Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
Front Immunol. 2019 Apr 12;10:726. doi: 10.3389/fimmu.2019.00726. eCollection 2019.
Investigation of cerebrospinal fluid (CSF) in the diagnostic work-up in suspected multiple sclerosis (MS) patients has regained attention in the latest version of the diagnostic criteria due to its good diagnostic accuracy and increasing issues with misdiagnosis of MS based on over interpretation of neuroimaging results. The hallmark of MS-specific changes in CSF is the detection of oligoclonal bands (OCB) which occur in the vast majority of MS patients. Lack of OCB has a very high negative predictive value indicating a red flag during the diagnostic work-up, and alternative diagnoses should be considered in such patients. Additional molecules of CSF can help to support the diagnosis of MS, improve the differential diagnosis of MS subtypes and predict the course of the disease, thus selecting the optimal therapy for each patient.
对疑似多发性硬化症（MS）患者的脑脊液（CSF）进行研究，由于其具有良好的诊断准确性，并且由于对神经影像学结果的过度解释导致 MS 误诊的问题日益增多，在最新的诊断标准中重新受到关注。CSF 中存在寡克隆带（OCB）是 MS 特异性改变的标志，这在绝大多数 MS 患者中都有发生。缺乏 OCB 具有非常高的阴性预测值，表明在诊断过程中出现了危险信号，应考虑此类患者的其他诊断。CSF 中的其他分子有助于支持 MS 的诊断，改善 MS 亚型的鉴别诊断，并预测疾病的病程，从而为每位患者选择最佳的治疗方法。
