Modifications to the McDonald MRI dissemination in space criteria for use in Asians with classic multiple sclerosis: the Taiwanese experience

2010 ◽  
Vol 16 (10) ◽  
pp. 1213-1219 ◽  
Author(s):  
Shao-Yuan Chen ◽  
Chung-Ping Lo ◽  
Wen-Lin Hsu ◽  
Hung-Wen Kao ◽  
Chun-Jen Hsueh ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Clinically Isolated Syndrome ◽  
Spinal Cord Lesion ◽  
Lesion Length ◽  
Taiwanese Population ◽  
Mcdonald Criteria ◽  
T2 Lesions ◽  
Definite Multiple Sclerosis ◽  
Cord Lesion

Background: The McDonald MRI dissemination in space criteria have been found to be less sensitive when applied to Asians with classic multiple sclerosis. The Asian neurological community thus proposed modifications to the criteria with reduction of minimal number of T2 lesions from nine to four, and removal of restriction on spinal cord lesion length and morphology for use in Asians. Objective: The study is to examine the accuracy of modified MRI dissemination in space criteria for prediction of conversion from clinically isolated syndrome to definite multiple sclerosis according to patients’ baseline MRI. Methods: From 2001 to 2007, we recruited 67 patients with clinically isolated syndrome. They had been followed-up until development of definite multiple sclerosis or remaining as clinically isolated syndrome for more than 2 years. The non-converters were taken as negative cases. The 67 patients’ baseline MRIs were evaluated by two radiologists and determined as either fulfilling or not fulfilling McDonald and modified MRI criteria for dissemination in space. Results: Thirty-two patients converted to definite multiple sclerosis and 35 did not. The modified criteria are slightly more sensitive (53.1% vs. 50.0%) and accurate (77.6% vs. 76.1%) as compared with McDonald criteria. However, further reduction of the cutoff of abnormal MRI criteria from three of four to two of four criteria yields best sensitivity (71.9%) and accuracy (83.6%). Conclusions: Modifications to the McDonald MRI dissemination in space criteria (by using fewer T2 lesions, removal of the restriction on the spinal cord lesion and reduction of the cutoff of MRI criteria) are more appropriate for use in the Taiwanese population for the diagnosis of classic multiple sclerosis.

A DTI study of the spinal cord lesion in patients with multiple sclerosis during the follow-up after relapse

2016 ◽  
Vol 116 (2. Vyp. 2) ◽  
pp. 21 ◽  
Author(s):  
S. N. Morozova ◽  
V. V. Bryukhov ◽  
O. V. Trifonova ◽  
E. I. Kremneva ◽  
M. V. Krotenkova
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Lesion ◽  
Cord Lesion

Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study

2015 ◽  
Vol 21 (8) ◽  
pp. 1013-1024 ◽  
Author(s):  
J Kuhle ◽  
G Disanto ◽  
R Dobson ◽  
R Adiutori ◽  
L Bianchi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinically Isolated Syndrome ◽  
Nuclear Antigen ◽  
Oligoclonal Bands ◽  
Serum Samples ◽  
T2 Lesions ◽  
Definite Multiple Sclerosis ◽  
Epstein Barr ◽  
Csf Oligoclonal Bands

Background and objective: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. Methods: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years’ follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. Results: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71–2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52–2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04–3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98–0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. Conclusions: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.

scholarly journals Grey matter involvement by focal cervical spinal cord lesions is associated with progressive multiple sclerosis

2015 ◽  
Vol 22 (7) ◽  
pp. 910-920 ◽  
Author(s):  
Hugh Kearney ◽  
Katherine A Miszkiel ◽  
Marios C Yiannakas ◽  
Daniel R Altmann ◽  
Olga Ciccarelli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Grey Matter ◽  
Cervical Spinal Cord ◽  
Spinal Cord Lesion ◽  
Cervical Cord ◽  
Focal Lesions ◽  
Lateral Column ◽  
Cord Lesion

Background: The in vivo relationship of spinal cord lesion features with clinical course and function in multiple sclerosis (MS) is poorly defined. Objective: The objective of this paper is to investigate the associations of spinal cord lesion features on MRI with MS subgroup and disability. Methods: We recruited 120 people: 25 clinically isolated syndrome, 35 relapsing–remitting (RR), 30 secondary progressive (SP), and 30 primary progressive (PP) MS. Disability was measured using the Expanded Disability Status Scale. We performed 3T axial cervical cord MRI, using 3D-fast-field-echo and phase-sensitive-inversion-recovery sequences. Both focal lesions and diffuse abnormalities were recorded. Focal lesions were classified according to the number of white matter (WM) columns involved and whether they extended to grey matter (GM). Results: The proportion of patients with focal lesions involving at least two WM columns and extending to GM was higher in SPMS than in RRMS ( p = 0.03) and PPMS ( p = 0.015). Diffuse abnormalities were more common in both PPMS and SPMS, compared with RRMS (OR 6.1 ( p = 0.002) and 5.7 ( p = 0.003), respectively). The number of lesions per patient involving both the lateral column and extending to GM was independently associated with disability ( p < 0.001). Conclusions: More extensive focal cord lesions, extension of lesions to GM, and diffuse abnormalities are associated with progressive MS and disability.

Evaluation of the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome

2012 ◽  
Vol 18 (12) ◽  
pp. 1768-1774 ◽  
Author(s):  
Barbara Kornek ◽  
Beate Schmitl ◽  
Karl Vass ◽  
Sonja Zehetmayer ◽  
Martin Pritsch ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Clinically Isolated Syndrome ◽  
Resonance Imaging ◽  
Mcdonald Criteria ◽  
Paediatric Multiple Sclerosis ◽  
Spinal Cord Imaging

Background: Magnetic resonance imaging diagnostic criteria for paediatric multiple sclerosis have been established on the basis of brain imaging findings alone. The 2010 McDonald criteria for the diagnosis of multiple sclerosis, however, include spinal cord imaging for detection of lesion dissemination in space. The new criteria have been recommended in paediatric multiple sclerosis. Objective: (1) To evaluate the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome and to compare them with recently proposed magnetic resonance criteria for children; (2) to assess whether the inclusion of spinal cord imaging provided additional value to the 2010 McDonald criteria. Methods: We performed a retrospective analysis of brain and spinal cord magnetic resonance imaging scans from 52 children with a clinically isolated syndrome. Sensitivity, specificity and accuracy of the magnetic resonance criteria were assessed. Results and conclusion: The 2010 McDonald dissemination in space criteria were more sensitive (85% versus 74%) but less specific (80% versus 100%) compared to the 2005 McDonald criteria. The Callen criteria were more accurate (89%) compared to the 2010 McDonald (85%), the 2005 McDonald criteria for dissemination in space (81%), the KIDMUS criteria (46%) and the Canadian Pediatric Demyelinating Disease Network criteria (76%). The 2010 McDonald criteria for dissemination in time were more accurate (93%) than the dissemination in space criteria (85%). Inclusion of the spinal cord did not increase the accuracy of the McDonald criteria.

Axonal damage markers in the cerebrospinal fluid of patients with clinically isolated syndrome improve predicting conversion to definite multiple sclerosis

2006 ◽  
Vol 12 (2) ◽  
pp. 143-148 ◽  
Author(s):  
J Brettschneider ◽  
A Petzold ◽  
A Junker ◽  
H Tumani
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Clinically Isolated Syndrome ◽  
Axonal Damage ◽  
T2 Lesions ◽  
Definite Multiple Sclerosis ◽  
Relapsing Remitting ◽  
Csf Levels ◽  
Magnetic Resonance Imaging Mri ◽  
In Cis

Clinically isolated syndrome (CIS) represents the earliest phase of multiple sclerosis (MS). This study tested whether biomarkers for axonal degeneration can improve upon sensitivity and specificity of magnetic resonance imaging (MRI) parameters in predicting conversion from CIS to MS. Patients with CIS ( n=52), relapsing-remitting MS (RRMS, n=38) and age-matched controls ( n=25) were included. Cerebrospinal fluid (CSF) levels of tau and neurofilaments (NfHSMI35) were measured using ELISA. The MRI T2-lesion load and the Expanded Disability Status Scale (EDSS) were recorded. CSF tau and NfHSMI35 were elevated in CIS compared to controls (p<0.05). RRMS patients with acute relapse had higher NfHSMI35 levels than stable patients. Tau and NfHSMI35 levels correlated with EDSS in CIS and RRMS. In RRMS, the number of T2-lesions correlated with tau levels ( R=0.53, P=0.01). The sensitivity predicting the conversion from CIS to MS was higher for the combination of CSF markers (either tau or NfHSMI35 elevated) than for MRI (40 versus 34%), but could be further increased to 60% if CSF and MRI criteria were combined. Similarly, the combination of tau and NfHSMI35 showed higher specificity (94%) than MRI (82%). Tau and NfHSMI35 are valuable biomarkers for axonal damage in the CIS patients. Predicting conversion from CIS to MS can be improved if CSF markers are combined with MRI.

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