Abstract
In multiple sclerosis (MS) more than 95% of the patients have positive oligoclonal bands (OCB) in the cerebrospinal fluid (CSF). Previous studies have reported differences between patients with and without OCB mainly with regard to clinical parameters such as age, gender, disease duration, and clinical severity. However, several MRI characteristics have also been hypothesized to be distinct, and a varying lesion load in OCB-negative and -positive patients is proposed. In this study, we aimed to evaluate whether Barkhof’s diagnostic MRI criteria are unequally frequently fulfilled in OCB-negative and -positive MS patients. We screened our database for all OCB-negative MS patients who had (1) been treated with the diagnosis of a clinical definite relapsing-remitting MS in our institution as well as (2) undergone CSF analysis and MR brain imaging during hospital stay between January 2004 and December 2007. Eleven OCB-negative patients were identified who fulfilled these criteria. In a second step, we carefully matched each of them to two OCB-positive controls according to age, gender, EDSS, and disease duration. The separate analysis of the several parameters of Barkhof’s criteria revealed a less frequent prevalence of infratentorial (3/11 vs. 18/22; P = 0.005) and a more frequent occurrence of juxtacortical lesions (10/11 vs. 10/22; P = 0.022) in OCB-negative as compared to OCB-positive patients. The overall fulfillment of the Barkhof criteria did not differ in OCB-negative and -positive patients (7/11 vs. 16/22; P = 0.696). Further analyses of MRI findings between OCB-negative and -positive MS patients might contribute to a better pathophysiological understanding of the genesis and evidence of OCB in the CSF of MS patients.
Similar content being viewed by others
References
Andersson M, Alvarez-Cermeno J, Bernardi G, Cogato I, Fredman P, Frederiksen J, Fredrikson S, Gallo P, Grimaldi LM, Gronning M et al (1994) Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report. J Neurol Neurosurg Psychiatry 57:897–902
Arnold DL, Matthews PM (2002) MRI in the diagnosis and management of multiple sclerosis. Neurology 58:S23–S31
Avasarala JR, Cross AH, Trotter JL (2001) Oligoclonal band number as a marker for prognosis in multiple sclerosis. Arch Neurol 58:2044–2045
Bakshi R, Hutton GJ, Miller JR, Radue EW (2004) The use of magnetic resonance imaging in the diagnosis and long-term management of multiple sclerosis. Neurology 63:S3–S11
Barkhof F, Filippi M, Miller DH, Scheltens P, Campi A, Polman CH, Comi G, Ader HJ, Losseff N, Valk J (1997) Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain 120(Pt 11):2059–2069
Bergamaschi R, Tonietti S, Franciotta D, Candeloro E, Tavazzi E, Piccolo G, Romani A, Cosi V (2004) Oligoclonal bands in Devic’s neuromyelitis optica and multiple sclerosis: differences in repeated cerebrospinal fluid examinations. Mult Scler 10:2–4
Brex PA, Ciccarelli O, O’Riordan JI, Sailer M, Thompson AJ, Miller DH (2002) A longitudinal study of abnormalities on MRI and disability from multiple sclerosis. N Engl J Med 346:158–164
Fukazawa T, Kikuchi S, Sasaki H, Hamada K, Hamada T, Miyasaka K, Tashiro K (1998) The significance of oligoclonal bands in multiple sclerosis in Japan: relevance of immunogenetic backgrounds. J Neurol Sci 158:209–214
Goffette S, Schluep M, Henry H, Duprez T, Sindic CJ (2004) Detection of oligoclonal free kappa chains in the absence of oligoclonal IgG in the CSF of patients with suspected multiple sclerosis. J Neurol Neurosurg Psychiatry 75:308–310
Imrell K, Landtblom AM, Hillert J, Masterman T (2006) Multiple sclerosis with and without CSF bands: clinically indistinguishable but immunogenetically distinct. Neurology 67:1062–1064
Kappos L, Moeri D, Radue EW, Schoetzau A, Schweikert K, Barkhof F, Miller D, Guttmann CR, Weiner HL, Gasperini C, Filippi M (1999) Predictive value of gadolinium-enhanced magnetic resonance imaging for relapse rate and changes in disability or impairment in multiple sclerosis: a meta-analysis. Gadolinium MRI Meta-analysis Group. Lancet 353:964–969
Lee KH, Hashimoto SA, Hooge JP, Kastrukoff LF, Oger JJ, Li DK, Paty DW (1991) Magnetic resonance imaging of the head in the diagnosis of multiple sclerosis: a prospective 2-year follow-up with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT. Neurology 41:657–660
Lycklama a Nijeholt G, Barkhof F (2003) Differences between subgroups of MS: MRI findings and correlation with histopathology. J Neurol Sci 206:173–174
Lycklama G, Thompson A, Filippi M, Miller D, Polman C, Fazekas F, Barkhof F (2003) Spinal-cord MRI in multiple sclerosis. Lancet Neurol 2:555–562
McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 50:121–127
Mesaroc S, Drulovic J, Levic Z, Peric V (2003) Magnetic resonance findings in the brain of patients with multiple sclerosis without oligoclonal bands in the cerebrospinal fluid. Srp Arh Celok Lek 131:31–35
Mesaros S, Drulovic J, Levic Z (2003) Clinical characteristics and neurophysiologic findings in patients with multiple sclerosis without oligoclonal IgG in cerebrospinal fluid. Srp Arh Celok Lek 131:122–126
Minneboo A, Barkhof F, Polman CH, Uitdehaag BM, Knol DL, Castelijns JA (2004) Infratentorial lesions predict long-term disability in patients with initial findings suggestive of multiple sclerosis. Arch Neurol 61:217–221
Minneboo A, Uitdehaag BM, Ader HJ, Barkhof F, Polman CH, Castelijns JA (2005) Patterns of enhancing lesion evolution in multiple sclerosis are uniform within patients. Neurology 65:56–61
Nakashima I, Fujihara K, Misu T, Fujimori J, Sato S, Takase S, Itoyama Y (2002) A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands. Mult Scler 8:459–462
Nakashima I, Fujihara K, Miyazawa H, Misu T, Fujimori J, Sato S, Itoyama Y (2006) Relevance of callosal and periventricular MRI lesions to oligoclonal bands in multiple sclerosis. Acta Neurol Scand 113:125–131
Nijeholt GJ, van Walderveen MA, Castelijns JA, van Waesberghe JH, Polman C, Scheltens P, Rosier PF, Jongen PJ, Barkhof F (1998) Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms. Brain 121(4):687–697
Paty DW, Oger JJ, Kastrukoff LF, Hashimoto SA, Hooge JP, Eisen AA, Eisen KA, Purves SJ, Low MD, Brandejs V et al (1988) MRI in the diagnosis of MS: a prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT. Neurology 38:180–185
Pittock SJ, McClelland RL, Mayr WT, Jorgensen NW, Weinshenker BG, Noseworthy J, Rodriguez M (2004) Clinical implications of benign multiple sclerosis: a 20-year population-based follow-up study. Ann Neurol 56:303–306
Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O’Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol 58:840–846
Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231
Reiber H (1994) Flow rate of cerebrospinal fluid (CSF)—a concept common to normal blood-CSF barrier function and to dysfunction in neurological diseases. J Neurol Sci 122:189–203
Reiber H, Peter JB (2001) Cerebrospinal fluid analysis: disease-related data patterns and evaluation programs. J Neurol Sci 184:101–122
Reiber H, Sindic CJM, Thompson EJ (2006) Cerebrospinal fluid—clinical neurochemistry of neurological diseases. Springer-Verlag, Heidelberg, Germany
Reiber H, Ungefehr S, Jacobi C (1998) The intrathecal, polyspecific and oligoclonal immune response in multiple sclerosis. Mult Scler 4:111–117
Tas MW, Barkhol F, van Walderveen MA, Polman CH, Hommes OR, Valk J (1995) The effect of gadolinium on the sensitivity and specificity of MR in the initial diagnosis of multiple sclerosis. AJNR Am J Neuroradiol 16:259–264
Tintore M, Rovira A, Martinez MJ, Rio J, Diaz-Villoslada P, Brieva L, Borras C, Grive E, Capellades J, Montalban X (2000) Isolated demyelinating syndromes: comparison of different MR imaging criteria to predict conversion to clinically definite multiple sclerosis. AJNR Am J Neuroradiol 21:702–706
Tintore M, Rovira A, Rio J, Nos C, Grive E, Sastre-Garriga J, Pericot I, Sanchez E, Comabella M, Montalban X (2003) New diagnostic criteria for multiple sclerosis: application in first demyelinating episode. Neurology 60:27–30
Tintore M, Rovira A, Rio J, Nos C, Grive E, Tellez N, Pelayo R, Comabella M, Sastre-Garriga J, Montalban X (2006) Baseline MRI predicts future attacks and disability in clinically isolated syndromes. Neurology 67:968–972
Tintore M, Rovira A, Rio J, Tur C, Pelayo R, Nos C, Tellez N, Perkal H, Comabella M, Sastre-Garriga J, Montalban X (2008) Do oligoclonal bands add information to MRI in first attacks of multiple sclerosis? Neurology 70:1079–1083
Villar LM, Masjuan J, Gonzalez-Porque P, Plaza J, Sadaba MC, Roldan E, Bootello A, Alvarez-Cermeno JC (2002) Intrathecal IgM synthesis in neurologic diseases: relationship with disability in MS. Neurology 58:824–826
Villar LM, Masjuan J, Gonzalez-Porque P, Plaza J, Sadaba MC, Roldan E, Bootello A, Alvarez-Cermeno JC (2003) Intrathecal IgM synthesis is a prognostic factor in multiple sclerosis. Ann Neurol 53:222–226
Villar LM, Masjuan J, Sadaba MC, Gonzalez-Porque P, Plaza J, Bootello A, Alvarez-Cermeno JC (2005) Early differential diagnosis of multiple sclerosis using a new oligoclonal band test. Arch Neurol 62:574–577
Zeman AZ, Kidd D, McLean BN, Kelly MA, Francis DA, Miller DH, Kendall BE, Rudge P, Thompson EJ, McDonald WI (1996) A study of oligoclonal band negative multiple sclerosis. J Neurol Neurosurg Psychiatry 60:27–30
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Huttner, H.B., Schellinger, P.D., Struffert, T. et al. MRI criteria in MS patients with negative and positive oligoclonal bands: equal fulfillment of Barkhof’s criteria but different lesion patterns. J Neurol 256, 1121–1125 (2009). https://doi.org/10.1007/s00415-009-5081-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00415-009-5081-y