Lipid-specific immunoglobulin M in CSF predicts adverse long-term outcome in multiple sclerosis

Mult Scler. 2008 Nov;14(9):1208-13. doi: 10.1177/1352458508095729. Epub 2008 Aug 28.


Background and objective: The presence of lipid-specific immunoglobulin M bands in the cerebrospinal fluid (CSF) predicts an aggressive course in patients with relapsing-remitting multiple sclerosis (MS) during early stages of the disease. This study examined whether it is also a predictor of long-term prognosis in MS.

Methods: Eighty-one patients with MS and 22 headache controls were analyzed for anti-lipid IgM reactivity in CSF samples. The correlation between the presence of lipid-specific immunoglobulin M bands in CSF and disease progression was assessed in patients with MS who had been followed longitudinally for, on average, more than 11 years.

Results: Lipid-specific immunoglobulin M bands were detected in the CSF of 24 of 81 patients with MS and were absent in the CSF of all headache controls. Median time to conversion to a secondary progressive course was 11 years in patients with bands and 22 years in patients without bands. Median time to an Expanded Disability Status Scale score of 4 was 14 years in patients with bands and 24 years in patients without bands.

Conclusion: The presence of lipid-specific immunoglobulin M bands in CSF predicts a more adverse long-term outcome in patients with MS; it may thus define a subset of patients who might benefit from aggressive treatment during the early phase of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibody Specificity
  • Biomarkers / cerebrospinal fluid*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lipids / immunology*
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / cerebrospinal fluid
  • Multiple Sclerosis, Relapsing-Remitting / immunology*
  • Multiple Sclerosis, Relapsing-Remitting / mortality*
  • Oligoclonal Bands / cerebrospinal fluid*
  • Oligoclonal Bands / immunology
  • Predictive Value of Tests
  • Prognosis
  • Young Adult


  • Biomarkers
  • Lipids
  • Oligoclonal Bands