The Relationship Between Oligoclonal Bands Status and Clinical Features in Patients with Multiple Sclerosis: a Retrospective Study in Lithuania

Abstract

Introduction: Multiple sclerosis (MS) is a widely spread and debilitating disease with 2.8 million people worldwide currently affected (Walton et al., 2020). Even in a relatively short period of time of 2 years at least one third of MS patients report disability progression (Pellegrini et al., 2020), however the exact pathogenesis of the disease still remains incompletely understood. Cerebrospinal Fluid Oligoclonal Bands (CSF OCBs) can be found in up to 85% of MS patients (Garg et al., 2015), nowadays they play a key role in the diagnostics of MS while presenting a prognostic value as well (Thompson et al., 2017). Objectives/Aims: The study aimed to evaluate the association between CSF OCBs status and clinical features in patients with MS in Lithuania. Methods: The selection of 200 MS patients treated in Lithuanian University of Health Sciences (LUHS) Kaunas Clinics was performed in order to find associations between CSF OCBs status and various disease features. The data was acquired from outpatient records and a retrospective analysis was performed. Variables included in the selection were patient age (at diagnosis and first symptoms), sex, course of the disease, EDSS (Expanded Status Disability Scale) scores at the first (EDSS1) and the last (EDSS2) visit, MRI data and CSF OCBs status. Results were seen as statisctically signifcant when p<0.05. Results: Out of 200 reviewed MS cases 65 (32.5%) were male patients and 135 (67.5%) were female. Mean age of diagnosis was 36.4 ±11.668. Mean age at first symptoms was 32.13 ±10.790. Positive CSF OCBs were found in 151 (75.5%) of the cases. There were no statistically significant associations between OCBs status and sex, as well as the course of the disease. OCBs positive MS patients (median=35 (18-74)) were diagnosed with MS earlier than OCBs negative patients (median=39 (20-59), U=3084, p=0.039) No relations were found between OCBs positivity results and patient age at the symptom onset, EDSS scores of first and last visit and its change through time. The majority of patients (81.3%) with spinal cord lesions were OCBs positive, meaning that spinal cord lesions were more frequently found in OCBs positive patients (χ2=4.473, p=0.034). Other MRI lesion localizations as well as the progression and number of MRI lesions were not associated with OCBs status. Conclusion: OCBs positive patients were diagnosed with MS earlier and had spinal cord lesions more frequently than OCBs negative patients.