Mayo Clinic Laboratories > Neurology > Demyelinating disease > Multiple sclerosis

Multiple sclerosis

Innovative evaluations to detect and diagnose

Mayo Clinic Laboratories offers a profile that can assist in the diagnosis of multiple sclerosis (MS) by measuring kappa immunoglobin light chains in cerebral spinal fluid (KCSF) with a reflex, if positive, to oligoclonal banding. Propelled by Mayo Clinic-led studies into the presence of kappa IgG biomarkers in the spinal fluid of patients with MS, the assay has been optimized for peak antibody detection. This increased sensitivity delivers precision results that set patients on the correct diagnostic pathway.

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30%-67%

30%-67% OF PATIENTS REFERRED TO MS SUBSPECIALTY CENTERS WITH SUSPECTED MS DIAGNOSIS ULTIMATELY DETERMINED NOT TO HAVE MS1

Multiple sclerosis Test menu

Multiple sclerosis Multiple sclerosis
Neurofilament light chain Neurofilament light chain

Multiple sclerosis

Key testing

Advantages

  • Automated assay is objective, standardized, and enables definitive, error-free results.
  • Same-day results for three-fourths of patients tested.
  • Reflexive testing provides increased sensitivity and definitive answers.
  • Adheres to widely used McDonald criteria for a positive diagnosis.
View diagram Based on internal Mayo Clinic studies, KCSF will be negative in 75% of cases, immediately ruling out demyelinating disease. For the remaining 25% of borderline or positive KCSF cases — between 0.06 and 0.1 or higher mg/dL — the test will reflex to oligoclonal banding. Both results are reported to the ordering physician.
View chart The use of preclinical data, such as results obtained with imaging studies and laboratory testing, has allowed for more sensitive and specific diagnoses. This leads to earlier disease detection and utilization of interventions and therapies when they are most beneficial to patients.
Read article CSF Kappa Free Light Chains: Cutoff Validation for Diagnosing

Highlights

Multiple Sclerosis Profile Updates

Maria Alice Willrich, Ph.D., explains kappa free light chain testing — Mayo Clinic Laboratories' data-driven approach to diagnose multiple sclerosis. The automated assay is more sensitive, cost-effective, and faster than traditional oligoclonal banding, enabling definitive answers for the challenging diagnosis.

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Neurofilament light chain

For patients suspected of having multiple sclerosis, testing for neurofilament light chain (NfL), a generic marker of neurodegeneration, can confirm a neurodegenerative disease process. Propelled by Mayo Clinic-led research, Mayo Clinic Laboratories has implemented a first-in-class assay to test for elevated levels of NfL in the blood. Positive test results not only confirm neuronal damage but can offer insights on disease severity, progression, and prognosis to guide therapeutic decision-making.

Key testing

Advantages

  • Rapid turnaround time.
  • A positive result suggests the presence of a neurodegenerative disease process.
  • Results reported in accordance with established age-based reference intervals.
  • Validated to align with CAP and CLIA testing guidelines.
Read article Head-to-head comparison of four plasma neurofilament light chain (NfL) immunoassays
Read article Guidance for use of neurofilament light chain as a cerebrospinal fluid and blood biomarker in multiple sclerosis management

Highlights

Neurofilament light chain: Bjorn Oskarsson, M.D.

In this test-specific episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic, and Bjorn Oskarsson, M.D., a neurologist at Mayo Clinic’s Florida campus, discuss how the neurofilament light chain test available through Mayo Clinic Laboratories helps physicians diagnose neurological disease and assess neuronal damage.

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Neurofilament Light Chain (NFLC)

Alicia Algeciras, Ph.D., describes Mayo Clinic Laboratories’ new blood test to detect NFLC, or neurofilament light chain protein. NFLC is a biomarker for several neurodegenerative conditions. The new assay can determine if a patient’s cognitive decline is due to a neurodegenerative condition or some other, reversible condition — while avoiding the need for more-invasive testing of cerebrospinal fluid.

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References
  1. Solomon AJ, Naismith RT, Cross AH. Misdiagnosis of multiple sclerosis: Impact of the 2017 McDonald criteria on clinical practice. Neurology. 2019;92(1):26-33. doi:10.1212/WNL.0000000000006583 
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