title: Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude.
abstract: BACKGROUND
  Oligoclonal bands (OCBs) unique to the cerebrospinal fluid are used in the diagnosis of multiple sclerosis (MS). The precise prevalence of OCBs in MS and clinically isolated syndrome (CIS) is unknown. The influence of OCBs on clinical outcomes has not been quantified. OCB prevalence has been associated with latitude in a single study, if confirmed this would provide avenues for further study.
  
  
  METHODS
  Using a systematic review and meta-analysis approach, the proportion of OCB-positive MS and CIS and the influence of OCBs on clinical outcomes were calculated. The relationship between latitude and OCB prevalence was calculated using linear regression.
  
  
  RESULTS
  Seventy-one articles were included. Overall, 87.7% of 12 253 MS and 68.6% of 2685 CIS patients were OCB positive. OCB-positive MS patients had an OR of 1.96 of reaching disability outcomes, although a number of negative studies did not provide data. OCB-positive CIS patients had an OR of 9.88 of conversion to MS. Latitude predicted OCB status in MS patients (p=0.009) but not in CIS patients.
  
  
  CONCLUSIONS
  This is the largest study of OCB prevalence in MS and CIS. OCB positivity strongly predicts conversion from CIS to MS. The relationship between latitude and OCBs is confirmed, and this finding warrants further investigation.
authors: Blizard Institute, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, 4 Newark Street, London E1 2AT, UK. ruth.dobson@qmul.ac.uk
authors: Ruth
authors: R
authors: Dobson
authors: Sreeram
authors: S
authors: Ramagopalan
authors: Angharad
authors: A
authors: Davis
authors: Gavin
authors: G
authors: Giovannoni
mesh_terms: D003627:Data Interpretation, Statistical; D005500:Follow-Up Studies; D005843:Geography; D006801:Humans; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid* / Q000453:epidemiology; D016017:Odds Ratio; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D015995:Prevalence; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D043025:Oligoclonal Bands
keywords: CSF; Immunology; Meta-Analysis