS One. .

Abstract

Background: The diagnostic accuracy of cerebrospinal fluid oligoclonal bands (CSF-OCB) detected by isoelectric focusing (IEF) in patients with multiple sclerosis (MS) was evaluated in our study.

Methods: Three hundred and twenty-one patients with MS and other central nervous system (CNS) immune mediated disorders were assessed (CIMD). Cerebrospinal fluid and matched serum samples were examined for the presence of OCB by IEF-IB (isoelectric focusing with immunoblotting).

Results: Isolated oligoclonal bands (ISO-OCB) were the only predictor of MS diagnosis independent of age, gender and CSF-OCB. ISO-OCB ≥ 3.5 detected by IEF yielded a sensitivity of 98% and specificity of 87% in distinguishing MS from MS mimickers.

Conclusions: For the neurologist, a score of ≥ 4 ISO-OCB supports the diagnosis of MS. On the other hand, ISO-OCB ≤3 favors CIMD. Further studies with larger population samples are warranted to confirm these findings.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. ROC curve plot demonstrating diagnostic accuracy of ISO OCB in MS diagnosis.
See this image and copyright information in PMC

References

    1. Gastaldi M, Zardini E, Franciotta D. An update on the use of cerebrospinal fluid analysis as a diagnostic tool in multiple sclerosis. Expert Rev Mol Diagn. 2017. January; 17(1): 31–46 doi: 10.1080/14737159.2017.1262260 - DOI - PubMed
    1. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011. February; 69 (2): 292–302. doi: 10.1002/ana.22366 - DOI - PMC - PubMed
    1. Link H, Huang YM. Oligoclonal bands in multiple sclerosis cerebrospinal fluid: an update on methodology and clinical usefulness. J Neuroimmunol. 2006. November; 180(1–2):17–28. Epub 2006 Sep 1. doi: 10.1016/j.jneuroim.2006.07.006 - DOI - PubMed
    1. Dale RC, Brilot F. Biomarkers of inflammatory and autoimmune central nervous system disorders. Curr Opin Pediatr. 2010. December; 22(6):718–25. doi: 10.1097/MOP.0b013e3283402b71 - DOI - PubMed
    1. Tintoré M, Rovira A, Brieva L, Grivé E, Jardí R, Borrás C, Montalban X. Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS. Mult Scler. 2001. December; 7(6):359–63. doi: 10.1177/135245850100700603 - DOI - PubMed