CEREBROSPINAL-FLUID ANALYSIS DIFFERENTIATES BETWEEN RELAPSING-REMITTING AND SECONDARY PROGRESSIVE MULTIPLE-SCLEROSIS

Objectives-To find whether CSF analysis may differentiate between rela psing-remitting and secondary progressive multiple sclerosis. Methods- In 17 patients with relapsing-remitting and 16 patients with secondary progressive multiple sclerosis, all without current or recent relapse s, albumin CSF: peripheral blood ratio, mononuclear cell number, CD4+, CD8+, and B1+ subsets, CD4+:CD8+ ratio, IgG, IgG index, IgM, IgM inde x, complement components C3 and C4, and C3 and C4 indices, myelin basi c protein, neuron specific enolase, S100, and lactate were determined. For each measure the statistical distance measure D-2 was calculated. For computation of a discriminant score variables with a P value less than or equal to 0.15 were included (two sided univariate t test). Th ese were albumin CSF: peripheral blood ratio, mononuclear cell number, IgM, IgM index, C3, C4, neuron specific enolase, S100, and lactate. S imultaneous distributions of the variables were compared between both groups (multivariate t test) and a discriminant score was computed (li near discriminant analysis). Results-The discriminant score allocated all 14 relapsing-remitting patients to the relapsing-remitting group ( positive score) and 12 of 13 secondary progressive patients to the sec ondary progressive group (negative score). One secondary progressive p atient was allocated to the relapsing-remitting group. Conclusions-Pat ients with relapsing-remitting or secondary progressive multiple scler osis differ in CSF profile and CSF analysis may help to differentiate between relapsing-remitting and secondary progressive multiple scleros is.