Related Experiment Video
Updated: Jun 26, 2026
Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
Published on: April 17, 2026
The prognostic significance of cerebrospinal fluid in multiple sclerosis
Sasitorn Siritho1, Mark S Freedman
1The Ottawa Hospital, General Campus, 4th Floor, Multiple Sclerosis Research Unit, Ottawa, ON, Canada.
Background:
Multiple Sclerosis (MS) patients lacking CSF oligoclonal bands are purported to have a milder course of disease. We reviewed the natural history of oligoclonal band (OCB) - negative (OCB-) compared to OCB positive (OCB+) patients.
Method:
A retrospective study of 451 MS patients.
Results:
Only 48/451 patients (10.6%) were CSF OCB-. The mean age at onset was 37.1+/-8.8 years with female:male ratio=2. First CNS location presentation was less well defined in OCB- vs. OCB+ patients with significantly more supratentorial presentation. The clinical course of OCB- vs OCB+ was somewhat different; 22.9 vs 15.1% PPMS; 18.8 vs 12.4% SPMS; and 56.3 vs 71% RRMS, respectively. There were significantly fewer WBC, less IgG and a lower IgG index in OCB- cases. Fewer OCB- cases fulfilled McDonald MRI criteria. There were no discernable differences in disease severity between the two groups as determined by the EDSS, progression index, MSSS, number of relapses or annualized relapse rate.
Conclusion:
The presence of OCB correlates better with other indications of acute inflammatory MS, especially an RR course. This study suggests that the simple lack of OCB positivity does not necessarily insure a more benign disease course.
Insights
Multiple Sclerosis (MS) patients without cerebrospinal fluid oligoclonal bands (OCB-) do not necessarily have a milder disease course. This study found no significant differences in disease severity between OCB- and OCB+ patients.
Area of Science:
- Neurology
- Immunology
- Clinical Research
Background:
- Multiple Sclerosis (MS) is often associated with cerebrospinal fluid (CSF) oligoclonal bands (OCB).
- Patients lacking OCB are presumed to have a milder disease course.
- This study investigates the natural history of OCB- versus OCB+ MS patients.
Purpose of the Study:
- To compare the clinical course and disease severity of MS patients with and without CSF OCB.
- To determine if the absence of OCB predicts a less severe form of MS.
Main Methods:
- Retrospective analysis of 451 MS patients.
- Comparison of demographic, clinical, and MRI data between OCB- and OCB+ groups.
- Assessment of disease severity using EDSS, progression index, MSSS, and relapse rates.
Main Results:
- Only 10.6% of patients were OCB-.
- OCB- patients showed more supratentorial presentations and fewer fulfilled McDonald MRI criteria.
- Despite some differences in inflammatory markers and disease course subtypes (e.g., RRMS, SPMS, PPMS), no significant differences in overall disease severity (EDSS, progression) were observed.
Conclusions:
- OCB presence correlates with acute inflammatory MS, particularly a relapsing-remitting (RR) course.
- Absence of OCB does not guarantee a milder or less severe MS disease progression.
- Further research may be needed to fully understand the prognostic implications of OCB status in MS.
More Related Videos
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:21Cerebrospinal Fluid
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
01:22Cerebral Edema ll: Pathophysiology