Cerebrospinal fluid free light chains compared to oligoclonal bands as biomarkers in multiple sclerosis

Cerebrospinal fluid (CSF) free light chains (FLC) may be an alternative biomarker to oligoclonal bands (OCB) in multiple sclerosis (MS). Herein, we compared the diagnostic accuracy of CSF OCB and FLC and we tested the prognostic value of FLC in a cohort of 64 MS patients and 106 controls. A kappa-index > 7.83 was more sensitive but less specific than OCB in discriminating MS patients from controls. Additionally, a kappa-index > 10.61 performed better than OCB in the discrimination between MS and controls with inflammatory neurological diseases (p <.001). In clinically isolated syndrome (CIS) patients, a kappa-index > 10.61 significantly predicted time to conversion to MS (p = .020). kappa-index might be a valid alternative to OCB as a diagnostic biomarker for MS and might also be a prognostic marker in CIS.