Clinical, magnetic resonance imaging, cerebrospinal fluid and electrophysiological characteristics of the earliest multiple sclerosis

Rot, Uroš; Ledinek, Alenka Horvat; Jazbec, Saša Šega

doi:10.1016/j.clineuro.2007.11.001

Cited by 22 publications

(20 citation statements)

References 21 publications

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“…Considering the OCB rates in geographically different Caucasian populations so far [3,5,6,9,10,32,33], it seems that Northern Caucasian populations present higher percentages of OCB. In the very recent meta-analysis of Dobson and colleagues [34], latitude predicts OCB status in MS patients but not in CIS patients, and the presence of OCB strongly predicts conversion from CIS to MS.…”

Section: Discussionmentioning

confidence: 96%

Clinical and cognitive implications of cerebrospinal fluid oligoclonal bands in multiple sclerosis patients

et al. 2015

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The presence of cerebrospinal fluid oligoclonal bands (CSF-OCB) in Caucasian patients with multiple sclerosis (MS) is supportive of diagnosis, though the relation with patients' clinical and specifically cognitive features has never been established or thoroughly examined. Thus, we investigated the clinical and for the first time the cognitive profile of MS patients in relation to CSF-OCB. We studied 108 patients with and without OCB and recorded demographic characteristics and detailed clinical data. A comprehensive neuropsychological battery covering different cognitive domains (attention/processing speed, memory, perception/constructions, reasoning, executive functions) was administered to MS patients and 142 demographically related healthy controls (HC). We did not find any significant differences between patients with and without OCB on demographic and clinical parameters (p > 0.05), including subtype and brain neuroimaging findings. Results revealed significantly higher cognitive scores in HC compared to both OCB subgroups, with more widespread cognitive changes in patients with OCB. Analysis between OCB subgroups showed significantly worse performance in patients with OCB on visual memory (Rey's complex figure test-recall; p = 0.006). Concluding, the presence of CSF-OCB in our MS patients tends to be related to more widespread cognitive changes, specifically worse visual memory. Future longitudinal studies in different populations are warranted to better clarify the clinical and cognitive characteristics related to CSF-OCB which could serve as early biomarker in disease monitoring.

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Section: Discussionmentioning

confidence: 96%

Clinical and cognitive implications of cerebrospinal fluid oligoclonal bands in multiple sclerosis patients

et al. 2015

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“…Accordingly, this gives an idea of how MS patients are usually managed, in their initial diagnosis, in habitual clinical practice when they are seen at the reference specialised MS units in Spain. The patients were young, mostly female, classified equally at referral as either CIS or MS, and of whom 25-50% had presented symptoms of their process during the previous year [37,40,44,51].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of multiple sclerosis at onset and delay of diagnosis and treatment in Spain (The Novo Study)

Fernández

Arbizu

et al. 2010

J Neurol

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Multiple sclerosis (MS) is a disease supposedly of autoimmune origin, with reactivity directed against myelin antigens. From the neuropathological point of view, MS produces inflammation, demyelination and axonal and neuronal degeneration. Inflammatory phenomena are predominant in the initial phase of the disease, followed later by neurodegenerative processes. Over the last decade, early treatment, during the most inflammatory phase of the disease, has been considered the best strategy to treat MS. Accordingly, we decided to determine the periods of delay between the first symptoms and the time to the first medical visit, the time to referral to a specialised MS unit, the delay in undertaking clinical and paraclinical tests, the diagnostic criteria used and the overall delay in diagnosis and treatment. The median time from onset of first symptoms to the first visit to a physician was 19.2 months, which represented the greatest delay. The median time between this initial medical consultation and the confirmation of the diagnosis by a specialised MS unit was 5.7 months, and the overall time from symptom onset to diagnosis was 24.9 months (2.08 years). The median time between onset of the first symptoms and the decision to give the first treatment was 2 years. The most important delay was that from symptom onset to the first medical visit, with the other delays being less. Thus, it is during this initial period that greater effort is required in order to reduce the time to diagnosis, by increasing awareness of the problem of MS among the general population and primary care physicians.

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“…The detection of this CSF profile may be helpful to suggest the occurrence of an inflammatory process in the CNS, especially in patients whose clinical and imaging abnormalities are not clearcut, thus providing the possibility of early diagnosis and treatment 8,25 . This is more important in progressive forms of MS, mainly in the primary progressive form.…”

Section: Resultsmentioning

confidence: 99%

“…So, the low frequency of OCB founded in this study may not be ascribed to problems in CSF analysis. Apart from the relatively low sensitivity, the detection of OCB seemed to have a low specificity, mainly when a blind method of analysis was used 7,8 . OCB have been described in other inflammatory diseases, their frequency of detection ranging from 25 to 80% 5,7,19 , as well as in noninflammatory diseases of the CNS (in up to 17% of patients 15 ).…”

Section: Resultsmentioning

confidence: 99%

Study of oligoclonal bands restricted to the cerebrospinal fluid in multiple sclerosis patients in the city of São Paulo

Gama

Machado

Livramento

et al. 2009

Arq. Neuro-Psiquiatr.

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-The frequency of oligoclonal bands (OCB) restricted to the cerebrospinal fluid (CSF) from patients with multiple sclerosis (MS) varies widely in different populations. The objective of this study was to determine the frequency of these OCB in a group of MS patients in the city of São Paulo. Techniques used to detect OCB consisted of isoelectric focusing followed by immunoblotting. Oligoclonal bands were found in 49 (54.4%) out of 90 patients with clinically definite MS; in (31.2%) of the 16 patients with clinically isolated syndrome; in 7 (17.9%) of 39 patients with inflammatory disorders of the central nervous system (IDCNS), and in none of the individuals with no neurological condition (control group). The specificity of the method was 100% when compared to the control group and 82.1% when compared to the IDCNS group. These results suggest that the frequency of CSF OCB is much lower in Brazilian MS patients from São Paulo city than that reported in MS series from Caucasian populations.KEY WORDS: multiple sclerosis, cerebrospinal fluid, oligoclonal bands, Brazilian population. estudo de bandas oligoclonais restritas ao líquido cefalorraquidiano em pacientes com esclerose múltipla na cidade de São paulo resumo -A frequência da detecção de bandas oligoclonais (BOC) restritas ao líquido cerebrorraquidiano (LCR) em pacientes com esclerose múltipla (EM) varia amplamente em diferentes populações. O objetivo deste estudo foi determinar a frequência destas BOC em pacientes com EM em amostra de população da cidade de São Paulo. A técnica utilizada para a detecção das BOC foi a focalização isoelétrica, seguida do immunoblotting. BOC foram detectadas: em 49 (54,4%) de 90 pacientes com EM clinicamente definida; em 5 (31,2%) de 16 pacientes com síndrome clínica isolada; em 7 (17,9%) de 30 pacientes com doenças inflamatórias do sistema nervoso central (DISNC); e em nenhum indivíduo sem doença neurológica. A especificidade do método foi 100% quando comparada ao grupo controle e 82,1% quando comparada ao grupo de DISNC. Estes resultados sugerem que a freqüência de BOC no LCR é mais baixa em pacientes da cidade de São Paulo portadores de EM do que aquelas descritas em populações caucasianas. PALAVRAS-CHAVE: esclerose múltipla, líquido cefalorraquidiano, bandas oligoclonais, população brasileira.

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Clinical, magnetic resonance imaging, cerebrospinal fluid and electrophysiological characteristics of the earliest multiple sclerosis

Cited by 22 publications

References 21 publications

Clinical and cognitive implications of cerebrospinal fluid oligoclonal bands in multiple sclerosis patients

Clinical and cognitive implications of cerebrospinal fluid oligoclonal bands in multiple sclerosis patients

Characteristics of multiple sclerosis at onset and delay of diagnosis and treatment in Spain (The Novo Study)

Study of oligoclonal bands restricted to the cerebrospinal fluid in multiple sclerosis patients in the city of São Paulo

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