OBJECTIVE

To examine clinico-demographic characteristics, incidence and patterns of oligoclonal IgG in cerebrospinal fluid (CSF), concentrations of free light chains of immunoglobulin kappa (k-FLC), and total CSF protein in patients with multiple sclerosis (MS) with and without headache.

MATERIAL AND METHODS

A retrospective single-center cohort study of patients with MS was performed between 2018 and 2024 at the Pavlov First St. Petersburg State Medical University. Medical records from 320 patients with MS were analyzed.

RESULTS

Among 320 patients with MS, 105 (32.8%) ones experienced headaches (H), including migraine (M) in 69 (21.6%), tension-type headache (TTH) in 19 (5.9%), and unclassified headache (UH) in 17 (5.3%) cases. M was more common in recurrent MS (19.1%) than in progressive MS (2.5%, p=0.006). TTH and UH did not demonstrate similar patterns. The incidence of type 2 IgG synthesis in CSF in the MS with M group was 79.31%, while in MS without headache — 64.42% (p=0.048). Levels of anti-FLC and total protein in CSF did not differ significantly between groups (p=0.395 and p=0.854, respectively). When comparing the incidence of type 2 IgG synthesis in CSF between groups for all headaches (M+TTH+ UH) and MS without headache, we found significant differences with higher incidence in the 1^st group: 78.8% and 64.4%, respectively (p=0.021). Levels of anti-FLC and total protein in CSF were similar.

CONCLUSION

Our data demonstrate high prevalence of M in patients with MS. Prevalence of M in remitting course of MS and high frequency of pathological synthesis of IgG in CSF in patients with any headache, and especially M, may indicate inflammatory mechanisms of headaches in some patients with MS. This justifies a prospective study on a large sample of patients with analysis of additional pathogenetically significant parameters.