To investigate whether cerebrospinal fluid (CSF) markers differ between pediatric-onset multiple sclerosis (PoMS, onset < 18 years) and adult-onset (AoMS), and whether these markers are associated with clinical outcomes among PoMS. Prospective nationwide registry study of incident MS, including persons with a CSF sample < 3 years post-MS onset. We compared CSF oligoclonal band (OCB) status, immunoglobulin G (IgG) index levels, and mononuclear cell count between PoMS and AoMS. Within the PoMS cohort we analyzed the association between CSF markers, relapse rate and Expanded Disability Status Scale (EDSS) score, using negative binomial regression and generalized estimating equations, respectively. The cohort consisted of 130 PoMS and 3228 AoMS cases. The PoMS group had higher odds of OCB-positivity (odds ratio: 2.70; 95% CI 1.21–7.67). None of the CSF markers were associated with relapse rate in the PoMS cohort; however, OCB-positivity was associated with higher EDSS scores. This study suggested that PoMS more commonly display CSF evidence for intrathecal IgG production than AoMS. Further, we found evidence of a relationship between OCB-positivity and subsequent disability, suggesting that they could play a role in the prognostication of MS in children.

研究儿童多发性硬化症（PoMS，发病 <18 岁）和成人发病 (AoMS) 的脑脊液 (CSF) 标志物是否不同，以及这些标志物是否与 PoMS 的临床结果相关。对发生 MS 的前瞻性全国登记研究，包括 MS 发病后 3 年内 CSF 样本的人。我们比较了 PoMS 和 AoMS 之间的 CSF 寡克隆带 (OCB) 状态、免疫球蛋白 G (IgG) 指数水平和单核细胞计数。在 PoMS 队列中，我们分别使用负二项式回归和广义估计方程分析了 CSF 标志物、复发率和扩展残疾状态量表 (EDSS) 评分之间的关​​联。该队列由 130 个 PoMS 和 3228 个 AoMS 病例组成。PoMS 组具有更高的 OCB 阳性几率（优势比：2.70；95% CI 1.21–7.67）。在 PoMS 队列中，没有一种 CSF 标志物与复发率相关；然而，OCB 阳性与较高的 EDSS 分数相关。这项研究表明，与 AoMS 相比，PoMS 更常显示鞘内 IgG 产生的 CSF 证据。此外，我们发现 OCB 阳性与随后的残疾之间存在关系的证据，表明它们可能在儿童 MS 的预后中发挥作用。