Comparison of clinical and laboratory characteristics of neuromyelitis optica spectrum disorder with or without cerebrospinal fluid oligoclonal bands: a cohort with 36-month follow-up

Wenbo Yang ¹ Xiaoni Liu ¹ Jie Wei ² Yu Hai ¹ Wanqing Wu ¹ Jingguo Wang ¹ Bo Deng ¹ Xiaoqin Wu ¹ Xiangjun Chen ^1,3* Xiang Zhang ¹

• ¹ Department of Neurology, Huashan Hospital, Fudan University and Insitute of Neurology, Fudan University, National Center for Neurological Disorders, Shanghai, China
• ² Department of Neurology, NO. 905 Hospital of PLA Navy affiliated to Naval Medical University, Shanghai, China
• ³ Human Phenome Institute, Fudan University, Shanghai, Shanghai Municipality, China

Purpose: To explore the significance of cerebrospinal fluid (CSF) oligoclonal bands (OCBs) in the clinical diagnosis and evaluation of neuromyelitis optica spectrum disorder (NMOSD).Methods: The demographic and clinical data of 143 AQP4-IgG positive NMOSD patients were collected and analyzed, including gender, age, clinical symptoms and signs, status of CSF OCBs, location and length of affected spinal cord vertebral segments, expanded disability status scale (EDSS) at first attack and 36-month follow-up, relapse times within 36 months, concomitant connective tissue disease (CTD) and other autoimmune antibodies (oAIA) status. Results: Fifteen patients (10.5%) were positive for OCBs (OCBs+). In contrast to those with negative OCBs (OCBs-), more OCBs+ cases had concomitant CTD (5/15 (33.3%) vs. 11/128 (8.6%), P=0.014) and oAIA (9/15 (60.0%) vs. 37/128 (28.9%), P=0.020). OCBs+ patients had higher CSF cell counts (15.0 (27.0) /mm3 vs. 5.0 (12.0) /mm3, P=0.008), higher IgG index (0.68 (0.23) vs. 0.52 (0.15), P<0.001), and more relapses within 36 months (2.0 (3.0) vs. 1.0 (2.0), P=0.039) than OCBs- patients. More OCBs+ patients had polynuclear cells predominance in CSF than OCBs- patients (P=0.032).There were no significant differences between the OCBs+ and the OCBs- groups in the distribution of lesion locations, length of affected spinal cord vertebral segments, CSF protein concentration and albumin quotient, EDSS score at the time of lumbar puncture and 36-month follow-up, as well as the onset episode, the relapse and cumulative clinical syndrome profiles (all P>0.05).Conclusions: For AQP4-IgG positive NMOSD patients, being positive for CSF OCBs is related with higher CSF cell counts and higher likelihood to have concomitant CTD and oAIA. OCBs+ is not uncommon in NMOSD, and may predict a more frequent relapses but not more serious illness.