Absence of latitudinal gradient in oligoclonal bands prevalence in Argentina

Negrotto, Laura; Marrodán, Mariano; Fiol, Marcela; Gaitán, María I.; Ysrraelit, María Célica; Vrech, Cárlos; Pappolla, Agustín; Míguez, Jimena; Patrucco, Liliana; Cristiano, Edgardo; Rojas, Juan Ignacio; Carrá, Adriana; Chertcoff, Aníbal; Steinberg, Judith; Martínez, Alejandra; Curbelo, María Celeste; Cohen, Leila; Alonso, Ricardo; Garcea, Orlando; Pita, Cecilia; Silva, Berenice; Luetic, Geraldine; Deri, Norma; Balbuena, María Eugenia; Tkachuk, Verónica; Contentti, Edgar Carnero; López, Pablo A.; Pettinicchi, Juan Pablo; Caride, Alejandro; Burgos, Marcos; Leguizamón, Felisa; Knorre, Eduardo; Piedrabuena, Raúl; Barboza, Andrés; Liwacki, Susana; Nofal, Pedro; Volman, Gabriel; Pinheiro, Amelia Alves; Javier, Hryb; Tavolini, Darío; Blaya, Patricio; Recchia, Luciano; Mainella, Carolina; Köhler, Manfred; Kohler, Eduardo; Blanche, Jorge; Tizio, Santiago; Saladino, Maria Luisa; Cáceres, Fernando; Liguori, Nora Fernández; Lázaro, Luciana; Zanga, Gisela; Marcilla, Marcela Parada; Fracaro, María Eugenia; Cassará, Fátima Pagani; Vázquez, Gabriel; Sinay, Vladimiro; Sgrilli, Gustavo; Divi, Pablo; Jacobo, Miguel; Silva, Emanuel; Reich, Edgardo; Cabrera, Lorena M.; Menichini, María Laura; Coppola, Mariano; Martos, Iván; Viglione, Juan Pablo; José, Gustavo; Bestoso, Santiago; Manzi, Rubén; Giunta, Diego; Doldan, María. L.; Serena, Marina Alonso; Correale, Jorge

doi:10.1016/j.msard.2020.102582

Cited by 9 publications

(5 citation statements)

References 6 publications

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“…OCB presence, an indication of chronicity 18 increased the 2017 criteria sensitivity, reinforcing the value of this assay in daily neurological practice 19 although the overall positivity in CIS and MS patients from Latin America was lower than levels observed in the Caucasian populations. 20,21 Cortical lesions were added to 2017 criteria for DIS diagnosis, but detection requires advanced MRI techniques not generally available in routine clinical practice. These lesions were therefore not considered in our analysis.…”

Section: Discussionmentioning

confidence: 99%

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Performance of McDonald 2017 multiple sclerosis diagnostic criteria and evaluation of genetic ancestry in patients with a first demyelinating event in Argentina

Marrodán¹,

Piedrabuena²,

Gaitán³

et al. 2023

Mult Scler

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Background: Information on performance of multiple sclerosis (MS) diagnostic criteria is scarce for populations from Latin America, Asia, or the Caribbean. Objective: To assess performance of revised 2017 McDonald criteria as well as evaluate genetic ancestry in a group of MS patients from Argentina experiencing a debut demyelinating event. Methods: Demographic and clinical characteristics, cerebrospinal fluid (CSF), and magnetic resonance imaging (MRI) findings and new T2 lesions were recorded at baseline and during relapses. Diagnostic accuracy in predicting conversion to clinically defined MS (CDMS) based on initial imaging applying revised 2017 criteria was evaluated and genetic ancestry-informative markers analyzed. Results: Of 201 patients experiencing their first demyelinating event (median follow-up 60 months), CDMS was confirmed in 67. We found 2017 diagnostic criteria were more sensitive (84% vs 67%) and less specific (14% vs 33%) than 2010 criteria, especially in a group of patients revised separately, presenting positive oligoclonal bands (88% vs 8%). Genetic testing performed in 128 cases showed 72% of patients were of European ancestry and 27% presented genetic admixture. Conclusion: 2017 McDonald criteria showed higher sensitivity and lower specificity compared with 2010 criteria, shortening both time-to-diagnosis and time-to-treatment implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Performance of McDonald 2017 multiple sclerosis diagnostic criteria and evaluation of genetic ancestry in patients with a first demyelinating event in Argentina

Marrodán¹,

Piedrabuena²,

Gaitán³

et al. 2023

Mult Scler

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View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…18 Other factors such as latitudinal gradient have been found to alter CSF OCB prevalence in large multinational studies, 12,19 but this latitudinal gradient was not confirmed in Argentina. 20 The use of CSF-elevated OCB and/or IgG index in the diagnostic criteria for MS has changed over subsequent revisions regaining diagnostic importance on the 2017 revised McDonald criteria as a substitute for dissemination in time that has assisted in facilitating an earlier diagnosis of MS. 21 While it is possible that there are separate processes leading to two distinct forms of MS (i.e. those with and without abnormal CSF findings), there is sparse evidence to support that.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid evaluation in patients with progressive motor impairment due to critical central nervous system demyelinating lesions

Barakat

Messina

Nayak

et al. 2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Elevated intrathecal immunoglobulin G (IgG; oligoclonal bands (OCBs)) or IgG in people with progressive motor impairment due to “critical” demyelinating lesions are of uncertain significance. Objective Compare clinical/radiological features of people with “critical” demyelinating lesion-induced progressive motor impairment with/without elevated intrathecal IgG synthesis. Methods A total of 133 people with progressive motor impairment attributable to “critical” demyelinating lesions (corticospinal tract location, consistent with the progressive motor deficit) were compared regarding clinical and radiological presentation with and without ≥2 unique cerebrospinal fluid (CSF) OCB and/or IgG index ≥0.85. Results Ninety-eight (74%) had CSF-elevated OCB and/or IgG index, higher with increased magnetic resonance imaging-lesion burden. No differences were found with/without CSF abnormalities in sex (46 of 98 female (47%) vs. 22 of 35 (63%), p = 0.11), onset-age (median 49 vs. 50 years, p = 0.5), progression from onset (62 of 98 (63%) vs. 25 of 35 (71%)), progression post-relapse (36 of 98 (37%) vs. 10 of 35 (29%), p = 0.4), and duration between demyelinating disease onset and CSF examination (30 (0–359) vs. 48 (0–323) months p = 0.7). “Critical” lesions were radiologically similar, most commonly cervical spine located (72 of 98 (74%) vs. 19 of 35 (54%), p = 0.18) both with/without CSF abnormalities. Conclusions People with “critical” demyelinating lesion-induced progressive motor impairment typically have elevated intrathecal IgG (OCB and/or IgG) and similar clinical and radiological presentation regardless of CSF findings, therefore representing valid presentations of progressive demyelinating disease.

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“… 204 , 205 But the study from Argentina showed latitude seemingly regardless of OCB prevalence. 206 This relationship should be investigated in more countries and larger patients.…”

Section: Clinical Featuresmentioning

confidence: 99%

Recent progress in epidemiology, clinical features, and therapy of multiple sclerosis in China

Wang,

Liu,

Zou

et al. 2023

Ther Adv Neurol Disord

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Multiple sclerosis (MS) is a demyelinating disease of the central nervous system characterized by inflammation, demyelination, and neurodegeneration. It mainly affects young adults, imposing a heavy burden on families and society. The epidemiology, clinical features, and management of MS are distinct among different countries. Although MS is a rare disease in China, there are 1.4 billion people in China, so the total number of MS patients is not small. Because of the lack of specific diagnostic biomarkers for MS, there is a high misdiagnosis rate in China, as in other regions. Due to different genetic backgrounds, the clinical manifestations of MS in Chinese are different from those in the West. Herein, this review aims to summarize the disease comprehensively, including clinical profile and the status of disease-modifying therapies in China based on published population-based observation and cohort studies, and also to compare with data from other countries and regions, thus providing help to develop diagnostic guideline and the novel therapeutic drugs. Meanwhile, we also discuss the problems and challenges we face, specifically for the diagnosis and treatment of MS in the middle- and low-income countries.

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Absence of latitudinal gradient in oligoclonal bands prevalence in Argentina

Cited by 9 publications

References 6 publications

Performance of McDonald 2017 multiple sclerosis diagnostic criteria and evaluation of genetic ancestry in patients with a first demyelinating event in Argentina

Performance of McDonald 2017 multiple sclerosis diagnostic criteria and evaluation of genetic ancestry in patients with a first demyelinating event in Argentina

Cerebrospinal fluid evaluation in patients with progressive motor impairment due to critical central nervous system demyelinating lesions

Recent progress in epidemiology, clinical features, and therapy of multiple sclerosis in China

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