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A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands
I Nakashima1, K Fujihara, T Misu
1Department of Neurology, Tohoku University School of Medicine, Sendai 980-8574, Japan. inakashima@neurol.med.tohoku.ac.jp
Abstract:
The cerebrospinal fluid oligodonal IgG bands (OB) are less frequently observed in Japanese multiple sclerosis (MS) patients compared with Caucasian patients. We studied 40 consecutive Japanese MS patients to investigate the differences in the clinical and magnetic resonance imaging (MRI) features of MS between OB-positive patients and OB-negative ones. Among the 40 patients, 22 (55%) patients were OB-positive by either agarose gel electrophoresis (AGE) or isoelectric focusing (IEF), and 18 (45%) patients were OB-negative by both AGE and IEF. There were differences between the two groups only in the clincal forms of MS, but not in terms of gender, onset age, disease duration, or disease severity. In the OB-negative group, nine (50%) of the patients had the optic-spinal form of MS (OS-MS), but only one patient (4.5%) in the OB-positive group had OS-MS. Although most OB-positive patients showed brain MRI lesions typical of MS, 13 (72%) of the OB-negative patients showed no or few brain MRI lesions and the rest of the OB-negative patients showed atypical MS lesions, such as diffuse white matter lesions or large ring-enhanced lesions. Our results suggest that the majority of OB-negative Japanese MS patents show either no or few brain MRI lesions or atypical brain MRI lesions.
Insights
Oligoclonal IgG bands (OB) are less common in Japanese multiple sclerosis (MS) patients. OB-negative Japanese MS patients often present with optic-spinal MS or atypical brain MRI findings.
Area of Science:
- Neurology
- Immunology
- Neuroimaging
Background:
- Oligoclonal IgG bands (OB) in cerebrospinal fluid are a diagnostic marker for multiple sclerosis (MS).
- Japanese MS patients exhibit lower frequencies of OB compared to Caucasian populations.
- Understanding clinical and MRI variations in Japanese MS patients based on OB status is crucial.
Purpose of the Study:
- To investigate the clinical and magnetic resonance imaging (MRI) differences in Japanese multiple sclerosis (MS) patients with and without oligoclonal IgG bands (OB).
Main Methods:
- Study included 40 consecutive Japanese MS patients.
- Oligoclonal IgG bands (OB) detection using agarose gel electrophoresis (AGE) and isoelectric focusing (IEF).
- Clinical data and brain MRI features were analyzed and compared between OB-positive and OB-negative groups.
Main Results:
- 55% of patients were OB-positive, 45% were OB-negative.
- Significant differences observed in clinical forms: OB-negative group had a higher prevalence of optic-spinal MS (OS-MS) (50%) compared to the OB-positive group (4.5%).
- OB-negative patients frequently showed no/few brain MRI lesions (72%) or atypical lesions, contrasting with typical MS lesions in most OB-positive patients.
Conclusions:
- The majority of OB-negative Japanese MS patients exhibit distinct clinical and neuroimaging characteristics, including a higher incidence of OS-MS and atypical or absent brain MRI lesions.
- These findings highlight the heterogeneity of MS presentation in Japanese patients, particularly in the absence of OB.
- Further research is warranted to elucidate the underlying mechanisms and diagnostic implications of these variations.