{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:04:44Z","timestamp":1787238284331,"version":"build-2736575974"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Limited evidence exists on how to use kappa free light chains (\u03baFLCs) and oligoclonal bands (OCBs) in diagnosing intrathecal immunoglobulin synthesis (IgS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare different algorithms to define IgS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis of the 2022 French cohort study was conducted. Patients were considered to have IgS if (1) the \u03baFLC index was \u2a7e6.1, (2) OCB was positive, (3) the \u03baFLC index was \u2a7e6.1 or OCB was positive, (4) the \u03baFLC index was \u2a7e20 or OCB was positive, regardless of the \u03baFLC index value, or (5) the \u03baFLC index was \u2a7e20 or OCB was positive (with OCB tested only when the \u03baFLC index was between 3.5 and 20). People with multiple sclerosis (MS) were compared with controls and with a subgroup of age- and sex-matched MS-mimicking disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 1531 patients, 675 had MS and 856 were controls (133 MS mimics). Agreement between OCB and \u03baFLC index (\u2a7e6.1) was high (89%). All tested algorithms demonstrated high accuracy in separating groups. Using the sequential approach (5) achieves higher specificity and a significant reduction in OCB testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Using a simple cut-off point of 6.1 for routine screening is accurate, but testing for OCB when the \u03baFLC index is between 3.5 and 20 increases specificity and should be prospectively studied in challenging cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261442020","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:30:18Z","timestamp":1778113818000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Kappa free light chain index or oligoclonal bands testing in clinical practice for multiple sclerosis diagnosis: An algorithm comparative study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-212X","authenticated-orcid":false,"given":"Micha\u00ebl","family":"Levraut","sequence":"first","affiliation":[{"name":"Unit\u00e9 de Recherche Clinique C\u00f4te d\"Azur (UR2CA-URRIS), Centre Hospitalier Universitaire de Nice, Centre de Ressources et de Comp\u00e9tences Scl\u00e9rose en Plaques (CRC-SEP), Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-1297","authenticated-orcid":false,"given":"Mikael","family":"Cohen","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Recherche Clinique C\u00f4te d\"Azur (UR2CA-URRIS), Centre Hospitalier Universitaire de Nice, Centre de Ressources et de Comp\u00e9tences Scl\u00e9rose en Plaques (CRC-SEP), Nice, France; D\u00e9partement de Neurologie, CRC-SEP, Centre Hospitalier Universitaire de Nice, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Sterlin","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019Immunologie, Assistance Publique des H\u00f4pitaux de Paris, Centre Hospitalier Universitaire de la Piti\u00e9-Salp\u00eatri\u00e8re, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3834-2981","authenticated-orcid":false,"given":"Xavier","family":"Ayrignac","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5176-580X","authenticated-orcid":false,"given":"K\u00e9vin","family":"Bigaut","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, H\u00f4pitaux Universitaires de Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4029-2012","authenticated-orcid":false,"given":"H\u00e9l\u00e8ne","family":"Z\u00e9phir","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm U1172, CHU de Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3386-6308","authenticated-orcid":false,"given":"Jonathan","family":"Ciron","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, CRC-SEP, Centre Hospitalier Universitaire de Toulouse, Toulouse C\u00e9dex, France"},{"name":"Universit\u00e9 Toulouse III, Infinity, Inserm UMR1291 - CNRS UMR5051, Toulouse C\u00e9dex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Camdessanch\u00e9","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Casez","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Moreau","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier de Dijon, Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7699-0328","authenticated-orcid":false,"given":"Elisabeth","family":"Maillart","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Assistance Publique des H\u00f4pitaux de Paris, Centre Hospitalier Universitaire de la Piti\u00e9-Salp\u00eatri\u00e8re, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Maurousset","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier Universitaire de Tours, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Laplaud","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier Universitaire de Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Bigot","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Biochimie, Centre Hospitalier Universitaire de Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Pelletier","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Assistance publique des H\u00f4pitaux de Marseille, Centre Hospitalier Universitaire de La Timone, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8671-7747","authenticated-orcid":false,"given":"Eric","family":"Thouvenot","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Neurologie, Centre Hospitalier Universitaire de N\u00eemes, N\u00eemes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3713-2416","authenticated-orcid":false,"given":"Christine","family":"Lebrun-Fr\u00e9nay","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Recherche Clinique C\u00f4te d\"Azur (UR2CA-URRIS), Centre Hospitalier Universitaire de Nice, Centre de Ressources et de Comp\u00e9tences Scl\u00e9rose en Plaques (CRC-SEP), Nice, France; 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