Groupe Hospitalier de l'Institut Catholique de Lille, Service de Neurologie, Lille, France.
Mult Scler. 2010 Jan;16(1):87-92. doi: 10.1177/1352458509352195. Epub 2009 Dec 22.
In clinically isolated syndrome (CIS), the detection of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is critical for space dissemination validation when magnetic resonance imaging (MRI) diagnostic criteria are not fulfilled. However, lumbar puncture for CSF collection is considered relatively invasive. Previous studies have demonstrated applicability of OCB detection in tears to the diagnosis of multiple sclerosis (MS). The objective of the present study was to assess concordance between OCB detection in tears and in CSF. We have prospectively included patients with CIS and compared results of CSF and tear OCB detection by isoelectric focusing (IEF). Tears were collected using a Schirmer strip. We included 82 patients. For 69 of them, samples were analysable. OCBs were detected in CSF for 63.8% and in tears for 42% of patients. All patients with tear OCBs had CSF OCBs. We suggest that tear OCB detection may replace CSF OCB detection as a diagnostic tool in patients with CIS. This would circumvent the practice of invasive lumbar punctures currently used in MS diagnosis.
在临床孤立综合征 (CIS) 中，当磁共振成像 (MRI) 诊断标准不满足时，脑脊液 (CSF) 中寡克隆带 (OCB) 的检测对于空间传播的验证至关重要。然而，腰椎穿刺采集 CSF 被认为具有一定的侵入性。先前的研究已经证明了在泪液中检测 OCB 对多发性硬化症 (MS) 的诊断具有适用性。本研究的目的是评估泪液和 CSF 中 OCB 检测的一致性。我们前瞻性地纳入 CIS 患者，并通过等电聚焦 (IEF) 比较 CSF 和泪液 OCB 检测的结果。使用 Schirmer 带收集眼泪。我们共纳入 82 例患者。其中 69 例样本可分析。CSF 中 OCB 的检出率为 63.8%，泪液中 OCB 的检出率为 42%。所有泪液 OCB 阳性的患者 CSF 中均存在 OCB。我们建议，在 CIS 患者中，泪液 OCB 检测可以替代 CSF OCB 检测作为一种诊断工具。这将避免目前在 MS 诊断中使用的侵入性腰椎穿刺。
