English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Open

Objective  Intrathecal Immunoglobulin M synthesis (IgM Intrathecal Fraction (IF)  + ) and spinal MRI lesions are both strong independent predictors of higher disease activity and severity in multiple sclerosis (MS). We investigated whether IgM IF  +  is associated with spinal cord manifestation and higher neuroaxonal damage in early MS.    Methods  In 122 patients with a first demyelinating event associations between (1) spinal versus (vs) non‐spinal clinical syndrome (2) spinal vs cerebral T2‐weighted (T2w) and (3) contrast‐enhancing (CE) lesion counts with IgG IF  +  (vs IgG IF  − ) or IgM IF  +  (vs IgM IF  − ) were investigated by logistic regression adjusted for age and sex, respectively. For serum neurofilament light chain (sNfL) analysis patients were categorized for presence or absence of oligoclonal IgG bands (OCGB), IgG IF  and IgM IF  (>0% vs 0%, respectively): (1) OCGB − /IgG IF  − /IgM IF  − ; (2) OCGB + /IgG IF  − /IgM IF  − ; (3) OCGB + /IgG IF  + /IgM IF  − ; and (4) OCGB + /IgG IF  + /IgM IF  + . Associations between categories 2 to 4 vs category 1 with sNfL concentrations were analyzed by robust linear regression, adjusted for sex and MRI parameters.    Results  Patients with a spinal syndrome had a 8.36‐fold higher odds of IgM IF  +  (95%CI 3.03–23.03;  p  < 0.01). Each spinal T2w lesion (odds Ratio 1.39; 1.02–1.90;  p  = 0.037) and CE lesion (OR 2.73; 1.22–6.09;  p  = 0.014) was associated with an increased risk of IgM IF  +  (but not of IgG IF  + ); this was not the case for cerebral lesions. OCGB + /IgG IF  + /IgM IF  +  category patients showed highest sNfL levels (estimate:1.80; 0.55–3.06;  p  < 0.01).    Interpretation  Intrathecal IgM synthesis is strongly associated with spinal manifestation and independently more pronounced neuroaxonal injury in early MS, suggesting a distinct clinical phenotype and pathophysiology. ANN NEUROL 2022;91:814–820

Intrathecal IgM Synthesis Is Associated with Spinal Cord Manifestation and Neuronal Injury in Early MS