No prognostic value of routine cerebrospinal fluid biomarkers in a population-based cohort of 407 multiple sclerosis patients

Becker, Madlyne; Latarche, Clotilde; Roman, Emilie; Debouverie, Marc; Malaplate-Armand, Catherine; Guillemin, Françis

doi:10.1186/s12883-015-0330-4

Cited by 23 publications

(17 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…27,28 The presence of OCB in the CSF, as an indication of local production of IgG in the central nervous system, has also been associated with a higher risk of disability worsening in patients with MS. 8,14,28 However, these associations were not confirmed by others. 15,16,29 In contrast with previous studies, we investigated this in a large, prospective, well-controlled, multicenter cohort of patients with newly diagnosed MS or CIS and a standardized EDSS rating every 12 months, and we carefully adjusted the analysis for known factors influencing disease worsening.…”

Section: Discussionmentioning

confidence: 99%

Association of Intrathecal Immunoglobulin G Synthesis With Disability Worsening in Multiple Sclerosis

et al. 2019

View full text Add to dashboard Cite

; for the German Competence Network of Multiple Sclerosis IMPORTANCE Reliable biomarkers associated with disability worsening in multiple sclerosis (MS) are still needed. OBJECTIVE To determine a possible association of intrathecal IgG synthesis and early disability worsening as measured by Expanded Disability Status Scale (EDSS) scoring in patients with relapsing-remitting MS or clinically isolated syndrome. DESIGN, SETTING, AND PARTICIPANTS Cerebrospinal fluid measurements and clinical data from the observational longitudinal German national multiple sclerosis cohort were analyzed.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of Intrathecal Immunoglobulin G Synthesis With Disability Worsening in Multiple Sclerosis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Additionally, the frequent use of gadolinium-based contrast agents can result in the development of gadolinium brain deposits in some patients (16). Unfortunately, an alternative imaging technique, diffusion-weighted imaging suffers from a high false positive rate (17), and traditional MS diagnostic markers in CSF, such as IgG, and oligoclonal bands, have not been shown to carry prognostic value for relapse (18). Since biomarkers have been used to identify and predict relapse in rheumatoid arthritis (RA) (19), research in recent years has sought to find a similar panel of markers for RRMS.…”

Section: Biomarkers For Ms Relapsementioning

confidence: 99%

Emerging Approaches for Validating and Managing Multiple Sclerosis Relapse

2017

View full text Add to dashboard Cite

The autoimmune disease multiple sclerosis (MS) is characterized by relapses in the majority of patients. A definitive clinical diagnosis of relapse in MS can be complicated by the presence of an infection or comorbid disorder. In this mini-review, we describe efforts to develop enhanced imaging techniques and biomarker detection as future tools for relapse validation. There is emerging evidence of roles for meningeal inflammation, sex hormones, comorbid metabolic or mood disorders, and a dysregulated immune profile in the manifestation and severity of relapse. Specific subsets of immune cells likely drive the pathophysiology of relapse, and identification of a patient’s unique immunological signature of relapse may help guide future diagnosis and treatment. Finally, these studies highlight the diversity in terms of relapse presentation, immunological signature, and response in patients with MS, indicating that going forward the best approach to assessment and treatment of relapse will be multifactorial and highly personalized.

show abstract

“…Studies on its specificity, however, generated mixing results (7)(8)(9)(10). Furthermore, the prognostic value of IgG index or OCB remains undetermined based on existing evidence (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

IgG Index Revisited: Diagnostic Utility and Prognostic Value in Multiple Sclerosis

et al. 2020

View full text Add to dashboard Cite

Objective: Early and accurate diagnosis of multiple sclerosis (MS) remains a clinical challenge. The main objective is to evaluate the diagnostic and prognostic value of the routinely performed immunoglobulin G (IgG) index for MS patients in the Asian population. Methods: A retrospective study was conducted among a cohort of clinically isolated syndrome (CIS) patients in China with known oligoclonal band (OCB) status and IgG index at baseline. We first evaluated the predictive value of IgG index for OCB status. Secondly, the diagnostic utility and prognostic value of IgG index alone were tested. Lastly, we incorporated IgG index into the 2017 McDonald criteria by replacing OCB with either "IgG index or OCB" (modified criteria 1), "IgG index and OCB" (modified criteria 2), or "IgG index" (modified criteria 3). The diagnostic utility of different criteria was calculated and compared. Results: In a CIS cohort in China (n = 105), IgG index > 0.7 forecasted OCB positivity (X 2 = 22.90, P < 0.001). An elevated IgG index was highly prognostic of more clinical relapses [1-year adjusted odds ratio [OR] = 1.32, P = 0.015; 2-years adjusted OR = 1.69, P = 0.013] and Expanded Disability Status Scale worsening (1-year adjusted OR = 1.76, P = 0.040; 2-years adjusted OR = 1.85, P = 0.032). Under the 2017 McDonald criteria (Positive Likelihood Ratio = 1.54, Negative Likelihood Ratio = 0.56), an IgG index > 0.7 in CIS patients increased the likelihood of developing MS within 2 years, either when OCB status was unknown (Positive Likelihood Ratio = 2.11) or with OCB positivity (Positive Likelihood Ratio = 2.11) at baseline; An IgG index ≤ 0.7, along with a negative OCB, helped rule out the MS diagnosis (Negative Likelihood Ratio = 0.53). Conclusions: IgG index > 0.7 predicts OCB positivity at the initial attack of MS and is prognostic of early disease activity. IgG index serves as an easily-obtainable and accurate OCB surrogate for MS diagnosis in the Asian population.

show abstract

No prognostic value of routine cerebrospinal fluid biomarkers in a population-based cohort of 407 multiple sclerosis patients

Cited by 23 publications

References 54 publications

Association of Intrathecal Immunoglobulin G Synthesis With Disability Worsening in Multiple Sclerosis

Association of Intrathecal Immunoglobulin G Synthesis With Disability Worsening in Multiple Sclerosis

Emerging Approaches for Validating and Managing Multiple Sclerosis Relapse

IgG Index Revisited: Diagnostic Utility and Prognostic Value in Multiple Sclerosis

Contact Info

Product

Resources

About