Oligoclonal Banding Patterns in Patients with Multiple Sclerosis

Background: Oligoclonal banding (OCB) detection in the cerebrospinal fluid (CSF) is used as an indicator of multiple sclerosis (MS) as a majority of patients with clinically definite MS show oligoclonal IgG antibodies in their CSF. Lin et al. (2012) recently analyzed a sample population in Australia. The banding patterns of patients with positive OCB were found to have two novel distinct patterns named theta and delta. The theta pattern had no association with MS and omission of the theta banding pattern improved the positive predictive value (PPV) of OCB testing for MS. It is uncertain if the theta and delta patterns have a similar correlation to MS in other populations which highlights the need for further research in this area.

Objectives: To confirm findings of theta and delta banding patterns and their association with a clinically definite diagnosis of MS through a retrospective study. To investigate if there are other subgroups of oligoclonal banding patterns among patients with positive oligoclonal banding tests within the same population. 

Methods: Oligoclonal banding tests from patients of the Fraser Health MS Clinic in 2014 were observed with 15 positive CSF samples identified. Tests with comments of “weak positive OCB” were not included in the study. Correlating clinical information was collected. Additional tests from 2013 and 2012 will be studied with details in the poster. Band intensity and migration distance will be measured in all samples with details provided in the poster.

Results: Of the 15 positive CSF samples, 3 delta pattern and 1 theta pattern sample were omitted for pending diagnosis leaving 11 positive CSF samples. 11 out of 11 (100%) samples positive for OCB were delta pattern, and 0 out of 11 (0%) were theta pattern. Of the 11 samples with delta pattern, 8 (73%) patients had clinically diagnosed MS while there were no patients with the theta pattern. Full statistical analysis will be detailed in the poster with additional results from 2012 and 2013. 

Conclusions: Frequency of the delta pattern to a diagnosis of MS was similar to that found by Lin et al. (2012), but since the samples analyzed were already narrowed to patients with a high suspicion of MS, this proportion may be lower, and therefore different from the frequency found by Lin et al. (2012). There were no samples with theta pattern which questions the clinical use of determining theta and delta patterning in patients with a high suspicion of MS. A larger sample size and further study is needed to confirm these findings.