Significance and stability of cerebrospinal fluid oligoclonal band patterns in multiple sclerosis

Background: Immunoglobulin G (IgG) oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is included in the diagnostic criteria for multiple sclerosis (MS), but their temporal stability and clinical significance remain uncertain. These issues were addressed in a retrospective cohort study. 

Methods: Patients analyzed for OCBs at a central laboratory were included (n = 16,596). Results and associations between OCBs, age at onset, and disease severity (assessed with the Age-Related Multiple Sclerosis Severity (ARMSS) score and Multiple Sclerosis Severity Score (MSSS)) were assessed. 

Results: OCBs were more common in MS (91 %) than in CIS (71 %) and other diseases (10 %) (both p < 0.001) and more frequent in CIS than other diseases (p < 0.001). A single band pattern was more common in CIS (5.8 %) and other diseases (5.6 %) than in MS (2.0 %) (both p < 0.001). In MS and CIS patients with repeated lumbar punctures, changes in OCBs occurred in 29 of 227 patients with MS (13 %) and 5 of 10 patients (50 %) with CIS (p = 0.007); 42 % changed from negative or single band to positive and 59 % from positive to negative or single band. MS patients with OCBs had 3.8 years earlier onset of disease (95 % confidence interval 2.2–5.4) but showed no difference in ARMSS or MSSS. 

Conclusion: IgG OCBs were highly prevalent in MS and CIS; a single band pattern was more prevalent in CIS and other diseases than in MS. Changes in IgG OCB result were uncommon, particularly in MS. The presence of IgG OCBs is associated with lower age of onset but not with severity of MS.