Research Article| Volume 19, P55-58, January 2018

Brain volume in early MS patients with and without IgG oligoclonal bands in CSF

Published:November 07, 2017DOI:


      • Oligoclonal bands of IgG (OB) are proposed as an early prognostic factor of the disease.
      • Growing attention is directed towards brain volume as a possible marker of the severity of MS.
      • In our study OB positive patients show more white matter atrophy since early phases.
      • Our data supporting the role of CSF analysis as a prognostic factor in MS.



      Oligoclonal bands of IgG (OB) are proposed as an early prognostic factor of the disease. Growing attention is directed towards brain volume evaluation as a possible marker of the severity of MS. Previous studies found that MS patients lacking OB have less brain atrophy.


      to evaluate a possible relationship between OB and cerebral volume in a cohort of early MS patients.


      Inclusion criteria were: diagnosis of relapsing-remitting MS; CSF analysis and MRI acquired simultaneously and within 12 months from clinical onset. A total of 15 healthy controls underwent MRI.


      In 20 MS patients, CSF analysis did not show OB synthesis (OB negative group). A control group of 25 MS patients in whom OB was detected was also randomly recruited (OB positive group). T test showed a significant difference in NWV between the OB positive and OB negative groups (P value = 0.01), and between the OB positive group and the healthy controls (P value = 0.001). No differences were detected between OB negative group and healthy controls.
      Multivariable linear regression showed a relationship between NWV and OB synthesis (P value = 0.02) controlling for age, gender, and EDSS.


      Our preliminary results suggest that OB positive patients show more atrophy of white matter since early phases of the disease, supporting the role of CSF analysis as a prognostic factor in MS.


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        • Álvarez-Cermeño J.C.
        • Villar L.M.
        Multiple sclerosis: oligoclonal bands--a useful tool to avoid MS misdiagnosis.
        Nat. Rev. Neurol. 2013; 9: 303-304
        • Battaglini M.
        • Jenkinson M.
        • De Stefano N.
        Evaluating and reducing the impact of white matter lesions on brain volume measurements.
        Hum. Brain Mapp. 2012; 33: 2062-2071
        • Brown J.W.
        • Pardini M.
        • Brownlee W.J.
        • et al.
        An abnormal periventricular magnetization transfer ratio gradient occurs early in multiple sclerosis.
        Brain. 2017; 140: 387-398
        • Brownlee W.J.
        • Hardy T.A.
        • Fazekas F.
        • Miller D.H.
        Diagnosis of multiple sclerosis: progress and challenges.
        Lancet. 2017; 389 (Epub 2016 Nov 24. Review PubMed PMID: 27889190.): 1336-1346
        • Cocco E.
        • Meloni A.
        • Murru M.R.
        • et al.
        Vitamin D responsive elements within the HLA-DRB1 promoter region in Sardinian multiple sclerosis associated alleles.
        PLoS One. 2012; 7: e41678
        • Cocco E.
        • Sardu C.
        • Spinicci G.
        • et al.
        Influence of treatments in multiple sclerosis disability: a cohort study.
        Mult. Scler. 2015; 21: 433-441
        • Confavreux C.
        • Vukusic S.
        The clinical course of multiple sclerosis.
        Handb. Clin. Neurol. 2014; 122 (Review PubMed PMID: 24507525.): 343-369
        • De Stefano N.
        • Airas L.
        • Grigoriadis N.
        • et al.
        Clinical relevance of brain volume measures in multiple sclerosis.
        CNS Drugs. 2014; 28: 147-156
        • Di Filippo M.
        • Anderson V.M.
        • Altmann D.R.
        • et al.
        Brain atrophy and lesion load measures over 1 year relate to clinical status after 6 years in patients with clinically isolated syndromes.
        J. Neurol. Neurosurg. Psychiatry. 2010; 81: 204-208
        • Dobson R.
        • Ramagopalan S.
        • Davis A.
        • et al.
        Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude.
        J. Neurol. Neurosurg. Psychiatry. 2013; 84: 909-914
        • Ferreira D.
        • et al.
        Multiple sclerosis patients lacking oligoclonal bands in the cerebrospinal fluid have less global and regional brain atrophy.
        J. Neuroimmunol. 2014; 2014
        • Gajofatto A.
        • Calabrese M.
        • Benedetti M.D.
        • et al.
        Clinical, MRI, and CSF markers of disability progression in multiple sclerosis.
        Dis. Markers. 2013; 35: 687-699
        • Giovannoni G.
        Cerebrospinal fluid analysis.
        Handb. Clin. Neurol. 2014; 122: 681-702
        • Haider L.
        • Zrzavy T.
        • Hametner S.
        • et al.
        The topograpy of demyelination and neurodegeneration in the multiple sclerosis brain.
        Brain. 2016; 139: 807-815
        • Joseph F.G.
        • Hirst C.L.
        • Pickersgill T.P.
        • et al.
        CSF oligoclonal band status informs prognosis in multiple sclerosis: a case control study of 100 patients.
        J. Neurol. Neurosurg. Psychiatry. 2009; 80: 292-296
        • Kantarci O.H.
        • Lebrun C.
        • Siva A.
        • et al.
        Primary progressive multiple sclerosis Evolving From Radiologically isolated syndrome.
        Ann. Neurol. 2016; 79: 288-294
        • Lechner-Scott J.
        • Spencer B.
        • de Malmanche T.
        • et al.
        The frequency of CSF oligoclonal banding in multiple sclerosis increases with latitude.
        Mult. Scler. 2012; 18: 974-982
        • Moroso A.
        • Deloire M.S.
        • Ruet A.
        • et al.
        Does cerebrospinal fluid analysis add predictive value to magnetic resonance imaging for long term irreversible disability in patients with early multiple sclerosis?.
        J. Neurol. Sci. 2015; 354: 51-55
        • Pérez-Miralles F.C.
        • Sastre-Garriga J.
        • Vidal-Jordana A.
        • et al.
        Predictive value of early brain atrophy on response in patients treated with interferon β.
        Neurol. Neuroimmunol. Neuroinflamm. 2015; 2: e132
        • Polman C.H.
        • Reingold S.C.
        • Banwell B.
        • et al.
        Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.
        Ann. Neurol. 2011; 69: 292-302
        • Rojas J.I.
        • Patrucco L.
        • Tizio S.
        • et al.
        Oligoclonal bands in the cerebrospinal fluid and increased brain atrophy in early stages of relapsing-remitting multiple sclerosis.
        Arq. Neuropsiquiatr. 2012; 70: 574-577
        • Rudick R.A.
        • Fisher E.
        • Lee J.C.
        • et al.
        Brain atrophy in relapsing multiple sclerosis: relationship to relapses, EDSS, and treatment with interferon beta-1a.
        Mult. Scler. 2000; 6: 365-372
        • Smith S.M.
        • Zhang Y.
        • Jenkinson M.
        • et al.
        Accurate, robust and automated longitudinal and cross-sectional brain change analysis.
        NeuroImage. 2002; 17: 479-489
        • Sormani M.P.
        • Kappos L.
        • Radue E.W.
        • et al.
        Defining brain volume cutoffs to identify clinically relevant atrophy in RRMS.
        Mult. Scler. 2016; 13: 187-193
        • Steri M.
        • Orrù V.
        • Idda M.L.
        • et al.
        Overexpression of the cytokine BAFF and autoimmunity risk.
        N. Engl. J. Med. 2017; 376: 1615-1626
        • Tintore M.
        • Rovira À.
        • Río J.
        • Otero-Romero S.
        • et al.
        Defining high, medium and low impact prognostic factors for developing multiple sclerosis.
        Brain. 2015; 138: 1863-1874
        • Uher T.
        • Vaneckova M.
        • Sobisek L.
        • et al.
        Combining clinical and magnetic resonance imaging markers enhances prediction of 12-year disability in multiple sclerosis.
        Mult. Scler. 2016; 6: 112-116
        • Vidal-Jordana A.
        • Sastre-Garriga J.
        • Rovira A.
        • et al.
        Treating relapsing-remitting multiple sclerosis: therapy effects on brain atrophy.
        J. Neurol. 2015; 262: 2617-2626
        • Vidal-Jordana A.
        • Sastre-Garriga J.
        • Pérez-Miralles F.
        • et al.
        Brain volume loss during the first year of interferon-beta treatment: baseline inflammation and tissue-specific volume dynamics.
        J. Neuroimaging. 2016;
        • Wang C.
        • Beadnall H.N.
        • Hatton S.N.
        • et al.
        Automated brain volumetrics in multiple sclerosis: a step closer to clinical application.
        J. Neurol. Neurosurg. Psychiatry. 2016;
        • Wattjes M.P.
        • Rovira À.
        • Miller D.
        • et al.
        Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis--establishing disease prognosis and monitoring patients.
        Nat. RevNeurol. 2015; 11: 597-606
        • Zivadinov R.
        • Jakimovski D.
        • Gandhi S.
        • et al.
        Clinical relevance of brain atrophy assessment in multiple sclerosis. Implications for its use in a clinical routine.
        Expert Rev. Neurother. 2016; 13: 1-17