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CSF parameters associated with early MRI activity in patients with MS
Ana Klein1, Rebecca C Selter1, Alexander Hapfelmeier1
1Department of Neurology (A.K., R.C.S., A.B., V.P., C.G., M.M., B.H.), Klinikum rechts der Isar, Medical Faculty, Technical University of Munich; Institute of Medical Informatics (A.H.), Statistics and Epidemiology, Medical Faculty, Technical University of Munich; Max Planck Institute of Psychiatry (B.M.-M.), Munich; Department of Neuroradiology (C.Z.), Klinikum rechts der Isar, Medical Faculty, Technical University of Munich; TUM Neuroimaging Center (M.M.), Klinikum rechts der Isar, Medical Faculty, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (B.H.), Germany.
Cerebrospinal fluid (CSF) IgG and IgM indices predict future MRI activity in early multiple sclerosis (MS) and clinically isolated syndrome (CIS). These biomarkers can aid early treatment decisions for MS and CIS patients.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Early inflammatory activity in clinically isolated syndrome (CIS) and multiple sclerosis (MS) impacts long-term prognosis.
- Predicting disease progression is crucial for timely therapeutic intervention.
Purpose of the Study:
- To identify cerebrospinal fluid (CSF) parameters associated with early inflammatory disease activity in CIS and MS.
- To correlate CSF biomarkers with cerebral MRI (cMRI) findings at diagnosis and follow-up.
Main Methods:
- Retrospective analysis of 149 newly diagnosed CIS and MS patients.
- cMRI assessment for T2 and gadolinium-enhancing lesions.
- CSF analysis for oligoclonal bands, immunoglobulin G (IgG), A (IgA), and M (IgM) indices, sCD27, neurofilament light chain, and IgG subclasses.
Main Results:
- CSF IgG index, sCD27 levels, and IgM index were associated with new cMRI lesions.
- IgG index and sCD27 showed a high correlation.
- Multivariable analysis identified IgG index, IgM index, DMT status, and gender as predictors of future cMRI activity.
Conclusions:
- CSF IgG and IgM indices are independent predictors of future MRI activity in early MS and CIS.
- These CSF parameters can assist in early treatment decisions for CIS and MS patients.
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