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Review
. 2019 Apr 12:10:726.
doi: 10.3389/fimmu.2019.00726. eCollection 2019.

The Cerebrospinal Fluid in Multiple Sclerosis

Florian Deisenhammer  1 , Henrik Zetterberg  2   3   4   5 , Brit Fitzner  6 , Uwe K Zettl  6
Affiliations
Review

The Cerebrospinal Fluid in Multiple Sclerosis

Florian Deisenhammer et al. Front Immunol. .

Abstract

Investigation of cerebrospinal fluid (CSF) in the diagnostic work-up in suspected multiple sclerosis (MS) patients has regained attention in the latest version of the diagnostic criteria due to its good diagnostic accuracy and increasing issues with misdiagnosis of MS based on over interpretation of neuroimaging results. The hallmark of MS-specific changes in CSF is the detection of oligoclonal bands (OCB) which occur in the vast majority of MS patients. Lack of OCB has a very high negative predictive value indicating a red flag during the diagnostic work-up, and alternative diagnoses should be considered in such patients. Additional molecules of CSF can help to support the diagnosis of MS, improve the differential diagnosis of MS subtypes and predict the course of the disease, thus selecting the optimal therapy for each patient.

Keywords: CSF (cerebrospinal fluid); biomarker; multiple sclerosis; neurofilament light (NfL); oligoclonal band (OCB).

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Figures

Figure 1
Figure 1
MS causes neuronal damage (demyelination, axon degeneration, synaptic loss) to the brain and spinal cord. Immune cells, pathological antibodies, adhesion molecules, cytokines, chemokines, and nucleic acids, which reflect inflammations in the CNS, are present in the CSF of the patients and can serve as biomarkers to support MS diagnosis and therapy.
See this image and copyright information in PMC

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