Journal ArticleDOI
Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude
TLDR
OCB positivity strongly predicts conversion from CIS to MS, and the relationship between latitude and OCBs is confirmed, and this finding warrants further investigation.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.read more
Citations
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Journal ArticleDOI
Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria
Alan J. Thompson,Brenda Banwell,Frederik Barkhof,Frederik Barkhof,William M. Carroll,Timothy Coetzee,Giancarlo Comi,Jorge Correale,Franz Fazekas,Massimo Filippi,Mark S. Freedman,Kazuo Fujihara,Steven L. Galetta,Hans-Peter Hartung,Ludwig Kappos,Fred D. Lublin,Ruth Ann Marrie,Aaron E. Miller,David Miller,Xavier Montalban,Xavier Montalban,Ellen M. Mowry,Per Soelberg Sørensen,Mar Tintoré,Anthony Traboulsee,Maria Trojano,Bernard M. J. Uitdehaag,Sandra Vukusic,Sandra Vukusic,Emmanuelle Waubant,Brian G. Weinshenker,Stephen C. Reingold,Jeffrey A. Cohen +32 more
TL;DR: The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation.
Journal ArticleDOI
Role of the innate and adaptive immune responses in the course of multiple sclerosis
TL;DR: It is suggested that a peripheral immune response targeting the CNS drives the disease process during the early phase, whereas immune reactions within the CNS dominate the progressive phase of multiple sclerosis.
Journal ArticleDOI
Diagnosis of multiple sclerosis: progress and challenges
TL;DR: The progress and challenges in the diagnosis of multiple sclerosis with reference to diagnostic criteria, important differential diagnoses, controversies and uncertainties, and future prospects are explored.
Journal ArticleDOI
Defining high, medium and low impact prognostic factors for developing multiple sclerosis
Mar Tintoré,Alex Rovira,Jordi Río,Susana Otero-Romero,Georgina Arrambide,Carmen Tur,Manuel Comabella,Carlos Nos,María Jesús Arévalo,Laura Negrotto,Ingrid Galán,Angela Vidal-Jordana,Joaquín Castilló,Filipe Palavra,Eva Simon,Raquel Mitjana,Cristina Auger,Jaume Sastre-Garriga,Xavier Montalban +18 more
TL;DR: The demographic and topographic characteristics are low-impact prognostic factors, the presence of oligoclonal bands is a medium- impact prognostic factor, and the number of lesions on brain magnetic resonance is a high-impact prediction factor.
Journal ArticleDOI
Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis - Clinical implementation in the diagnostic process
Alex Rovira,Mike P. Wattjes,Mar Tintoré,Carmen Tur,Tarek A. Yousry,Maria Pia Sormani,Nicola De Stefano,Massimo Filippi,Cristina Auger,Maria A. Rocca,Frederik Barkhof,Franz Fazekas,Ludwig Kappos,Chris H. Polman,David Miller,Xavier Montalban +15 more
TL;DR: Recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.
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