The Value of Oligoclonal Bands in Multiple Sclerosis Compared to Other Neurological Disorders: A Retrospective Data Analysis From an Austrian Tertiary Center

Abstract

Background: Cerebrospinal fluid (CSF) analysis is key to diagnosing multiple sclerosis (MS). In particular, the presence of CSF-specific oligoclonal bands (OCB) is examined alongside differential diagnostic aspects. This study aims to investigate the diagnostic value of OCB in MS compared to other neurological disorders. Methods: Patients who presented to the Department of Neurology of the Medical University of Vienna between January 1, 2004 and December 31, 2020, due to neurological complaints and underwent lumbar puncture (LP) for diagnostic purposes were included in this retrospective analysis. Exclusion criteria were incomplete laboratory data and/or a missing final diagnosis. Results: Of 5744 patients who underwent LP, 5225 were available for analysis. Of these, 745 (14.3%) were diagnosed with MS, whereby CSF-specific OCB showed a sensitivity of 92.8% and a specificity of 90.4%. While the positive predictive value (PPV) was merely 61.5%, the negative predictive value (NPV) yielded 98.7%. In comparison, OCB displayed low sensitivity rates for most other neurological disease groups. Of note, neuroborreliosis (n = 66) had a relatively high OCB positive rate of 70%, followed by CNS human immunodeficiency virus infections (n = 32) with 62.5%. Conclusions: CSF-specific OCB have a high sensitivity and specificity and a very high NPV for diagnosing MS. However, the PPV was lower in this cohort. These findings must be carefully considered when diagnosing MS and interpreting OCB, especially in the context of differential diagnostic workup.