ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
Exploring the Type 4 Cerebrospinal Fluid Oligoclonal Band Pattern: Clinical and Paraclinical Features with Diagnostic Implications.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
33 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveType 4 ("mirror-pattern") oligoclonal bands (OCBs) are commonly viewed as systemic immune activation indicators, but their clinical significance in demyelinating disorders remains uncertain. This study assessed features of patients with type 4 OCB positivity and determined variables associated with multiple sclerosis (MS).
methodsThis multicenter retrospective study included 92 patients with type 4 OCB positivity detected during cerebrospinal fluid evaluation for suspected demyelinating disease. Patients were grouped as: MS, non-MS inflammatory disorders, and diagnostic evaluation ongoing (DEO). Demographic characteristics, relapse features, treatment response, Expanded Disability Status Scale (EDSS) scores, and magnetic resonance imaging (MRI) findings were analyzed. Logistic regression identified factors associated with MS diagnosis.
resultsMS patients were younger and had higher relapse frequency than non-MS and DEO groups. Relapses with pyramidal and multisystem involvement were frequent in MS, while opticospinal attacks were more common in non-MS disorders. Periventricular and cortical/juxtacortical MRI lesions were associated with MS, whereas systemic autoimmune diseases occurred only in non-MS and DEO groups. Younger age and polysymptomatic presentation were independently associated with MS, whereas a higher relapse frequency and typical MS-related lesion distribution were associated with MS in the univariable analysis only.
conclusionType 4 OCB positivity should not be viewed solely as a systemic immune activation marker. In patients with inflammatory demyelinating disease, the mirror pattern does not exclude MS and should be interpreted with clinical presentation and MRI findings. Its diagnostic relevance depends on patient age, relapse profile, and lesion distribution rather than OCB pattern alone. Type 4 OCB status may inform clinical reasoning but should not independently direct diagnostic decisions.
Indexed as
Identifiers
42711549What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.