Comparison of neurophysiological and mri findings of patients with multiple sclerosis using oligoclonal band technique

Elli̇dağ, Hamit Yaşar; Eren, Esin; Erdoğan, Nuri; Türe, Sabiha; Yılmaz, Necat

doi:10.5214/ans.0972.7531.200406

Cited by 10 publications

(8 citation statements)

References 44 publications

(36 reference statements)

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“…Therefore, the detection of sub-clinical lesions of the visual pathway has become an important aspect in the assessment of newly diagnosed MS cases [ 38 , 39 ]. While electrophysiological examinations are not a part of the McDonald 2010 criteria, studies demonstrated that VEP latency combined with MRI could improve the accuracy of MS prediction [ 9 , 40 ]. Our results confirm that delayed VEP represent an additional risk factor for conversion to MS in OCB negative CIS patients with optic neuritis.…”

Section: Discussionmentioning

confidence: 99%

Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis

Schwenkenbecher

Sarikidi

Bönig

et al. 2017

IJMS

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While the revised McDonald criteria of 2010 allow for the diagnosis of multiple sclerosis (MS) in an earlier stage, there is still a need to identify the risk factors for conversion to MS in patients with clinically isolated syndrome (CIS). Since the latest McDonald criteria were established, the prognostic role of cerebrospinal fluid (CSF) and visual evoked potentials (VEP) in CIS patients is still poorly defined. We conducted a monocentric investigation including patients with CIS in the time from 2010 to 2015. Follow-ups of 120 patients revealed that 42% converted to MS. CIS patients with positive oligoclonal bands (OCB) were more than twice as likely to convert to MS as OCB negative patients (hazard ratio = 2.6). The probability to develop MS was even higher when a quantitative intrathecal IgG synthesis was detected (hazard ratio = 3.8). In patients with OCB, VEP did not add further information concerning the conversion rate to MS. In patients with optic neuritis and negative OCB, a significantly higher rate converted to MS when VEP were delayed. In conclusion, the detection of an intrathecal IgG synthesis increases the conversion probability to MS. Pathological VEP can help to predict the conversion rate to MS in patients with optic neuritis without an intrathecal IgG synthesis.

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Section: Discussionmentioning

confidence: 99%

Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis

Schwenkenbecher

Sarikidi

Bönig

et al. 2017

IJMS

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“…It is the leading cause of disabilities in young adults. Although it does not have a limiting effect on survival, it is associated with the potential of development of disability over years, thus having significant socioeconomic outcomes [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

The Three Sisters of Fate in Multiple Sclerosis: Klotho (Clotho), Fibroblast Growth Factor-23 (Lachesis), and Vitamin D (Atropos)

Elli̇dağ

Yılmaz

Kurtuluş³

et al. 2016

Ann Neurosci

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Background: The klotho (Klt)-fibroblast growth factor-23 (FGF-23)-vitamin D axis is the main component of calcium (Ca) and phosphorus (P) metabolisms; on the contrary, it is also secreted from the choroid plexus (CP). Purpose: This study is aimed at evaluating serum soluble Klt (sKlt), FGF-23, and 25-(OH)-vitamin D levels in multiple sclerosis (MS) patients. Methods: Thirty-two relapsing-remitting MS patients (11 males and 21 females; mean age 38.3 years) and 31 age-sex matched healthy controls (12 males and 19 females; median age 38.5 years) were included in this study. All patients were diagnosed with MS according to the criteria of McDonald. Results: Serum sKlt, FGF-23, and P levels were significantly higher in MS patients compared to the control group (p < 0.01, p < 0.01, and p = 0.02, respectively). Serum 25-(OH)-vitamin D and Ca levels were significantly lower in MS patients (p < 0.01 and p = 0.04, respectively). Conclusion: Klt, which is secreted from CP, could be a response to the inflammatory condition in MS. Elevated FGF-23 levels suppress 1α-hydroxylase and upregulates 24α-hydroxylase, which results in a decrease in 1,25-(OH)₂D₃ levels. Thus, the neuroprotective and immunomodulatory effects of vitamin D might not be seen in MS patients.

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“…The association between CSF-OCB status and MRI features remains unclear. Previous studies on the MRI differences between OCB-positive and OCB-negative patients have been limited to traditional MRI parameters such as anatomical lesion locations or visually graded brain atrophy, and results have been inconsistent 13,14 . Thus, in this study, we explored the association between CSF-OCB status and advanced MRI metrics that are related to disease prognosis.…”

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confidence: 99%

Advanced MRI features in relapsing multiple sclerosis patients with and without CSF oligoclonal IgG bands

Zhao

Abrigo

Chen

et al. 2020

Sci Rep

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Oligoclonal IgG bands (OCB) in cerebrospinal fluid (CSF) are important in diagnosis of multiple sclerosis (MS). We evaluated the MRI features of clinically definite MS subjects with and without CSF-OCB. Relapsing MS subjects were recruited from a prospective registry in a university center. CSF-OCB were detected using isoelectric focusing and lgG-specific immunofixation. MRI metrics including brain volumes, lesion volumes and microstructural measures, were analyzed by fMRiB Software Library (fSL) and Statistical parametric Mapping (SpM). Seventy-five subjects with relapsing MS were analyzed. Forty-four (59%) subjects had an interval MRI at around 1 year. CSF-OCB were detected in 46 (61%) subjects. The OCB-positive group had a higher proportion of cerebellar lesions than the OCB-negative group (23.9% vs. 3.4%, p = 0.057). Except for amygdala volumes which were lower in the OCB-positive group (p = 0.034), other regional brain volumes including the subcortical deep gray matter and corpus callosum were similar. the two groups also showed comparable brain atrophy rate. For DTI, the OCB-positive group showed significantly higher mean diffusivity (MD) value in perilesional normal-appearing white matter (p = 0.043). Relapsing MS patients with and without CSF-OCB shared similar MRi features regarding volumetric analyses and Dti microstructural integrity. Oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) are one of the most sensitive biomarkers in the diagnostic work-up of multiple sclerosis (MS), and inclusion of their presence into the updated McDonald criteria has improved clinical diagnosis 1. Up to 95% of Caucasian patients and 60% of Asian patients with MS are positive for CSF-OCB 2,3. Limited data support that CSF-OCB may be involved in the pathogenesis of MS; some pathological studies revealed that tissue damage may be underpinned by other types of oligoclonal bands such as IgM 4. Meanwhile, the relationship between CSF-OCB status and disease characteristics, such as clinical course, disease progression, responses to disease modifying therapies, remain unclear 3,5. Magnetic resonance imaging (MRI) is now standard of care in the management of MS, allowing diagnosis and monitoring of treatment response in clinical practice 6. Compared to conventional MRI alone, the use of high-resolution images, advanced pulse sequences and advanced computational techniques provides a more comprehensive information on the pathophysiological extent of disease. For instance, volumetric imaging allows a more precise quantitative assessment of brain atrophy which in turn has been shown to occur early in the disease course and is associated with disease progression of MS 7,8. Recent clinical trials have incorporated brain atrophy, at an annual brain volume loss (BVL) rate threshold of 0.4%, as a secondary outcome measure and marker of neurodegeneration in MS 9. Meanwhile, diffusion tensor imaging (DTI) allows microstructural assessment of white matter integrity by quantifying the magnitude and directionality of the molecular di...

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Comparison of neurophysiological and mri findings of patients with multiple sclerosis using oligoclonal band technique

Cited by 10 publications

References 44 publications

Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis

Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis

The Three Sisters of Fate in Multiple Sclerosis: Klotho (Clotho), Fibroblast Growth Factor-23 (Lachesis), and Vitamin D (Atropos)

Advanced MRI features in relapsing multiple sclerosis patients with and without CSF oligoclonal IgG bands

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