TY  - JOUR
A1  - Brecht, Isabel
A1  - Weissbrich, Benedikt
A1  - Braun, Julia
A1  - Toyka, Klaus Viktor
A1  - Weishaupt, Andreas
A1  - Buttmann, Mathias
T1  - Intrathecal, Polyspecific Antiviral Immune Response in Oligoclonal Band Negative Multiple Sclerosis
JF  - PLoS One
N2  - Background: Oligoclonal bands (OCB) are detected in the cerebrospinal fluid (CSF) in more than 95% of patients with multiple sclerosis (MS) in the Western hemisphere. Here we evaluated the intrathecal, polyspecific antiviral immune response as a potential diagnostic CSF marker for OCB-negative MS patients. 
Methodology/Principal Findings: We tested 46 OCB-negative German patients with paraclinically well defined, definite MS. Sixteen OCB-negative patients with a clear diagnosis of other autoimmune CNS disorders and 37 neurological patients without evidence for autoimmune CNS inflammation served as control groups. Antibodies against measles, rubella, varicella zoster and herpes simplex virus in paired serum and CSF samples were determined by ELISA, and virus-specific immunoglobulin G antibody indices were calculated. An intrathecal antibody synthesis against at least one neurotropic virus was detected in 8 of 26 (31%) patients with relapsing-remitting MS, 8 of 12 (67%) with secondary progressive MS and 5 of 8 (63%) with primary progressive MS, in 3 of 16 (19%) CNS autoimmune and 3 of 37 (8%) non-autoimmune control patients. Antibody synthesis against two or more viruses was found in 11 of 46 (24%) MS patients but in neither of the two control groups. On average, MS patients with a positive antiviral immune response were older and had a longer disease duration than those without. 
Conclusion: Determination of the intrathecal, polyspecific antiviral immune response may allow to establish a CSF-supported diagnosis of MS in OCB-negative patients when two or more of the four virus antibody indices are elevated.
KW  - MS
KW  - cerebrospinal fluid
KW  - differential diagnosis
KW  - nervous-system
KW  - criteria
KW  - serum
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-134426
VL  - 7
IS  - 7
ER  - 
TY  - JOUR
A1  - Huss, André M.
A1  - Halbgebauer, Steffen
A1  - Öckl, Patrick
A1  - Trebst, Corinna
A1  - Spreer, Annette
A1  - Borisow, Nadja
A1  - Harrer, Andrea
A1  - Brecht, Isabel
A1  - Balint, Bettina
A1  - Stich, Oliver
A1  - Schlegel, Sabine
A1  - Retzlaff, Nele
A1  - Winkelmann, Alexander
A1  - Roesler, Romy
A1  - Lauda, Florian
A1  - Yildiz, Özlem
A1  - Voß, Elke
A1  - Muche, Rainer
A1  - Rauer, Sebastian
A1  - Bergh, Florian Then
A1  - Otto, Markus
A1  - Paul, Friedemann
A1  - Wildemann, Brigitte
A1  - Kraus, Jörg
A1  - Ruprecht, Klemens
A1  - Stangel, Martin
A1  - Buttmann, Mathias
A1  - Zettl, Uwe K.
A1  - Tumani, Hayrettin
T1  - Importance of cerebrospinal fluid analysis in the era of McDonald 2010 criteria: a German-Austrian retrospective multicenter study in patients with a clinically isolated syndrome
JF  - Journal of Neurology
N2  - The majority of patients presenting with a first clinical symptom suggestive of multiple sclerosis (MS) do not fulfill the MRI criteria for dissemination in space and time according to the 2010 revision of the McDonald diagnostic criteria for MS and are thus classified as clinically isolated syndrome (CIS). To re-evaluate the utility of cerebrospinal fluid (CSF) analysis in the context of the revised McDonald criteria from 2010, we conducted a retrospective multicenter study aimed at determining the prevalence and predictive value of oligoclonal IgG bands (OCBs) in patients with CIS. Patients were recruited from ten specialized MS centers in Germany and Austria. We collected data from 406 patients; at disease onset, 44/406 (11 %) fulfilled the McDonald 2010 criteria for MS. Intrathecal IgG OCBs were detected in 310/362 (86 %) of CIS patients. Those patients were twice as likely to convert to MS according to McDonald 2010 criteria as OCB-negative individuals (hazard ratio = 2.1, p = 0.0014) and in a shorter time period of 25 months (95 % CI 21-34) compared to 47 months in OCB-negative individuals (95 % CI 36-85). In patients without brain lesions at first attack and presence of intrathecal OCBs (30/44), conversion rate to MS was 60 % (18/30), whereas it was only 21 % (3/14) in those without OCBs. Our data confirm that in patients with CIS the risk of conversion to MS substantially increases if OCBs are present at onset. CSF analysis definitely helps to evaluate the prognosis in patients who do not have MS according to the revised McDonald criteria.
KW  - multiple sklerosis
KW  - MRI criteria
KW  - conversion
KW  - MS
KW  - CSF
KW  - biomarker
KW  - OCB
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-186619
VL  - 263
IS  - 12
ER  -