{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:17:45Z","timestamp":1790360265013,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cerebrospinal fluid (CSF) free light chains (FLCs) can be an alternative assay to oligoclonal bands (OCBs) in inflammatory neurological disorders, but threshold has no consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the diagnostic accuracy of CSF FLCs in multiple sclerosis (MS) and other neurological diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 406 patients from five Italian centers. FLCs were measured in CSF and serum using Freelite MX assays on Optilite.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 171 patients were diagnosed as MS, 154 non-inflammatory neurological diseases, 48 inflammatory central nervous system (CNS) diseases, and 33 peripheral neurological diseases. Both kFLC and \u03bbFLC indices were significantly higher in patients with MS compared to other groups ( p\u2009&lt;\u20090.0001). The kFLC index\u2009\u2a7e\u20096.4 is comparable to OCB for MS diagnosis (area under the receiver operating characteristic curve (AUC)\u2009=\u20090.876; sensitivity 83.6% vs 84.2%; specificity 88.5% vs 90.6%). \u03bbFLC index\u2009\u2a7e\u20095 showed an AUC of 0.616, sensitivity of 33.3% and specificity of 90.6%. In all, 12\/27 (44.4%) MS patients with negative OCB had kFLC index\u2009\u2a7e\u20096.4. Interestingly, 37.5% of 24 patients with a single CSF IgG band showed high kFLC index and 12.5% positive \u03bbFLC index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings support the diagnostic utility of FLC indices in MS and other CNS inflammatory disorders, suggesting a combined use of FLC and OCB to help clinicians with complementary information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585211064121","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T03:52:31Z","timestamp":1640836351000},"page":"1364-1372","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["The contribute of cerebrospinal fluid free light-chain assay in the diagnosis of multiple sclerosis and other neurological diseases in an Italian multicenter study"],"prefix":"10.1177","volume":"28","author":[{"given":"Gaetano","family":"Bernardi","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Investigation, Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Biagioli","sequence":"additional","affiliation":[{"name":"General Laboratory, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4553-9571","authenticated-orcid":false,"given":"Paola","family":"Malpassi","sequence":"additional","affiliation":[{"name":"Laboratorio Unico Metropolitano, Azienda Unit\u00e0 Sanitaria Locale Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"De Michele","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Laboratory, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domizia","family":"Vecchio","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Neurology Unit, University of Piemonte Orientale, Novara, Italy\/Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Repice","sequence":"additional","affiliation":[{"name":"SOD Department of Neurology 2, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2902-5589","authenticated-orcid":false,"given":"Alessandra","family":"Lugaresi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy\/IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Mirabella","sequence":"additional","affiliation":[{"name":"UOS Sclerosi Multipla, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Torri Clerici","sequence":"additional","affiliation":[{"name":"Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Crespi","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"key":"bibr1-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2007.03.022"},{"key":"bibr2-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25119"},{"key":"bibr3-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-017-8961-8"},{"key":"bibr4-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneuro0154"},{"key":"bibr5-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2017.1262260"},{"key":"bibr6-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"bibr7-13524585211064121","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2013.06.014"},{"issue":"9","key":"bibr8-13524585211064121","doi-asserted-by":"crossref","first-page":"e0239453","DOI":"10.1371\/journal.pone.0239453","volume":"15","author":"Berek K","year":"2020","journal-title":"Borrelia burgdorferi. 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