Spinal taps prognostic in CIS


REPORT FROM THE ACTRIMS-ECTRIMS – BOSTON, MA, SEPTEMBER 10-13, 2014 – Testing for oligoclonal Ig bands in cerebrospinal fluid is useful in predicting which patients with clinically isolated syndrome (CIS) are at risk of developing clinically-definite MS (Tumani et al. ECTRIMS 2014; abstract P197).

CSF was obtained from 410 patients (mean age 34 years); 44 patients (11%) met McDonald 2010 criteria for MS at onset. OCBs were detected in 351 of 406 CSF samples (86.5%). After a median follow-up of 32 months, 290 of 410 patients (70.7%) converted to MS. The MS conversion rate was 73.8% in patients who were OCB-positive at onset compared to 44.2% for patients who were OCB-negative at onset. The median time to MS diagnosis was 25 months in OCB-positive patients versus 47 months in OCB-negative patients.

Previous studies have also suggested that OCB status may be an indicator of a more aggressive and more rapidly evolving disease process. A 5-year retrospective study  reported that OCB+ MS patients had an earlier age of disease onset, and a higher proportion had developed SPMS at 10-year follow-up (Sharipova et al. ECTRIMS 2013; abstract P246). A prospective study of radiologically isolated syndrome (RIS) found that subjects with OCBs detected in CSF or tears were at higher risk of having a clinical demyelinating event (Frenay et al. AAN 2013; abstract P03).

Guest Reviewer: Dr. Daniel Selchen, St. Michael’s Hospital, Toronto, Ontario.

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