Oligoclonal M bands and cervical spinal cord lesions predict early secondary progressive multiple sclerosis

Carmen Alcalá Vicente; Laura Lacruz; Francisco Gascón; Sara Carratalà; Carlos Quintanilla-Bordás; Maria T Sanz; María Carcelén-Gadea; Javier Mallada; Joan Carreres; Laura Gabaldón Torres; Jose Andres Dominguez; Emmanuel Cañizares; Sara Gil-Perotin; Laura Cubas; Raquel Gasqué Rubio; Jéssica Castillo-Villalba; Francisco Carlos Pérez-Miralles; Bonaventura Casanova

doi:10.3389/fneur.2022.991596

Oligoclonal M bands and cervical spinal cord lesions predict early secondary progressive multiple sclerosis

Front Neurol. 2022 Oct 28:13:991596. doi: 10.3389/fneur.2022.991596. eCollection 2022.

Authors

Carmen Alcalá Vicente¹, Laura Lacruz¹, Francisco Gascón², Sara Carratalà¹, Carlos Quintanilla-Bordás¹, Maria T Sanz³, María Carcelén-Gadea⁴, Javier Mallada⁵, Joan Carreres⁶, Laura Gabaldón Torres⁷, Jose Andres Dominguez², Emmanuel Cañizares⁸, Sara Gil-Perotin¹, Laura Cubas¹, Raquel Gasqué Rubio¹, Jéssica Castillo-Villalba¹, Francisco Carlos Pérez-Miralles¹, Bonaventura Casanova¹

Affiliations

¹ Neuroimmunology Unit, Polytechnic and University Hospital La Fe, Valencia, Spain.
² Neurology Service, Clinic University Hospital of València, Valencia, Spain.
³ Didactics of Mathematics Department, University of València, Valencia, Spain.
⁴ Neurology Service, General Hospital of València, Valencia, Spain.
⁵ Neurology Service, General Hospital of Elda, Alicante, Spain.
⁶ Radiology Service, Polytechnic and University Hospital La Fe, Valencia, Spain.
⁷ Neurology Service, San Francesc de Borja Hospital, Valencia, Spain.
⁸ Neurology Service, La Ribera Hospital, Valencia, Spain.

Abstract

Objective: To determine baseline cerebrospinal fluid and magnetic resonance imaging (MRI) variables at the onset of a clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS) that predict evolution to secondary progressive MS (SPMS).

Methods: 276 CIS patients with a minimum follow-up of 10 years were studied. Baseline presence of oligoclonal IgG and IgM bands (OCGB and OCMB respectively); number of brain T2 lesions (B-T2L), brain gadolinium enhancement lesions (brain-GEL), cervical spinal cord T2 lesions (cSC-T2L); and fulfillment of 2017 McDonald criteria among other variables were collected.

Results: 14 patients ended up with a non-MS condition. 138/276 CIS patients fulfilled 2017 McDonald criteria. Mean age was 32.4 years, 185 female. 227 received treatment, 95 as CIS. After a mean follow-up of 12 years, 36 patients developed SPMS. Conversion to SPMS was associated with OCGB (p = 0.02), OCMB (p = 0.0001); ≥ 9 B-T2L (p = 0.03), brain-GEL (p = 0.03), and cSC-T2L (p = 0.03). However, after adjusting for sex, age, BT2L, brain-GEL, SC-T2, and OCMB status, only OCMB (HR 4.4, 1.9-10.6) and cSC-T2L (HR 2.2, 1.0-6.2) suggested an independent association with risk of conversion to SPMS. Patients with both risk factors had a HR of 6.12 (2.8-12.9).

Discussion: OCMB and SC-T2 lesions are potential independent predictors of conversion to SPMS.

Keywords: OCMB; multiple sclerosis; oligoclonal M bands; secondary progressive MS; spinal cord.

Copyright © 2022 Alcalá Vicente, Lacruz, Gascón, Carratalà, Quintanilla-Bordás, Sanz, Carcelén-Gadea, Mallada, Carreres, Gabaldón Torres, Dominguez, Cañizares, Gil-Perotin, Cubas, Gasqué Rubio, Castillo-Villalba, Pérez-Miralles and Casanova.