Background: There is increasing evidence on cerebrospinal fluid (CSF) oligoclonal IgM (OCIgM) predicting a more aggressive disease course in relapsing-remitting Multiple Sclerosis (MS), while there is a scarcity of data for primary progressive MS (PPMS). Objective: Our aim was to investigate the presence and possible prognostic value of CSF OCIgM in a group of PPMS and in a group of relapsing-onset MS patients. The possible prognostic role of other clinical and biological factors was also evaluated. Methods: We calculated the impact of single clinical and biological factors, including CSF OCIgM at onset, on the probability of reaching an Expanded Disability Status Scale of 3 and 4 in 45 PPMS and 104 relapsing-onset MS patients. Results: CSF OCIgM were found in only 13% of PPMS patients and did not influence the time taken to reach an Expanded Disability Status Scale of 3 and 4. Conversely, they were present in 46% of relapsing-onset MS patients and increased the risk of reaching an Expanded Disability Status Scale of 4. Clinical factors with a negative prognostic value in PPMS were age at onset <30 years and onset with pyramidal symptoms, while onset with sensory symptoms in relapsing-onset MS predicted a more favourable course. Conclusion: This study confirms that, in relapsing-onset MS patients, the presence of CSF OCIgM at onset predicts a worse disease course. In the cohort of PPMS patients, however, CSF OCIgM were rare, suggesting that heterogeneous pathogenetic mechanisms may be involved in the different MS forms.

Primary progressive versus relapsing-onset multiple sclerosis: presence and prognostic value of cerebrospinal fluid oligoclonal IgM / P., Sola; MANDRIOLI, Jessica; SIMONE, ANNA MARIA; FERRARO, Diana; BEDIN, Roberta; R., Annecca; VENNERI, Maria Grazia; NICHELLI, Paolo Frigio; E., Merelli. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - STAMPA. - 17:(2011), pp. 303-311. [10.1177/1352458510386996]

Primary progressive versus relapsing-onset multiple sclerosis: presence and prognostic value of cerebrospinal fluid oligoclonal IgM

MANDRIOLI, Jessica;SIMONE, ANNA MARIA;FERRARO, Diana;BEDIN, Roberta;VENNERI, Maria Grazia;NICHELLI, Paolo Frigio;
2011

Abstract

Background: There is increasing evidence on cerebrospinal fluid (CSF) oligoclonal IgM (OCIgM) predicting a more aggressive disease course in relapsing-remitting Multiple Sclerosis (MS), while there is a scarcity of data for primary progressive MS (PPMS). Objective: Our aim was to investigate the presence and possible prognostic value of CSF OCIgM in a group of PPMS and in a group of relapsing-onset MS patients. The possible prognostic role of other clinical and biological factors was also evaluated. Methods: We calculated the impact of single clinical and biological factors, including CSF OCIgM at onset, on the probability of reaching an Expanded Disability Status Scale of 3 and 4 in 45 PPMS and 104 relapsing-onset MS patients. Results: CSF OCIgM were found in only 13% of PPMS patients and did not influence the time taken to reach an Expanded Disability Status Scale of 3 and 4. Conversely, they were present in 46% of relapsing-onset MS patients and increased the risk of reaching an Expanded Disability Status Scale of 4. Clinical factors with a negative prognostic value in PPMS were age at onset <30 years and onset with pyramidal symptoms, while onset with sensory symptoms in relapsing-onset MS predicted a more favourable course. Conclusion: This study confirms that, in relapsing-onset MS patients, the presence of CSF OCIgM at onset predicts a worse disease course. In the cohort of PPMS patients, however, CSF OCIgM were rare, suggesting that heterogeneous pathogenetic mechanisms may be involved in the different MS forms.
17
303
311
Primary progressive versus relapsing-onset multiple sclerosis: presence and prognostic value of cerebrospinal fluid oligoclonal IgM / P., Sola; MANDRIOLI, Jessica; SIMONE, ANNA MARIA; FERRARO, Diana; BEDIN, Roberta; R., Annecca; VENNERI, Maria Grazia; NICHELLI, Paolo Frigio; E., Merelli. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - STAMPA. - 17:(2011), pp. 303-311. [10.1177/1352458510386996]
P., Sola; Mandrioli, Jessica; Simone, ANNA MARIA; Ferraro, Diana; Bedin, Roberta; R., Annecca; Venneri, Maria Grazia; Nichelli, Paolo Frigio; E., Merelli
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/649375
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