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Cerebrospinal Fluid Oligoclonal Bands in the Diagnosis of Multiple Sclerosis
Isoelectric Focusing With IgG Immunoblotting Compared With High-Resolution Agarose Gel Electrophoresis and Cerebrospinal Fluid IgG Index

Alexandre S. Fortini MD, Elizabeth L. Sanders, Brian G. Weinshenker MD, Jerry A. Katzmann PhD
DOI: http://dx.doi.org/10.1309/Y5VFF2UAW0RK5W63 672-675 First published online: 1 November 2003


Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. We compared the diagnostic performance of isoelectric focusing (IEF) combined with IgG immunoblotting to high-resolution agarose gel electrophoresis for the detection of intrathecal synthesis of IgG due to the MS disease process.

In 20 patients with definite MS, IEF and high-resolution agarose gel electrophoresis had sensitivities of 90% and 60%, respectively. In the 51 patients with no evidence of MS, the methods had specificities of 94% and 96%, respectively. With a prevalence of 15% in this test population, IEF and high-resolution agarose gel electrophoresis had positive predictive values of 73% and 73% and negative predictive values of 98% and 93%, respectively.

The IEF method improves the sensitivity and the negative predictive value of the oligoclonal-banding assay, the IEF gels are easier to interpret, and the IEF assay requires a smaller cerebrospinal fluid volume.

Key Words:
  • Multiple sclerosis
  • Cerebrospinal fluid
  • Oligoclonal bands
  • Isoelectric focusing
  • High-resolution agarose gel electrophoresis
  • Cerebrospinal fluid IgG index