More antibody bands in spinal fluid tied to broader MRI lesions in MS
Study also found a modest link with poorer verbal learning and memory
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Laboratory testing of cerebrospinal fluid can detect oligoclonal bands, higher counts of which were linked to broader MRI lesion distribution in newly diagnosed MS. (Image from iStock)
- New multiple sclerosis research found that higher oligoclonal band counts were linked to more widespread lesions on MRI scans.
- Higher antibody band counts in spinal fluid were also linked to poorer verbal learning and memory in newly diagnosed patients.
- While not a standalone biomarker, oligoclonal band counts may provide added information about disease differences at the time of diagnosis.
In people newly diagnosed with relapsing-remitting multiple sclerosis (MS), a higher number of oligoclonal bands (OCBs) — bands of antibodies found in the fluid surrounding the brain and spinal cord — may reflect more widespread lesions on MRI scans and poorer verbal learning and memory, a study found.
“While OCB count should not be considered a standalone biomarker, it may contribute to a more nuanced understanding of disease [variability] at onset,” the researchers wrote.
The study, “Oligoclonal band count as a marker of MRI lesion burden and clinical profile in newly diagnosed multiple sclerosis,” was published in Neurological Sciences.
Spinal fluid biomarkers may offer added clues about MS
MS is a disease in which the immune system damages the myelin sheath, the protective covering around nerve fibers in the brain and spinal cord. This damage can cause a wide range of symptoms. MRI remains the gold standard for diagnosing and monitoring MS because it can show areas of inflammatory damage, called lesions.
However, biomarkers in cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord, can “provide complementary diagnostic information,” the researchers wrote.
One such biomarker is the presence of two or more OCBs. These are bands of antibodies found in CSF that reflect abnormal immune activity within the brain and spinal cord.
While the use of OCBs as biomarkers is well established in MS, it is unclear whether their count provides additional information about how active the disease is.
The researchers reviewed data from 62 adults with newly diagnosed relapsing–remitting MS (RRMS) and 59 healthy adults who served as controls. RRMS is a type of MS in which periods of new or worsening symptoms are followed by periods when symptoms ease or stabilize.
Patients had lived with the disease for a mean of 12.8 months, or just over a year. Their median score on the Expanded Disability Status Scale (EDSS), which measures MS-related disability, was 1, indicating no walking difficulties and only minimal abnormalities on neurological examination.
All patients tested positive for OCBs, with counts ranging from 3 to 28. MRI scans showed that most had periventricular lesions, which occur around the brain’s fluid-filled cavities (90%) and subcortical lesions, which occur beneath the brain’s outer layer (70%). About one-third (35%) had gadolinium-enhancing lesions, a sign of active inflammation.
Higher OCB counts linked to broader MRI lesion spread
Statistical analyses demonstrated that higher OCB counts were significantly associated with more widespread lesions on MRI scans and a higher CSF IgG index, a measure used to assess IgG antibody production within the central nervous system. However, OCB counts were not significantly associated with EDSS scores.
The researchers also looked at cognitive problems, which are common in MS. Compared with controls, patients performed worse on the Symbol Digit Modalities Test, which measures processing speed; the California Verbal Learning Test-II, which measures verbal learning and memory; and the Brief Visuospatial Memory Test-Revised, which measures visual and spatial memory.
Importantly, higher OCB counts were significantly associated with poorer verbal learning and memory. The relationship remained similar in strength after accounting for age and education.
The number of OCBs was not significantly linked to processing speed or visual and spatial memory.
The researchers noted that because the study looked at patients at a single point in time, it cannot show whether higher OCB counts come before later lesion buildup or cognitive decline.
“Our findings suggest that higher OCB counts are associated with a broader distribution of MRI lesions, as reflected by the number of lesion-involved anatomical regions, and with markers of [antibody production within the central nervous system], particularly the IgG index,” the researchers wrote. “In contrast, associations with clinical disability and most cognitive domains were limited, with a modest but significant relationship observed specifically for verbal learning and memory in early MS.”
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