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- Title
Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A systematic review and meta-analysis.
- Authors
Hegen, Harald; Walde, Janette; Berek, Klaus; Arrambide, Georgina; Gnanapavan, Sharmilee; Kaplan, Batia; Khalil, Michael; Saadeh, Ruba; Teunissen, Charlotte; Tumani, Hayrettin; Villar, Luisa M; Willrich, Maria Alice V; Zetterberg, Henrik; Deisenhammer, Florian
- Abstract
Background: Intrathecal immunoglobulin-G synthesis is a hallmark of multiple sclerosis (MS), which can be detected by oligoclonal IgG bands (OCB) or by κ-free light chains (κ-FLC) in cerebrospinal fluid. Objective: To perform a systematic review and meta-analysis to evaluate whether κ-FLC index has similar diagnostic value to identify patients with clinically isolated syndrome (CIS) or MS compared to OCB, and to determine κ-FLC index cut-off. Methods: PubMed was searched for studies that assessed diagnostic sensitivity and specificity of κ-FLC index and OCB to discriminate CIS/MS patients from control subjects. Two reviewers following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines performed study eligibility assessment and data extraction. Findings from studies were analyzed with bivariate mixed models. Results: A total of 32 studies were included in the meta-analysis to evaluate diagnostic value of κ-FLC index. Sensitivity and specificity ranged from 52% to 100% (weighted average: 88%) and 69% to 100% (89%) for κ-FLC index and from 37% to 100% (85%) and 74% to 100% (92%) for OCB. Mean difference of sensitivity and specificity between κ-FLC index and OCB was 2 and −4 percentage points. Diagnostic accuracy determined by mixed models revealed no significant difference between κ-FLC index and OCB. A discriminatory cut-off for κ-FLC index was determined at 6.1. Conclusion: The findings indicate that κ-FLC index has similar diagnostic accuracy in MS as OCB.
- Subjects
IMMUNOGLOBULIN light chains; CEREBROSPINAL fluid; MULTIPLE sclerosis; MONOCLONAL gammopathies
- Publication
Multiple Sclerosis Journal, 2023, Vol 29, Issue 2, p169
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/13524585221134213