Diagnostic performance of central vein sign versus oligoclonal bands for multiple sclerosis.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Multiple Sclerosis Journal Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI:10.1177/13524585241271988

Karlo Toljan, Lynn Daboul, Praneeta Raza, Melissa L Martin, Quy Cao, Carly M O'Donnell, Paulo Rodrigues, John Derbyshire, Christina J Azevedo, Amit Bar-Or, Eduardo Caverzasi, Peter A Calabresi, Bruce Ac Cree, Leorah Freeman, Roland G Henry, Erin E Longbrake, Jiwon Oh, Nico Papinutto, Daniel Pelletier, Rohini D Samudralwar, Matthew K Schindler, Elias S Sotirchos, Nancy L Sicotte, Andrew J Solomon, Russell T Shinohara, Daniel S Reich, Pascal Sati, Daniel Ontaneda

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引用次数: 0

Abstract

Background: Cerebrospinal fluid (CSF) oligoclonal bands (OCB) are a diagnostic biomarker in multiple sclerosis (MS). The central vein sign (CVS) is an imaging biomarker for MS that may improve diagnostic accuracy.

Objectives: The objective of the study is to examine the diagnostic performance of simplified CVS methods in comparison to OCB in participants with clinical or radiological suspicion for MS.

Methods: Participants from the CentrAl Vein Sign in MS (CAVS-MS) pilot study with CSF testing were included. Select-3 and Select-6 (counting up to three or six CVS+ lesions per scan) were rated on post-gadolinium FLAIR* images. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value for Select-3, Select-6, OCB, and combinations thereof were calculated for MS diagnosis at baseline and at 12 months.

Results: Of 53 participants, 25 were OCB+. At baseline, sensitivity for MS diagnosis was 0.75 for OCB, 0.83 for Select-3, and 0.71 for Select-6. Specificity for MS diagnosis was 0.76 for OCB, 0.48 for Select-3, and 0.86 for Select-6. At 12 months, PPV for MS diagnosis was 0.95 for Select-6 and 1.00 for Select-6 with OCB+ status.

Discussion: Results suggest similar diagnostic performance of simplified CVS methods and OCB. Ongoing studies will refine whether CVS could be used in replacement or in conjunction with OCB.

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中央静脉征与寡克隆带对多发性硬化症的诊断效果。

背景：脑脊液（CSF）寡克隆带（OCB）是多发性硬化症（MS）的诊断生物标志物。中心静脉征（CVS）是多发性硬化症的影像生物标志物，可提高诊断的准确性：本研究的目的是在临床或放射学怀疑为多发性硬化症的参与者中，检验简化的 CVS 方法与 OCB 相比的诊断性能：方法：纳入进行脑脊液检测的多发性硬化症中心静脉征（CAVS-MS）试验研究的参与者。在钆FLAIR*后图像上对Select-3和Select-6（每次扫描最多计数3个或6个CVS+病灶）进行评级。计算了选择-3、选择-6、OCB 及其组合在基线和 12 个月时对 MS 诊断的敏感性、特异性、阳性预测值 (PPV) 和阴性预测值：结果：在 53 名参与者中，25 人为 OCB+。基线时，OCB 对 MS 诊断的灵敏度为 0.75，Select-3 为 0.83，Select-6 为 0.71。对 MS 诊断的特异性，OCB 为 0.76，Select-3 为 0.48，Select-6 为 0.86。12 个月后，Select-6 的 MS 诊断 PPV 为 0.95，Select-6 的 OCB+ 状态为 1.00：讨论：结果表明，简化 CVS 方法和 OCB 具有相似的诊断性能。正在进行的研究将完善 CVS 是否可以替代或与 OCB 结合使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple Sclerosis Journal 医学-临床神经学

CiteScore

10.90

自引率

6.90%

发文量

186

审稿时长

3-8 weeks

期刊介绍： Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system. The journal for your research in the following areas: * __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics * __Epidemology and genetics:__ genetics epigenetics, epidemiology * __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures * __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management Print ISSN: 1352-4585