MRI only conversion to multiple sclerosis following a clinically isolated syndrome
Open accessAbstract
OBJECTIVES: Using current diagnostic criteria, patients who present with a clinically isolated syndrome (CIS) may develop multiple sclerosis (MS) by subsequently exhibiting dissemination in space and time on clinical (clinically definite (CD) MS) or radiological (MRI) grounds. This study investigated the frequency of radiological without clinical conversion to MS after long term follow-up as this has not previously been defined. METHODS: Two cohorts who underwent serial clinical and MRI studies from presentation with a CIS and who were followed-up over a mean of 6 and 20 years were investigated. The distribution and formation of lesions visible on brain MRI were assessed using the revised McDonald criteria (2005). Radiologically defined (RD) MS was determined by fulfilment of the MRI but not the CDMS criteria. RESULTS: 105 people were followed-up for 6 years after a CIS, of whom 51% developed CDMS, 15% RDMS and the remainder were classified as still having had a CIS. 70 people were followed-up at 20 years, of whom 61% and 11% had developed CDMS and RDMS, respectively. CONCLUSION: About 10-15% of CIS patients may develop MS on MRI criteria only, without further clinical events for up to two decades.
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The McDonald criteria identify a subgroup of patients with a single attack and MRI evidence of dissemination in time and space who do not experience further relapses even with long-term follow-up.
“The McDonald criteria identify a subgroup of patients with a single attack and MRI evidence of dissemination in time and space who do not experience further relapses even with long-term follow-up.71”
From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [71]
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Cites
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Self-citationMRI criteria for MS in patients with clinically isolated syndromes
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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
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- Authors
- Chard, D. T., Dalton, C. M., Swanton, J., Fisniku, L. K., Miszkiel, K. A., Thompson, A. J., Plant, G. T., & Miller, D. H.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- UCL Queen Square Institute of Neurology (GB)
- Corresponding author
- Chard, D. T.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2010-06-02
- Volume
- 82
- Issue
- 2
- Pages
- 176-179
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2131420603
- Cited by
- 47
- References
- 3
- Citations by year
- 2023: 2 · 2021: 1 · 2019: 1 · 2018: 3 · 2017: 7 · 2016: 2 · 2015: 2 · 2014: 10 · 2013: 4 · 2012: 9
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (publishedVersion)
- HAL (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- multiple sclerosis, clinically isolated syndrome, conversion to multiple sclerosis, brain MRI lesions, long-term follow-up
- MeSH terms
- Adult, Brain, Disability Evaluation, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Retrospective Studies, Cohort Studies, Disease Progression
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