Increased cortical lesion load and intrathecal inflammation is associated with oligoclonal bands in multiple sclerosis patients: A combined CSF and MRI study

Background: although igg oligoclonal bands (ocbs) in the cerebrospinal fluid (csf) are a frequent phenomenon in multiple sclerosis (ms) patients,their relationship with grey matter lesions,intrathecal/meningeal inflammation and clinical evolution has not been clarified yet. the aim of our study was to assess the relationship between the ocbs,the inflammatory/neurodegenerative csf profile at diagnosis,the cortical lesion load and the clinical evolution after 10 years. methods: this is a 10-year observational,cross-sectional study based on a combined mri,cognitive and csf profiling of the examined patients. forty consecutive ocb-negative (ocb-) and 50 ocb-positive (ocb+) ms patients were included in this study. both groups had mean disease duration of 10 years and were age and gender matched. each patient underwent neurological and neuropsychological evaluation and 3-t mri. analysis of the presence and levels of 28 inflammatory mediators was performed in the csf obtained from 10 ocb- ms,11 ocb+ ms and 10 patients with other neurological conditions. results: increased number of cls was found in ocb+ compared to ocb- patients (p < 0.0001),whereas no difference was found in white matter lesion (wml) load (p = 0.36). the occurrence of ocb was also associated with increased levels of neurofilament light chains and of several inflammatory mediators linked to b lymphocyte activity and lymphoid-neogenesis (cxcl13,cxcl12,cxcl10,tnfsf13,tnfsf13b,il6,il10) and other pro-inflammatory molecules,such as ifn-γ,tnf,mmp2,gm-csf,osteopontin and scd163. finally,the occurrence of ocb was found associated with poor prognosis,from both physical and cognitive points of view. conclusions: ocb at ms onset are associated with more severe gm pathology and with a more severe physical disability and cognitive impairment after 10 years. increased levels of cytokines linked to b cell activation,lymphoid-neogenesis,and pro-inflammatory immune response in the csf of ocb+ patients support the hypothesis of crucial role played by compartmentalized,intrathecal b cell response in the pathogenesis of cls and ocb production. © 2017 the author(s).