Lorenzo Gaetani1, Fulvia Fanelli2, Ilenia Riccucci1, Paolo Eusebi1, Paola Sarchielli1, Carlo Pozzilli2, Paolo Calabresi3, Luca Prosperini2, Massimiliano Di Filippo4. 1. Dipartimento di Medicina, Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy. 2. Dipartimento di Neurologia e Psichiatria, Università degli Studi di Roma 'La Sapienza', Roma, Italy. 3. Dipartimento di Medicina, Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy; IRCCS, Fondazione Santa Lucia, Roma, Italy. 4. Dipartimento di Medicina, Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy. Electronic address: massimiliano.difilippo@unipg.it.
Abstract
INTRODUCTION: Multiple sclerosis (MS) usually presents at onset with a clinically isolated syndrome (CIS). According to 2010 McDonald criteria, a diagnosis of MS can be made if CIS patients satisfy clinical/MRI criteria of both dissemination in time (DIT) and space (DIS). OBJECTIVE: The aim of this study was to analyze the follow-up data and possible prognostic factors of CIS patients satisfying DIS MRI criteria. PATIENTS AND METHODS: We performed a retrospective, multicenter study across 2 Italian centers. Clinical, MRI, and laboratory assessments were performed according to real-life clinical workup. RESULTS: Out of the 137 enrolled patients, during a median follow-up time of 3.1years, 116 (84.7%) converted to MS with the large majority (78.4%) of the converters developing MS within 1year. In multivariate analysis, baseline predictors of an earlier conversion were a cerebellar/brainstem CIS (HR 2.00, 95% CI: 1.3-3.0, p=0.001) and the presence of all the Barkhof-Tintore MRI criteria (HR 1.67, 95% CI: 1.1-2.6, p=0.028). CONCLUSIONS: Patients with CIS and DIS are at very high risk of an early conversion to MS. The onset with cerebellar/brainstem symptoms and the evidence of a higher MRI lesion load at baseline are the strongest independent predictors of an early conversion to MS.
INTRODUCTION:Multiple sclerosis (MS) usually presents at onset with a clinically isolated syndrome (CIS). According to 2010 McDonald criteria, a diagnosis of MS can be made if CIS patients satisfy clinical/MRI criteria of both dissemination in time (DIT) and space (DIS). OBJECTIVE: The aim of this study was to analyze the follow-up data and possible prognostic factors of CIS patients satisfying DIS MRI criteria. PATIENTS AND METHODS: We performed a retrospective, multicenter study across 2 Italian centers. Clinical, MRI, and laboratory assessments were performed according to real-life clinical workup. RESULTS: Out of the 137 enrolled patients, during a median follow-up time of 3.1years, 116 (84.7%) converted to MS with the large majority (78.4%) of the converters developing MS within 1year. In multivariate analysis, baseline predictors of an earlier conversion were a cerebellar/brainstem CIS (HR 2.00, 95% CI: 1.3-3.0, p=0.001) and the presence of all the Barkhof-Tintore MRI criteria (HR 1.67, 95% CI: 1.1-2.6, p=0.028). CONCLUSIONS:Patients with CIS and DIS are at very high risk of an early conversion to MS. The onset with cerebellar/brainstem symptoms and the evidence of a higher MRI lesion load at baseline are the strongest independent predictors of an early conversion to MS.
Authors: Lorenzo Gaetani; Luca Prosperini; Andrea Mancini; Paolo Eusebi; Maria Chiara Cerri; Carlo Pozzilli; Paolo Calabresi; Paola Sarchielli; Massimiliano Di Filippo Journal: J Neurol Date: 2018-09-08 Impact factor: 4.849
Authors: T K Banerjee; M Saha; E Ghosh; A Hazra; A Das; D Choudhury; S Ojha; A Haldar; A Mukherjee; S S Nandi; A Ghosh; A Mukherjee; A Chatterjee; A Datta; S Purakayastha Journal: Mult Scler J Exp Transl Clin Date: 2019-05-13
Authors: Tamás Biernacki; Zsófia Kokas; Dániel Sandi; Judit Füvesi; Zsanett Fricska-Nagy; Péter Faragó; Tamás Zsigmond Kincses; Péter Klivényi; Krisztina Bencsik; László Vécsei Journal: Int J Mol Sci Date: 2022-03-21 Impact factor: 5.923