Huttner Hagen B, Schellinger Peter D, Struffert Tobias, Richter Gregor, Engelhorn Tobias, Bassemir Teresa, Mäurer Mathias, Garcia Meritxell, Schwab Stefan, Köhrmann Martin, Doerfler Arnd
Department of Neurology, University of Erlangen-Nuremberg, 91054 Erlangen, Germany.
J Neurol. 2009 Jul;256(7):1121-5. doi: 10.1007/s00415-009-5081-y. Epub 2009 Mar 1.
In multiple sclerosis (MS) more than 95% of the patients have positive oligoclonal bands (OCB) in the cerebrospinal fluid (CSF). Previous studies have reported differences between patients with and without OCB mainly with regard to clinical parameters such as age, gender, disease duration, and clinical severity. However, several MRI characteristics have also been hypothesized to be distinct, and a varying lesion load in OCB-negative and -positive patients is proposed. In this study, we aimed to evaluate whether Barkhof's diagnostic MRI criteria are unequally frequently fulfilled in OCB-negative and -positive MS patients. We screened our database for all OCB-negative MS patients who had (1) been treated with the diagnosis of a clinical definite relapsing-remitting MS in our institution as well as (2) undergone CSF analysis and MR brain imaging during hospital stay between January 2004 and December 2007. Eleven OCB-negative patients were identified who fulfilled these criteria. In a second step, we carefully matched each of them to two OCB-positive controls according to age, gender, EDSS, and disease duration. The separate analysis of the several parameters of Barkhof's criteria revealed a less frequent prevalence of infratentorial (3/11 vs. 18/22; P = 0.005) and a more frequent occurrence of juxtacortical lesions (10/11 vs. 10/22; P = 0.022) in OCB-negative as compared to OCB-positive patients. The overall fulfillment of the Barkhof criteria did not differ in OCB-negative and -positive patients (7/11 vs. 16/22; P = 0.696). Further analyses of MRI findings between OCB-negative and -positive MS patients might contribute to a better pathophysiological understanding of the genesis and evidence of OCB in the CSF of MS patients.
在多发性硬化症（MS）患者中，超过95%的患者脑脊液（CSF）中的寡克隆带（OCB）呈阳性。既往研究报道了有OCB和无OCB患者之间的差异，主要涉及年龄、性别、病程和临床严重程度等临床参数。然而，也有研究推测一些MRI特征存在差异，并提出OCB阴性和阳性患者的病灶负荷不同。在本研究中，我们旨在评估Barkhof诊断性MRI标准在OCB阴性和阳性MS患者中得到满足的频率是否不同。我们在数据库中筛选了所有OCB阴性的MS患者，这些患者（1）在我们机构被诊断为临床确诊的复发缓解型MS并接受过治疗，以及（2）在2004年1月至2007年12月住院期间接受过脑脊液分析和脑部MRI检查。共识别出11例符合这些标准的OCB阴性患者。第二步，我们根据年龄、性别、扩展残疾状态量表（EDSS）和病程，将每例OCB阴性患者与两名OCB阳性对照进行仔细匹配。对Barkhof标准的几个参数进行单独分析发现，与OCB阳性患者相比，OCB阴性患者幕下病灶的发生率较低（3/11 vs. 18/22；P = 0.005），皮质旁病灶的发生率较高（10/11 vs. 10/22；P = 0.022）。Barkhof标准的总体满足情况在OCB阴性和阳性患者中无差异（7/11 vs. 16/22；P = 0.696）。对OCB阴性和阳性MS患者的MRI结果进行进一步分析，可能有助于更好地从病理生理学角度理解MS患者脑脊液中OCB的产生及其证据。
