Routine CSF parameters as predictors of disease course in multiple sclerosis: an MSBase cohort study.
Journal: Journal of neurology, neurosurgery, and psychiatry
Volume:
Issue:
Year of Publication:
Affiliated Institutions:
Neurology, University Hospital Ghent, Gent, Belgium catherine.dekeyser@uzgent.be.
Neurology, University Hospital Ghent, Gent, Belgium.
Neurology, Sint-Jan Bruges Hospital, Bruges, Belgium.
Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Neuroscience, University of Catania Department of Surgical and Medical Sciences and Advanced Technologies 'G.F. Ingrassia', Catania, Italy.
Neurology, University Hospital Basel, Basel, Switzerland.
Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia.
Neurology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
UOSI Riabilitazione Sclerosi Multipla, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
Centro Sclerosi Multipla, UOC Neurologia, Azienda Ospedaliera Cannizzaro, Catania, Italy.
Department of Neuroscience, MS Center, S Maria delle Croci Hospital, Ravenna, Italy.
CISSS Chaudière-Appalaches Research Center, Levis, Quebec, Canada.
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
University Hospital Centre Zagreb Department of Neurology, Zagreb, Croatia.
Neurology, Universitair Ziekenhuis Antwerpen, Edegem, Belgium.
Austin Health, Melbourne, Victoria, Australia.
Clinical Neurosciences, Division of Neurology, Unit of Neuroimmunology, Geneva University Hospitals Department of Medicine, Geneve, Switzerland.
Department of Neurology, University of Debrecen, Debrecen, Hungary.
Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia.
Neurology, Karadeniz Technical University, Medical Faculty, Trabzon, Turkey.
Istituto di Tecnologie Avanzate Biomediche (ITAB), Dipartimento di Neuroscienze e Imaging e Scienze Cliniche; Centro Sclerosi Multipla, Clinica Neurologica, Ospedale SS Annunziata, Università degli Studi Gabriele d'Annunzio Chieti Pescara, Chieti, Italy.
Department of Neuroscience, MS Center, Neurology Unit, S. Maria delle Croci Hospital, Ravenna, Italy.
Neurology, Galdakao-Usansolo University Hospital, Osakidetza-Basque Health Service, Galdakao, Spain.
Neurology, Koc University School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey.
Neurology, Razi University Hospital, Clinical Investigation Centre Neurosciences and Mental Health, Tunis, Tunisia.
Ospedali Riuniti di Salerno, Salerno, Italy.
Neurology, Centro Hospitalar de São João, Porto, Portugal.
Neurology, Amiri Hospital, Kuwait City, Kuwait.
Neurological Sciences, Yeditepe Universitesi, Istanbul, Turkey.
Neurology, Hospital Universitario Reina Sofia, Cordoba, Spain.
South Eastern HSC Trust, Belfast, UK.
Groene Hart Ziekenhuis, Gouda, The Netherlands.
Monash University Central Clinical School, Melbourne, Victoria, Australia.
UQCCR, Royal Brisbane and Woman's Hospital Health Service District, Herston, Queensland, Australia.
Hospital Fernandez, Buenos Aires, Argentina.
Westmead Hospital, Sydney, New South Wales, Australia.
Sultan Qaboos University College of Medicine and Health Science, Muscat, Muscat Governorate, Oman.
Neurosciences, The Alfred, Melbourne, Victoria, Australia.
CHUM and Universite de Montreal, Montreal, Quebec, Canada.
UOC Neurologia, Azienda Sanitaria Unica Regionale Marche - AV, Macerata, Italy.
Neurology, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità San Giuseppe Moscati Neurologia e Stroke Unit, Avellino, Italy.
University of Tunis El Manar Faculty of Medicine of Tunis, Tunis, Tunisia.
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey.
University Hospital Ghent, Gent, Belgium.
Neurology, Flinders Medical Centre, Adelaide, South Australia, Australia.
Department NEUROFARBA, University of Florence, Florence, Italy.
Department of Neurology, Box Hill Hospital, Melbourne, Victoria, Australia.
Abstract summary
It remains unclear whether routine cerebrospinal fluid (CSF) parameters can serve as predictors of multiple sclerosis (MS) disease course.This large-scale cohort study included persons with MS with CSF data documented in the MSBase registry. CSF parameters to predict time to reach confirmed Expanded Disability Status Scale (EDSS) scores 4, 6 and 7 and annualised relapse rate in the first 2 years after diagnosis (ARR2) were assessed using (cox) regression analysis.In total, 11 245 participants were included of which 93.7% (n=10 533) were persons with relapsing-remitting MS (RRMS). In RRMS, the presence of CSF oligoclonal bands (OCBs) was associated with shorter time to disability milestones EDSS 4 (adjusted HR=1.272 (95% CI, 1.089 to 1.485), p=0.002), EDSS 6 (HR=1.314 (95% CI, 1.062 to 1.626), p=0.012) and EDSS 7 (HR=1.686 (95% CI, 1.111 to 2.558), p=0.014). On the other hand, the presence of CSF pleocytosis (≥5 cells/µL) increased time to moderate disability (EDSS 4) in RRMS (HR=0.774 (95% CI, 0.632 to 0.948), p=0.013). None of the CSF variables were associated with time to disability milestones in persons with primary progressive MS (PPMS). The presence of CSF pleocytosis increased ARR2 in RRMS (adjusted R=0.036, p=0.015).In RRMS, the presence of CSF OCBs predicts shorter time to disability milestones, whereas CSF pleocytosis could be protective. This could however not be found in PPMS. CSF pleocytosis is associated with short-term inflammatory disease activity in RRMS. CSF analysis provides prognostic information which could aid in clinical and therapeutic decision-making.
Authors & Co-authors:
Dekeyser Cathérine C
Hautekeete Matthias M
Cambron Melissa M
Van Pesch Vincent V
Patti Francesco F
Kuhle Jens J
Khoury Samia S
Lechner Scott Jeanette J
Gerlach Oliver O
Lugaresi Alessandra A
Maimone Davide D
Surcinelli Andrea A
Grammond Pierre P
Kalincik Tomas T
Habek Mario M
Willekens Barbara B
Macdonell Richard R
Lalive Patrice P
Csepany Tunde T
Butzkueven Helmut H
Boz Cavit C
Tomassini Valentina V
Foschi Matteo M
Sánchez-Menoyo José Luis JL
Altintas Ayse A
Mrabet Saloua S
Iuliano Gerardo G
Sa Maria Jose MJ
Alroughani Raed R
Karabudak Rana R
Aguera-Morales Eduardo E
Gray Orla O
de Gans Koen K
van der Walt Anneke A
McCombe Pamela A PA
Deri Norma N
Garber Justin J
Al-Asmi Abdullah A
Skibina Olga O
Duquette Pierre P
Cartechini Elisabetta E
Spitaleri Daniele D
Gouider Riadh R
Soysal Aysun A
Van Hijfte Liesbeth L
Slee Mark M
Amato Maria Pia MP
Buzzard Katherine K
Laureys Guy G
Study Outcome
Source Link: Visit source