KFLC in CSF and serum.

<p>Immunoglobulin kappa free light chain (KFLC) in CSF and serum of patients with MS, CIS, pathogen-related diseases and NIND (for abbreviations see legend of <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088680#pone-0088680-t001" target="_blank">table 1</a>). Q KFLC: CSF- serum ratio of KFLC. Data are shown as the median and IQR.</p

Sensitivity, specificity, positive and negative predictive value for elevated KFLC, MRI parameters and OCB regarding conversion of clinically isolate syndrome to definite multiple sclerosis.

<p>Data are shown as percent and 95% confidence interval. Q KFLC = CSF-serum ratio of KFLC above the approximately upper reference value described in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088680#pone-0088680-g002" target="_blank">figure 2</a>. OCB = cerebrospinal fluid oligoclonal bands of IgG class not detectable in serum. Intrathecal IgG- Synthesis according to Reiber quotients diagrams. IgG- Index = CSF/serum IgG:CSF/serum albumin >0.7. Barkhof = 3 of 4 Barkhof criteria <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088680#pone.0088680-Barkhof1" target="_blank">[21]</a> fulfilled.</p

CSF-serum ratio of KFLC (Q KFLC) among different oligoclonal IgG band patterns.

<p>There are five classic patterns of oligoclonal bands <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088680#pone.0088680-Andersson1" target="_blank">[48]</a> (type 1, no bands in CSF and serum; type 2, oligoclonal IgG bands in CSF but not in serum, indicative of intrathecal IgG synthesis; type 3, oligoclonal bands in CSF plus identical oligoclonal bands in serum and CSF, indicative of intrathecal IgG synthesis; type 4, identical pattern of oligoclonal bands in CSF and serum. There was no patient with type 5 (identical patterns of monoclonal bands in CSF and serum) in the study. Horizontal solid line indicates median, Kruskal-Wallis test among groups revealed a significant difference (p<0.001), significant P-values for pairwise comparisons (Mann-Whitney U test) are displayed.</p

Correlation between CSF-lactate and EDSSLP and yearly progression rate in the entire cohort, EDSSLP and LPD.

<p>Spearman correlation between the CSF-lactate and expanded disability score scale at the LP (EDSS_LP) and yearly progression rate showed consistently statistically significant positive correlation in the entire cohort, treatment-näive patients PPMS_TN and in the results of the diagnostic LP (LP_D). On the other side, a significant correlation between CSF-lactate and EDSS_LP was found only in the LP_D.</p

Demographic data and basic cerebrospinal fluid findings.

<p>Data are shown as the median and IQR. Abbreviations: B-CNS-I bacterial central nervous system infections, CIS clinically isolated syndrome, CSF cerebrospinal fluid, MS multiple sclerosis, NB neuroborreliosis, NIND non-inflammatory neurological diseases, OCB oligoclonal IgG bands, V-CNS-I viral central nervous system infections.</p

CSF-serum ratio of KFLC (Q KFLC) was elevated in patients with positive oligoclonal IgG (OCB). Q KFLC of 77 CIS patients are shown.

<p>Dashed line indicates the approximately upper reference value of Q KFLC, described in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088680#pone-0088680-g002" target="_blank">figure 2</a>. Black rhomb indicate positive OCBs, white rhomb indicate negative OCBs.</p

Clinical features of primary progressive multiple sclerosis (PPMS) patients.

<p>Clinical features of primary progressive multiple sclerosis (PPMS) patients.</p

Summary of the results of lumbar puncture (LP) in patients with primary progressive multiple sclerosis (PPMS).

<p>Summary of the results of lumbar puncture (LP) in patients with primary progressive multiple sclerosis (PPMS).</p

Prevalence of single positive AI against measles (M), Rubella (R) and varicella-zoster virus (Z) and different combinations in our PPMS cohort.

<p>Prevalence of single positive AI against measles (M), Rubella (R) and varicella-zoster virus (Z) and different combinations in our PPMS cohort.</p

Spearman correlation (ρ) between CSF-lactate and EDSS at the lumbar puncture (EDSSLP) and the yearly progression rate in the entire cohort, treatment-naïve PPMS patients (PPMSTN) and at the LP at the year of diagnosis (LPD).

<p>Spearman correlation (ρ) between CSF-lactate and EDSS at the lumbar puncture (EDSSLP) and the yearly progression rate in the entire cohort, treatment-naïve PPMS patients (PPMSTN) and at the LP at the year of diagnosis (LPD).</p