How do you interpret the results of oligoclonal bands ordered to evaluate for demyelinating disease in patients with brain MRI lesions of unclear etiology?

Does the number of bands matter in making the diagnosis? Does it make a difference whether isolated or also in the serum? How do you interpret other results in this context such as the IgG index, synthesis rate, or others?

1 Answer

Mednet MemberInvited Expert

Neurology · UTHealth

Answered on

While the presence of oligoclonal bands (OCBs) has been incorporated in the updated diagnostic criteria as a surrogate for dissemination in time, OCBs should not be used in isolation to make the diagnosis of multiple sclerosis. There are several systemic and peripheral immune diseases, including inflammatory encephalitides, neurodegenerative diseases, and CNS infectious disorders that can cause OCB (please see a recent review by Carta et al., PMID 35277112).

While a few early studies suggested an association between the number of bands and clinical severity in MS, generally, there is no clear consensus. However, there is evolving data on the utility of kappa-free light chain bands and disease severity.

When OCBs are used to support the diag...

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