학술논문
Oligoclonal M bands and cervical spinal cord lesions predict early secondary progressive multiple sclerosis
Document Type
article
Author
Carmen Alcalá Vicente; Laura Lacruz; Francisco Gascón; Sara Carratalà; Carlos Quintanilla-Bordás; Maria T. Sanz; María Carcelén-Gadea; Javier Mallada; Joan Carreres; Laura Gabaldón Torres; Jose Andres Dominguez; Emmanuel Cañizares; Sara Gil-Perotin; Laura Cubas; Raquel Gasqué Rubio; Jéssica Castillo-Villalba; Francisco Carlos Pérez-Miralles; Bonaventura Casanova
Source
Frontiers in Neurology, Vol 13 (2022)
Subject
Language
English
ISSN
1664-2295
Abstract
ObjectiveTo determine baseline cerebrospinal fluid and magnetic resonance imaging (MRI) variables at the onset of a clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS) that predict evolution to secondary progressive MS (SPMS).Methods276 CIS patients with a minimum follow-up of 10 years were studied. Baseline presence of oligoclonal IgG and IgM bands (OCGB and OCMB respectively); number of brain T2 lesions (B-T2L), brain gadolinium enhancement lesions (brain-GEL), cervical spinal cord T2 lesions (cSC-T2L); and fulfillment of 2017 McDonald criteria among other variables were collected.Results14 patients ended up with a non-MS condition. 138/276 CIS patients fulfilled 2017 McDonald criteria. Mean age was 32.4 years, 185 female. 227 received treatment, 95 as CIS. After a mean follow-up of 12 years, 36 patients developed SPMS. Conversion to SPMS was associated with OCGB (p = 0.02), OCMB (p = 0.0001); ≥ 9 B-T2L (p = 0.03), brain-GEL (p = 0.03), and cSC-T2L (p = 0.03). However, after adjusting for sex, age, BT2L, brain-GEL, SC-T2, and OCMB status, only OCMB (HR 4.4, 1.9–10.6) and cSC-T2L (HR 2.2, 1.0–6.2) suggested an independent association with risk of conversion to SPMS. Patients with both risk factors had a HR of 6.12 (2.8–12.9).DiscussionOCMB and SC-T2 lesions are potential independent predictors of conversion to SPMS.