Periventricular lesions and MS diagnostic criteria in young adults with typical clinically isolated syndromes

Wallace J Brownlee; Katherine A Miszkiel; Daniel R Altmann; Olga Ciccarelli; David H Miller

doi:10.1177/1352458516667565

Periventricular lesions and MS diagnostic criteria in young adults with typical clinically isolated syndromes

Mult Scler. 2017 Jun;23(7):1031-1034. doi: 10.1177/1352458516667565. Epub 2016 Sep 6.

Authors

Wallace J Brownlee¹, Katherine A Miszkiel², Daniel R Altmann³, Olga Ciccarelli⁴, David H Miller⁴

Affiliations

¹ Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, UK/National Hospital for Neurology and Neurosurgery, London, UK.
² Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK.
³ Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, UK/Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
⁴ Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, UK/NIHR University College London Hospitals Biomedical Research Centre, London, UK.

PMID: 27600111
DOI: 10.1177/1352458516667565

Abstract

In patients who present with a clinically isolated syndrome (CIS), whose features are suggestive of multiple sclerosis (MS), fulfilling McDonald 2010 magnetic resonance imaging (MRI) criteria for dissemination in space (DIS) and dissemination in time (DIT) enables a diagnosis of MS. While ⩾1 periventricular lesion is included in the 2010 DIS criteria, earlier McDonald criteria required ⩾3 periventricular lesions to confirm DIS and recent Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS)-recommended DIS criteria also require ⩾3 lesions. We investigated the effect of varying the required number of periventricular lesions and found that the best combination of specificity and sensitivity for clinically definite MS was seen for ⩾1 periventricular lesion using both the McDonald 2010 and MAGNIMS 2016 criteria.

Keywords: Multiple sclerosis; clinically isolated syndrome; diagnostic criteria; magnetic resonance imaging.

MeSH terms

Adolescent
Adult
Cerebral Ventricles / diagnostic imaging*
Decision Support Techniques*
Demyelinating Diseases / diagnostic imaging*
Disease Progression
Female
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Multiple Sclerosis / diagnostic imaging*
Predictive Value of Tests
Prognosis
Reproducibility of Results
Retrospective Studies
Time Factors
Young Adult