TY - JOUR
T1 - Performance of the 2017 and 2010 Revised McDonald Criteria in Predicting MS Diagnosis After a Clinically Isolated Syndrome
T2 - A MAGNIMS Study
AU - Filippi, Massimo
AU - Preziosa, Paolo
AU - Meani, Alessandro
AU - Costa, Gloria Dalla
AU - Mesaros, Sarlota
AU - Drulovic, Jelena
AU - Ivanovic, Jovana
AU - Rovira, Alex
AU - Tintorè, Mar
AU - Montalban, Xavier
AU - Ciccarelli, Olga
AU - Brownlee, Wallace
AU - Miszkiel, Katherine
AU - Enzinger, Christian
AU - Khalil, Michael
AU - Barkhof, Frederik
AU - Strijbis, Eva M M
AU - Frederiksen, Jette L
AU - Cramer, Stig P
AU - Fainardi, Enrico
AU - Amato, Maria Pia
AU - Gasperini, Claudio
AU - Ruggieri, Serena
AU - Martinelli, Vittorio
AU - Comi, Giancarlo
AU - Rocca, Maria A
AU - MAGNIMS Study Group
N1 - © 2021 American Academy of Neurology.
PY - 2022/1/4
Y1 - 2022/1/4
N2 - BACKGROUND AND OBJECTIVES: To compare the performance of the 2017 revisions to the McDonald criteria with the 2010 McDonald criteria in establishing multiple sclerosis (MS) diagnosis and predicting prognosis in patients with clinically isolated syndrome (CIS) suggestive of MS.METHODS: CSF examination and brain and spinal cord MRI obtained ≤5 months from CIS onset and a follow-up brain MRI acquired within 15 months from CIS onset were evaluated in 785 patients with CIS from 9 European centers. Date of second clinical attack and of reaching Expanded Disability Status Scale score (EDSS) ≥3.0, if they occurred, were also collected. Performance of the 2017 and 2010 McDonald criteria for dissemination in space (DIS), dissemination in time (DIT) (including oligoclonal bands assessment), and DIS plus DIT for predicting a second clinical attack (clinically definite MS [CDMS]) and EDSS ≥3.0 at follow-up was evaluated. Time to MS diagnosis for the different criteria was also estimated.RESULTS: At follow-up (median 69.1 months), 406/785 patients with CIS developed CDMS. At 36 months, the 2017 DIS plus DIT criteria had higher sensitivity (0.83 vs 0.66), lower specificity (0.39 vs 0.60), and similar area under the curve values (0.61 vs 0.63). Median time to MS diagnosis was shorter with the 2017 vs the 2010 or CDMS criteria (2017 revision, 3.2; 2010 revision, 13.0; CDMS, 58.5 months). The 2 sets of criteria similarly predicted EDSS ≥3.0 milestone. Three periventricular lesions improved specificity in patients ≥45 years.DISCUSSION: The 2017 McDonald criteria showed higher sensitivity, lower specificity, and similar accuracy in predicting CDMS compared to 2010 McDonald criteria, while shortening time to diagnosis of MS.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that the 2017 McDonald Criteria more accurately distinguish CDMS in patients early after a CIS when compared to the 2010 McDonald criteria.
AB - BACKGROUND AND OBJECTIVES: To compare the performance of the 2017 revisions to the McDonald criteria with the 2010 McDonald criteria in establishing multiple sclerosis (MS) diagnosis and predicting prognosis in patients with clinically isolated syndrome (CIS) suggestive of MS.METHODS: CSF examination and brain and spinal cord MRI obtained ≤5 months from CIS onset and a follow-up brain MRI acquired within 15 months from CIS onset were evaluated in 785 patients with CIS from 9 European centers. Date of second clinical attack and of reaching Expanded Disability Status Scale score (EDSS) ≥3.0, if they occurred, were also collected. Performance of the 2017 and 2010 McDonald criteria for dissemination in space (DIS), dissemination in time (DIT) (including oligoclonal bands assessment), and DIS plus DIT for predicting a second clinical attack (clinically definite MS [CDMS]) and EDSS ≥3.0 at follow-up was evaluated. Time to MS diagnosis for the different criteria was also estimated.RESULTS: At follow-up (median 69.1 months), 406/785 patients with CIS developed CDMS. At 36 months, the 2017 DIS plus DIT criteria had higher sensitivity (0.83 vs 0.66), lower specificity (0.39 vs 0.60), and similar area under the curve values (0.61 vs 0.63). Median time to MS diagnosis was shorter with the 2017 vs the 2010 or CDMS criteria (2017 revision, 3.2; 2010 revision, 13.0; CDMS, 58.5 months). The 2 sets of criteria similarly predicted EDSS ≥3.0 milestone. Three periventricular lesions improved specificity in patients ≥45 years.DISCUSSION: The 2017 McDonald criteria showed higher sensitivity, lower specificity, and similar accuracy in predicting CDMS compared to 2010 McDonald criteria, while shortening time to diagnosis of MS.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that the 2017 McDonald Criteria more accurately distinguish CDMS in patients early after a CIS when compared to the 2010 McDonald criteria.
KW - Brain/diagnostic imaging
KW - Demyelinating Diseases/diagnostic imaging
KW - Disease Progression
KW - Humans
KW - Magnetic Resonance Imaging
KW - Multiple Sclerosis/diagnostic imaging
KW - Oligoclonal Bands
UR - http://www.scopus.com/inward/record.url?scp=85122351628&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000013016
DO - 10.1212/WNL.0000000000013016
M3 - Journal article
C2 - 34716250
SN - 0028-3878
VL - 98
SP - e1-e14
JO - Neurology
JF - Neurology
IS - 1
M1 - 0000000000013016
ER -