title: McDonald Criteria 2010 and 2005 Compared: Persistence of High Oligoclonal Band Prevalence Despite Almost Doubled Diagnostic Sensitivity.
abstract: The 2010 McDonald criteria were developed to allow a more rapid diagnosis of relapsing-remitting multiple sclerosis (MS) by only one MRI of the brain. Although cerebrospinal fluid (CSF) is not a mandatory part of the latest criteria, the evidence of an intrathecal humoral immunoreaction in the form of oligoclonal bands (OCB) is crucial in the diagnostic workup. To date, the impact of the 2010 McDonald criteria on the prevalence of OCB has not been investigated. We retrospectively evaluated data of 325 patients with a clinical relapse suggestive of demyelination that were treated in a German university hospital between 2010 and 2015. One hundred thirty-six patients (42%) were diagnosed with MS and 189 patients with CIS when the criteria of 2010 were applied. The criteria of 2005 allowed only 70 patients (22%) to be designated as MS. In contrast, the prevalence of OCB was marginal affected in MS patients with 96% for the criteria of 2010 and 98.5% for the criteria of 2005. In conclusion, OCB are prevalent in most MS patients and reflect the chronic inflammatory nature of the disease. We recommend CSF examination to exclude alternative diagnoses and reevaluation of the diagnosis MS in patients with negative OCB.
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. schwenkenbecher.philipp@mh-hannover.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Schwenkenbecher
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. sarikidi.anastasia@mh-hannover.de.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Sarikidi
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. wurster.ulrich@mh-hannover.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wurster
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover 30625, Germany. bronzlik.paul@mh-hannover.de.
authors.forename: Paul
authors.initials: P
authors.lastname: Bronzlik
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. suehs.kurt-wolfram@mh-hannover.de.
authors.forename: Kurt-Wolfram
authors.initials: KW
authors.lastname: Sühs
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover 30625, Germany. raab.peter@mh-hannover.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Raab
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. stangel.martin@mh-hannover.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Stangel
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. pul.refik@mh-hannover.de.
authors.forename: Refik
authors.initials: R
authors.lastname: Pul
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover 30625, Germany. skripuletz.thomas@mh-hannover.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Skripuletz
keywords: CSF; OCB; multiple sclerosis