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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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The Cerebrospinal Fluid in Multiple Sclerosis.

Florian Deisenhammer1, Henrik Zetterberg2,3,4,5, Brit Fitzner6

  • 1Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.

Frontiers in Immunology
|April 30, 2019
PubMed
Summary
This summary is machine-generated.

Cerebrospinal fluid (CSF) analysis, particularly oligoclonal bands (OCB), is crucial for diagnosing multiple sclerosis (MS). The absence of OCB suggests alternative diagnoses, guiding accurate patient management.

Keywords:
CSF (cerebrospinal fluid)biomarkermultiple sclerosisneurofilament light (NfL)oligoclonal band (OCB)

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Area of Science:

  • Neurology
  • Clinical Diagnostics
  • Biomarker Research

Background:

  • Multiple sclerosis (MS) diagnosis faces challenges due to neuroimaging misinterpretations.
  • Cerebrospinal fluid (CSF) analysis is re-emphasized in recent MS diagnostic criteria for improved accuracy.
  • Oligoclonal bands (OCB) in CSF are a key indicator of MS.

Purpose of the Study:

  • To highlight the diagnostic significance of CSF analysis in suspected MS.
  • To emphasize the role of oligoclonal bands (OCB) in MS diagnosis and differential diagnosis.
  • To explore the utility of additional CSF biomarkers for MS subtyping and prognosis.

Main Methods:

  • Review of diagnostic criteria and literature concerning CSF analysis in MS.
  • Analysis of the diagnostic accuracy and negative predictive value of OCB.
  • Exploration of other CSF molecules for diagnostic support and disease course prediction.

Main Results:

  • CSF analysis, especially OCB detection, shows high diagnostic accuracy for MS.
  • The absence of OCB is a strong negative predictor, warranting consideration of alternative diagnoses.
  • Additional CSF biomarkers can aid in differentiating MS subtypes and predicting disease progression.

Conclusions:

  • CSF analysis, particularly OCB, is vital for accurate MS diagnosis and ruling out other conditions.
  • Negative OCB results serve as a critical flag for further diagnostic investigation.
  • CSF biomarkers offer potential for personalized MS treatment strategies based on disease course prediction.