title: Tear analysis in clinically isolated syndrome as new multiple sclerosis criterion.
abstract: In clinically isolated syndrome (CIS), the detection of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is critical for space dissemination validation when magnetic resonance imaging (MRI) diagnostic criteria are not fulfilled. However, lumbar puncture for CSF collection is considered relatively invasive. Previous studies have demonstrated applicability of OCB detection in tears to the diagnosis of multiple sclerosis (MS). The objective of the present study was to assess concordance between OCB detection in tears and in CSF. We have prospectively included patients with CIS and compared results of CSF and tear OCB detection by isoelectric focusing (IEF). Tears were collected using a Schirmer strip. We included 82 patients. For 69 of them, samples were analysable. OCBs were detected in CSF for 63.8% and in tears for 42% of patients. All patients with tear OCBs had CSF OCBs. We suggest that tear OCB detection may replace CSF OCB detection as a diagnostic tool in patients with CIS. This would circumvent the practice of invasive lumbar punctures currently used in MS diagnosis.
authors.affiliation: Groupe Hospitalier de l'Institut Catholique de Lille, Service de Neurologie, Lille, France. calais.gauthier@ghicl.net
authors.forename: Gauthier
authors.initials: G
authors.lastname: Calais
authors.forename: Gerard
authors.initials: G
authors.lastname: Forzy
authors.forename: Charlotte
authors.initials: C
authors.lastname: Crinquette
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mackowiak
authors.forename: Jerome
authors.initials: J
authors.lastname: de Seze
authors.forename: Frederic
authors.initials: F
authors.lastname: Blanc
authors.forename: Christine
authors.initials: C
authors.lastname: Lebrun
authors.forename: Olivier
authors.initials: O
authors.lastname: Heinzlef
authors.forename: Pierre
authors.initials: P
authors.lastname: Clavelou
authors.forename: Thibault
authors.initials: T
authors.lastname: Moreau
authors.forename: Bernadette
authors.initials: B
authors.lastname: Hennache
authors.forename: Helene
authors.initials: H
authors.lastname: Zephir
authors.forename: Albert
authors.initials: A
authors.lastname: Verier
authors.forename: Véronique
authors.initials: V
authors.lastname: Neuville
authors.forename: Christian
authors.initials: C
authors.lastname: Confavreux
authors.forename: Patrick
authors.initials: P
authors.lastname: Vermersch
authors.forename: Patrick
authors.initials: P
authors.lastname: Hautecoeur
mesh_terms: D000328:Adult; D017668:Age of Onset; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000134:cerebrospinal fluid / Q000378:metabolism; D007525:Isoelectric Focusing; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000378:metabolism; D043025:Oligoclonal Bands; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry* / Q000276:immunology; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G; D043025:Oligoclonal Bands