title: Intrathecal oligoclonal IgG synthesis in multiple sclerosis.
abstract: The diagnosis of multiple sclerosis is based on dissemination in time and space. Before 2010 lack of evidence for dissemination in space could be substituted by a paraclinical test, cerebrospinal fluid (CSF) oligoclonal bands (OCBs). The present meta-analysis (13,467 patients) shows that the diagnostic specificity of OCB drops from 94% to 61% if inflammatory etiologies are considered. Importantly, this was not caused by poor laboratory practice. This review on CSF OCB further illustrates the conceptional problem of substituting dissemination in space with a biomarker. The potential prognostic value of intrathecal OCB will need to be tested prospectively.
authors.affiliation: Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology, Neuroimmunology & CSF Laboratory, Queen Square, London, United Kingdom. Electronic address: a.petzold@vumc.nl.
authors.forename: Axel
authors.initials: A
authors.lastname: Petzold
mesh_terms: D016175:B-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers / Q000134:cerebrospinal fluid; D006801:Humans; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid* / Q000276:immunology* / Q000378:metabolism; D043025:Oligoclonal Bands / Q000096:biosynthesis* / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D043025:Oligoclonal Bands
keywords: Cerebrospinal fluid; Diagnostic criteria; Multiple sclerosis