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In this article they say that the MRZH reaction (at least two of measles, rubeole and zoster reactions) increases sensitivity of body fluid diagnosis in MS. But for me this is pointing to the possibility of two different kinds of MS. Those with oligoclonal bands (OGB), and those without OGB, but with MRZ reaction.

what do you think?

Source: http://www.sciencedirect.com/science/ar ... 2816303265
MRZH reaction increases sensitivity for intrathecal IgG synthesis in IgG Oligoclonal band negative Multiple Sclerosis patients

Highlights

• MRZH reaction was present in 67% MS patients and IgG-OCB in 72%.
• Bispecific or higher MRZH reaction was present in 67% of IgG-OCB negative patients.
• Analyzing IgG-OCB and MRZH, intrathecal IgG synthesis was seen in 97% MS patients.
• Detection of either two viral antibodies or IgG-OCB had sensitivity of 88% for MS.
• Detection of either two viral antibodies or IgG-OCB had specificity of 92% for MS.

More information pointing to this possibility:

Brain volume in early MS patients with and without IgG oligoclonal bands in CSFç

Source: http://www.msard-journal.com/article/S2211-0348(17%2930300-0/fulltext

Background

Oligoclonal bands of IgG (OB) are proposed as an early prognostic factor of the disease. Growing attention is directed towards brain volume evaluation as a possible marker of the severity of MS. Previous studies found that MS patients lacking OB have less brain atrophy.

Aim

to evaluate a possible relationship between OB and cerebral volume in a cohort of early MS patients.

Methods

Inclusion criteria were: diagnosis of relapsing-remitting MS; CSF analysis and MRI acquired simultaneously and within 12 months from clinical onset. A total of 15 healthy controls underwent MRI.

Results

In 20 MS patients, CSF analysis did not show OB synthesis (OB negative group). A control group of 25 MS patients in whom OB was detected was also randomly recruited (OB positive group). T test showed a significant difference in NWV between the OB positive and OB negative groups (P value = 0.01), and between the OB positive group and the healthy controls (P value = 0.001). No differences were detected between OB negative group and healthy controls.

Multivariable linear regression showed a relationship between NWV and OB synthesis (P value = 0.02) controlling for age, gender, and EDSS.

Conclusions

Our preliminary results suggest that OB positive patients show more atrophy of white matter since early phases of the disease, supporting the role of CSF analysis as a prognostic factor in MS.