Earlier and more frequent diagnosis of multiple sclerosis using the McDonald criteria: Figure 1
Open accessAbstract
The McDonald criteria allow multiple sclerosis (MS) to be diagnosed in patients with a clinically isolated syndrome (CIS) who have MRI evidence of dissemination in time and space.1–3 There have been successive versions of the criteria in 2001,1 20052 and 20103 with different requirements for dissemination in time and space. Although each version has been shown to have a high sensitivity and specificity for the development of clinically-definite MS (CDMS), few studies have investigated how much sooner4 and how more often5 MS can be diagnosed in patients with CIS using the McDonald criteria. We recruited 178 patients with CIS presenting to Moorfields Eye Hospital and the National Hospital for Neurology and Neurosurgery between 1995 and 2004. The study was approved by ethics committees at both hospitals. Patients were seen at baseline, then for follow-up after 3 months, 1 year, 3 years and 6 years. At each study visit informed consent was obtained. Patients were assessed with a detailed review of neurological symptoms and neurological examination. Relapses were recorded at study visits, but patients were also encouraged to contact the research team at the time of new neurological symptoms. MRI of the brain and whole spine was obtained at each visit on the same 1.5 T Signa scanner, as described elsewhere.6 Each scan was reviewed by a neuroradiologist blinded to the patient's clinical status. The number, location and activity (ie, gadolinium enhancement) of T2 lesions was recorded. During follow-up CDMS was defined according …
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The McDonald 2010 criteria are easily applied in a clinical setting and allow for an earlier diagnosis of MS.
“The McDonald 2010 criteria are easily applied in a clinical setting and allow for an earlier diagnosis of MS. 19”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [19]
The paper’s conclusion (page not specified in our copy) says the McDonald criteria allow earlier MS diagnosis in patients with a clinically isolated syndrome, and its results report a shorter mean time to diagnosis with the 2010 criteria. It does not say the criteria are easily applied in a clinical setting; the claim also omits the study’s CIS population qualifier. (LLM, conf=0.87)
Experimental — accuracy not yet measuredUsing the McDonald 2010 criteria a diagnosis of RRMS can be made in up to one third of CIS patients with a single MRI scan.
“Using the McDonald 2010 criteria a diagnosis of RRMS can be made in up to one third of CIS patients with a single MRI scan.19”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [19]
The Results (page unavailable) show that the 2010 McDonald criteria identified MS in CIS patients using MRI evidence, including 36 of 157 patients (23%) with MRI-only MS after six years. The Methods (page unavailable) required at least one follow-up MRI, so these findings do not establish that up to one third of all CIS patients could be diagnosed from a single scan. The paper also reports MS diagnosis, not specifically RRMS diagnosis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredUsing the McDonald criteria, MS is being diagnosed significantly earlier than with the use of clinical criteria alone facilitating earlier treatment.
“Using the McDonald criteria, MS is being diagnosed significantly earlier than with the use of clinical criteria alone facilitating earlier treatment.19”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [19]
The results (page unavailable) report significantly earlier MS diagnosis with McDonald criteria than with clinical criteria in patients with clinically isolated syndrome. The discussion says earlier diagnosis allows timely conversations about disease-modifying treatment, but does not establish that treatment began earlier. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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Cites
Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria
Polman, C. H., Reingold, S. C., Banwell, B., Clanet, M., Cohen, J. A., Filippi, M., Fujihara, K., Havrdova, E., Hutchinson, M., Kappos, L., et al. (2011) · Annals of Neurology · doi:10.1002/ana.22366 · Cited by 9,802 · see citing works
Flagged first, then by citations
Research works printed but not linked: 7
- [1]McDonald WI Compston A Edan G Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50: 121– 7. 11456302
- [2]Polman CH Reingold SC Edan G Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘McDonald Criteria’. Ann Neurol 2005; 58: 840– 6. 16283615
- [4]Runia TF Jafari N Hintzen RQ Application of the 2010 revised criteria for the diagnosis of multiple sclerosis to patients with clinically isolated syndromes. Eur J Neurol 2013; 20: 1510– 16. 23906114
- [5]Chard DT Dalton CM Swanton J MRI only conversion to multiple sclerosis following a clinically isolated syndrome. J Neurol Neurosurg Psychiatry 2011; 82: 176– 9. 20519235
- [6]Swanton J Fernando K Dalton C Early MRI in optic neuritis: the risk for clinically definite multiple sclerosis. Mult Scler 2010; 16: 156– 65. 20086028
- [7]Sormani MP Tintore M Rovaris M Will Rogers phenomenon in multiple sclerosis. Ann Neurol 2008; 64: 428– 33. 18688811
- [8]Tintore M Rovira A Rio J Is optic neuritis more benign than other first attacks in multiple sclerosis? Ann Neurol 2005; 57: 210– 15. 15668965
Cited by
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Diagnosis of multiple sclerosis: progress and challenges
Brownlee, W. J., Hardy, T. A., Fazekas, F., & Miller, D. H. (2017) · The Lancet · doi:10.1016/s0140-6736(16)30959-x · Cited by 701 · see citing works
Self-citationVidal-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
Self-citationMisdiagnosis of multiple sclerosis: Time for action
Brownlee, W. J., & Solomon, A. J. (2021) · Multiple Sclerosis Journal · doi:10.1177/13524585211005367 · Cited by 15 · see citing works
Self-citation
- Authors
- Brownlee, W. J., Swanton, J. K., Altmann, D. R., Ciccarelli, O., & Miller, D. H.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- London School of Hygiene & Tropical Medicine (GB)
- National Institute for Health and Care Research (GB)
- Corresponding author
- Brownlee, Wallace J
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2014-11-20
- Volume
- 86
- Issue
- 5
- Pages
- 584-585
- ISSN
- 0022-3050 (ISSN-L)
- 1468-330X
- PMC
- PMC4451169
- OpenAlex
- W2132444350
- Cited by
- 84
- References
- 1
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 11 · 2023: 5 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 9 · 2018: 13 · 2017: 7 · 2016: 7 · 2015: 1
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Funders
- GlaxoSmithKline
- Biogen
- National Institute for Health and Care Research (NF-SI-0508-10058)
- Multiple Sclerosis Society
- University College London Hospitals NHS Foundation Trust
- Chugai Pharmaceutical
- 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, clinically isolated syndrome, McDonald criteria, early diagnosis, MRI lesions, gadolinium enhancement, clinically definite multiple sclerosis, relapse
- MeSH terms
- Adult, Demyelinating Diseases, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Multiple Sclerosis, Practice Guidelines as Topic, Disease Progression, Early Diagnosis, Kaplan-Meier Estimate, Neuroimaging
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