Cerebrospinal fluid igm and oligoclonal igg bands in multiple sclerosis: A meta-analysis of prevalence and prognosis

Mattia Fonderico, Emilio Portaccio, Lorenzo Razzolini, Luisa Pastò, Angelo Bellinvia, Ilaria Addazio, Matteo Betti, Maria Grazia Aprea, Clara Ballerini, Tiziana Biagioli, Maria Pia Amato

Research output: Contribution to journalReview articlepeer-review


The presence of intrathecal IgM synthesis (ITMS) has been associated with an aggressive multiple sclerosis (MS) clinical course. In the present systematic review, we aimed at assessing the prevalence of ITMS among different MS phenotypes. Moreover, we aimed at quantifying the risk of a second relapse in ITMS positive and oligoclonal IgG bands (OCGBs)-positive patients. We selected clinical studies reporting the ITMS prevalence assessed as oligoclonal IgM Bands (OCMBs), lipid-specific OCMBs (LS-OCMBs), and/or as an intrathecal IgM production > 0% (IgMLoc, Reiber formula). The overall prevalence of ITMS was higher in relapsing-remitting (RR) than clinically isolated syndrome (CIS) patients (40.1% versus 23.8%, p < 0.00001), while was in line with that detected in primary progressive MS (PPMS, 26.7%). Almost all patients (98%) with ITMS had also OCGBs. The risk of having a second relapse was higher in OCGBs positive patients (HR = 2.18, p = 0.007) but much higher in ITMS positive patients (HR = 3.62, p = 0.0005). This study revealed that the prevalence of ITMS is higher in RRMS patients. It suggests that the risk of having a second relapse, previously ascribed to OCGBs, may, to a certain extent, be related to the presence of intrathecal IgM.

Original languageEnglish
Article number1444
JournalBrain Sciences
Issue number11
Publication statusPublished - Nov 2021


  • Biomarker
  • Intrathecal IgM synthesis
  • Multiple sclerosis
  • Oligoclonal bands

ASJC Scopus subject areas

  • Neuroscience(all)


Dive into the research topics of 'Cerebrospinal fluid igm and oligoclonal igg bands in multiple sclerosis: A meta-analysis of prevalence and prognosis'. Together they form a unique fingerprint.

Cite this