Added value of optic nerve lesions for multiple sclerosis diagnostic criteria
Abstract
Background Optic neuritis is a frequent initial presentation of multiple sclerosis (MS). It has been suggested that optic nerve lesions on magnetic resonance imaging (MRI) should be considered as an additional lesion location for the demonstration of dissemination in space (DIS) in diagnostic criteria for MS. However, the potential value of optic nerve lesion(s) in MS diagnostic criteria has not yet been sufficiently investigated. Methods We prospectively included 79 patients presenting with the first clinical event suggestive of MS. All patients underwent neurological work-up, visual-evoked potential (VEP) testing, cerebrospinal fluid (CSF) analysis and contrast-enhanced MRI of the brain, spinal cord and optic nerves (ON). Patients were classified results according to the McDonald 2017 criteria, the MAGNIMS criteria and alternative criteria considering ON imaging findings for both DIS and dissemination in time (DIT). Results 69 patients (87%) fulfilled DIS according to the MAGNIMS criteria, 67 patients (85%) according to McDonald 2017 and 70 patients (89%) according to the alternative diagnostic criteria. Including contrast enhancing ON lesions as an additional criterion for DIT and disregarding CSF results led to n = 9 (11%) additional patients fulfilling DIT and receiving the diagnosis MS compared to the McDonald 2017 and MAGNIMS criteria. Considering CSF findings in addition to MRI, 68 patients received the diagnosis of MS according to McDonald 2017 compared to 66 patient…
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MRI acquisition followed the 2021 MAGNIMS-CMSC-NAIMS guidelines and included standard-dose gadolinium enhancement for detection of active inflammatory lesions.
“MRI acquisition followed the 2021 MAGNIMS-CMSC-NAIMS guidelines and included standard-dose gadolinium enhancement for detection of active inflammatory lesions.21,22”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [22]
Optic nerve lesions have significant diagnostic yield and improve early classification of MS.
“recent works that demonstrated that optic nerve lesions have significant diagnostic yield and improve early classification of MS.”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [22]
Cites
Vidal-Jordana, A., Rovira, A., Calderon, W., Arrambide, G., Castilló, J., Moncho, D., Rahnama, K., Collorone, S., Toosy, A. T., Ciccarelli, O., et al. (2024) · Neurology · doi:10.1212/wnl.0000000000207805 · Cited by 88 · see citing works
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Konen, F. F., Mahmoudi, N., Albers, L. M., Arrambide, G., Streichert, A. L., Haar, M., Soldatov, A., Bucak, E., Jendretzky, K. F., Nay, S., et al. (2026) · eClinicalMedicine · doi:10.1016/j.eclinm.2026.104098
“8,13 These revisions aim to increase diagnostic sensitivity while incorporating additional features intended to preserve, even increase, diagnostic specificity, thereby enabling an earlier and more accurate diagnosis of MS. 8 However, the real-world impact and applicability of these newly incorporated modifications on…”
InfluentialSelf-citation
- Authors
- Mahmoudi, N., Renne, J., Konen, F. F., Jendretzky, K. F., Möhn, N., Grote-Levi, L., Gingele, S., Hümmert, M. W., Schwenkenbecher, P., Soldatov, A., Sühs, K.-W., Skripuletz, T., & Wattjes, M. P.
- Affiliations
- Medizinische Hochschule Hannover (DE)
- Humboldt-Universität zu Berlin (DE)
- Corresponding author
- Wattjes, Mike P.
- ORCID
- Venue
- Journal of Neurology
- Published
- 2025-04-24
- Volume
- 272
- Issue
- 5
- Pages
- 358-358
- ISSN
- 0012-1037 (ISSN-L)
- 0340-5354
- 1432-1459
- OpenAlex
- W4409768744
- Cited by
- 4
- References
- 1
- Citations by year
- 2026: 4
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Keywords
- multiple sclerosis, optic nerve lesions, optic neuritis, diagnostic criteria, dissemination in space, dissemination in time, visual evoked potentials, cerebrospinal fluid findings, contrast-enhanced MRI, sensitivity and specificity
- MeSH terms
- Adult, Evoked Potentials, Visual, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Optic Nerve, Optic Neuritis, Prospective Studies, Young Adult
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