title: No prognostic value of routine cerebrospinal fluid biomarkers in a population-based cohort of 407 multiple sclerosis patients.
abstract: BACKGROUND
  We aimed to determine the association of clinical and routine cerebrospinal fluid biochemical markers (total protein, IgG index and oligoclonal bands) with disability in multiple sclerosis and whether these biomarkers assessed at diagnosis add prognostic value.
  
  
  METHODS
  We followed a cohort of patients included in the Multiple Sclerosis Lorraine Register (eastern France) who had a diagnosis of multiple sclerosis for at least 5 years, as well as biological markers values and MRI findings (Barkhof's criteria). In a Cox regression model, endpoint was time to score of 4 on the Expanded Disability Status Scale (EDSS) (i.e., limited time walking without aid or rest for more than 500 m).
  
  
  RESULTS
  For 407 patients included, the median time from multiple sclerosis onset to EDSS score 4 was 4.5 years [2.2-7.2]. Cerebrospinal fluid total protein factor < 500 mg/L was associated with EDSS score 4 on bivariate analysis (hazard ratio 0.66, 95% confidence interval 0.46-0.95, p = 0.02). On multivariate analysis, older age at disease onset (≥50 years) and initial primary progressive course of MS but not biological markers predicted worse prognosis.
  
  
  CONCLUSIONS
  Routine cerebrospinal fluid biological markers at diagnosis were not prognostic factors of multiple sclerosis progression.
authors.affiliation: INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. m.becker@chu-nancy.fr.|Departement of Clinical Epidemiology and Evaluation, Nancy University Hospital, F-54 000, Nancy, France. m.becker@chu-nancy.fr.|Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France. m.becker@chu-nancy.fr.
authors.forename: Madlyne
authors.initials: M
authors.lastname: Becker
authors.affiliation: INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. c.latarche@chu-nancy.fr.|Departement of Clinical Epidemiology and Evaluation, Nancy University Hospital, F-54 000, Nancy, France. c.latarche@chu-nancy.fr.|Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France. c.latarche@chu-nancy.fr.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Latarche
authors.affiliation: Metz-Thionville Hospital, Bel Air Hospital, Departement of Biology, F-57 100, Thionville, France. e.roman@chr-metz-thionville.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Roman
authors.affiliation: INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. m.debouverie@chu-nancy.fr.|Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France. m.debouverie@chu-nancy.fr.|Department of Neurology, Nancy University Hospital, F-54 000, Nancy, France. m.debouverie@chu-nancy.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Debouverie
authors.affiliation: Department of Biochemistry and Molecular Biology, Nancy University Hospital, F-54 000, Nancy, France. c.armand@chu-nancy.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Malaplate-Armand
authors.affiliation: INSERM, CIC-EC, CIC 1433, F-54 000, Nancy, France. francis.guillemin@chu-nancy.fr.|Departement of Clinical Epidemiology and Evaluation, Nancy University Hospital, F-54 000, Nancy, France. francis.guillemin@chu-nancy.fr.|Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, F-54 000, Nancy, France. francis.guillemin@chu-nancy.fr.|Department of Clinical Epidemiology and Evaluation, CHU de Nancy, Hôpitaux de Brabois, Allée du Morvan, 54500 Vandoeuvre Les, Nancy, France. francis.guillemin@chu-nancy.fr.
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers