Oligoclonal Bands (OCB) and MS

Here is My Question:
I had a spinal tap done and it came back with oligoclonal bands (OCBs) band number matching and negative for oligoclonal bands. Do I have MS?

Answer:
Spinal fluid Oligoclonal bands (OCBs) are immunoglobulins (also called antibodies) usually of the IgG subtype, although some labs also measure IgM Oligoclonal bands. They are called "bands" because of their stained appearance (colored stripes or bands in a row)  on an agarose gel electrophoresis plate. For assisting in the diagnosis of MS, we look for Oligoclonal bands in a spinal fluid sample that are not observed in a matching serum sample obtained from a blood draw at the time of your lumbar puncture. Those bands that are seen in both the serum and CSF sample are not unique to your nervous system. They simply represent immunoglobulin that leaked into your spinal fluid from the blood stream. For instance, you could have 14 OCBs in your spinal fluid sample and 10 of them could match OCBs observed in your serum sample. This would mean you have 4 spinal fluid oligoclonal bands (14-10=4), each produced by plasma cells residing in your nervous system. Some labs consider an abnormal result as 2 or more unique spinal fluid OCBs whereas others consider 4 or more as abnormal.

Oligoclonal bands are not diagnostic of MS and can be seen in people with many different inflammatory and degenerative conditions. People can also have forms of MS without Oligoclonal bands in the CSF.  The presence of absence of spinal fluid OCBs are just one of the pieces of information we used to help establish a diagnosis of MS.

​Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego