Assessing the presence of oligoclonal IgM bands as a prognostic biomarker of cognitive decline in the early stages of multiple sclerosis

Coll, Clàudia; Quintana, Ester; Salavedra-Pont, Judit; Buxó, María; Gonzalez-Del-Rio, Marina; Gómez, Immaculada; Martín, María Muñoz-San; Villar, Luisa M.; Álvarez-Bravo, G; Robles-Cedeño, René; Ramió-Torrentà, Lluı́s; Gich, Jordi

doi:10.1002/brb3.2405

Cited by 4 publications

(2 citation statements)

References 43 publications

(88 reference statements)

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“…In contrast, a previous study did not show an impact from intrathecal IgM synthesis (ITMS) determined with lipid-specific oligoclonal IgM bands (LS-OCMB) on IPS worsening in RRMS (43). In fact, except for the long-term storage, assessed with the selective reminding test, no association between increased ITMS and MS-related CI was found.…”

Section: Discussioncontrasting

confidence: 57%

“…This is an unexpected finding since ITMS is considered a prognostic disease severity marker (44,45). The lack of relationship found between ITMS and IPS might depend on a relatively short follow-up period of four years as well as a limited sample size (n=44) (43). Thus, further studies with larger cohorts and longer follow-up time are warranted to investigate if also other measures of early intrathecal immunoglobulin synthesis are involved in the development of CI in MS.…”

Section: Discussionmentioning

confidence: 90%

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High levels of kappa free light chain synthesis predict cognitive decline in relapsing-remitting multiple sclerosis

et al. 2023

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BackgroundEvolving evidence suggests that measurement of cerebrospinal fluid (CSF) kappa free light chain (KFLC) synthesis has high diagnostic sensitivity and specificity for multiple sclerosis (MS), but its prognostic ability is less investigated. The usefulness of KFLC in predicting cognitive impairment (CI) is still unknown.MethodsIn a monocentric longitudinal retrospecitve cohort study, KFLC-index ([CSF KFLC/serum KFLC]/[CSF albumin/serum albumin]) measured by latex-enhanced immunonephelometry was prospectively determined as part of the diagnostic workup in patients with early relapsing-remitting MS (RRMS, n=77). The ability of KFLC-index to predict information processing speed (IPS) worsening as assessed with the symbol digit modalities test (SDMT) was investigated in univariable and multivariable models.ResultsIn patients with KFLC-index>100 (n=31), 11 subjects (35.5%) showed reduced SDMT scores by ≥8 points at follow-up (mean follow-up time 7.3 ± 2.6 years), compared with their baseline scores (p=0.01). Baseline KFLC-index>100 was strongly associated with a higher hazard of SDMT score reduction at follow-up (adjusted hazard ratio 10.5, 95% confidence interval 2.2-50.8, p=0.003; median time to SDMT reduction 7 years).ConclusionIntrathecal KFLC synthesis has become an attractive diagnostic tool for MS. We show for the first time that in a real-world setting of early RRMS, KFLC-index predicted cognitive decline. Whether this predictive ability of KFLC-index also concerns other cognitive domains than IPS, warrants further investigations.

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Section: Discussioncontrasting

confidence: 57%