The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year follow-up.
J. I. O'riordan,Alan J. Thompson,D. P. E. Kingsley,D. G. MacManus,Brian Kendall,Peter Rudge,W. I. McDonald,David Miller +7 more
TLDR
Brain MRI at presentation with a clinically isolated syndrome is predictive of the long-term risk of subsequent development of multiple sclerosis, the type of disease and extent of disability.Abstract:
A definitive diagnosis of multiple sclerosis cannot be made at presentation on patients with a clinically isolated syndrome of the optic nerve, spinal cord or brainstem suggestive of demyelination, as dissemination in time is not established. To determine the long-term risk of abnormalities on brain MRI for the development of multiple sclerosis and disability we performed a 10-year follow-up on 81 such patients who had T2-weighted brain MRI at presentation. Initial brain MRI was abnormal in 54 (67%). Follow up of those patients with an abnormal MRI revealed progression to clinically definite multiple sclerosis in 45 out of 54 (83%), of whom 11 (20%) had relapsing/remitting disease (EDSS > 3), 13 (24%) secondary progressive and 21 (39%) benign (relapsing/remitting with EDSS < or = 3) disease. For those with a normal MRI progression to clinically definite multiple sclerosis occurred in only three out of 27 (11%), all benign. There was a significant relationship between the number of lesions at presentation and both EDSS (r = 0.45, P < 0.001) and the type of disease at follow-up (P < 0.0001). Brain MRI at presentation with a clinically isolated syndrome is predictive of the long-term risk of subsequent development of multiple sclerosis, the type of disease and extent of disability.read more
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Defining the clinical course of multiple sclerosis: The 2013 revisions
Fred D. Lublin,Stephen C. Reingold,Jeffrey A. Cohen,Gary Cutter,Per Soelberg Sørensen,Alan J. Thompson,Jerry S. Wolinsky,Laura J. Balcer,Brenda Banwell,Frederik Barkhof,Bruce F. Bebo,Peter A. Calabresi,Michel Clanet,Giancarlo Comi,Robert J. Fox,Mark S. Freedman,Andrew D. Goodman,Matilde Inglese,Ludwig Kappos,Bernd C. Kieseier,John A. Lincoln,Catherine Lubetzki,Aaron E. Miller,Xavier Montalban,Paul O'Connor,John Petkau,Carlo Pozzilli,Richard A. Rudick,Maria Pia Sormani,Olaf Stüve,Emmanuelle Waubant,Chris H. Polman +31 more
TL;DR: Refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression are proposed and strategies for future research to better define phenotypes are outlined.
Journal ArticleDOI
Diagnostic criteria for multiple sclerosis.
Charles M. Poser,Vesna V. Brinar +1 more
TL;DR: The history of clinical diagnostic criteria demonstrates the evolution from rather tentative classifications of restricted value to the more elaborate 1983 scheme which incorporates some laboratory procedures under the rubric paraclinical tests as well as a new category based on the presence of specific abnormalities of the cerebrospinal fluid (CSF).
Journal ArticleDOI
Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis
Lawrence Jacobs,Roy W. Beck,J H Simon,R. P. Kinkel,C. M. Brownscheidle,T J Murray,N. A. Simonian,P J Slasor,Alfred Sandrock +8 more
TL;DR: Starting treatment with interferon beta-1a at the time of a first demyelinating event is beneficial for patients with brain lesions on MRI that indicate a high risk of clinically definite multiple sclerosis.
Journal ArticleDOI
Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study.
Giancarlo Comi,Massimo Filippi,Frederik Barkhof,Luca Durelli,Gilles Edan,Oscar Fernandez,Hans-Peter Hartung,Pierrette A. Seeldrayers,Per Soelberg Sørensen,Marco Rovaris,Vittorio Martinelli,Otto R. Hommes +11 more
TL;DR: Interferon beta-1a treatment at an early stage of multiple sclerosis had significant positive effects on clinical and MRI outcomes.
Journal ArticleDOI
Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis.
L Fisniku,P A Brex,Daniel R. Altmann,K. A. Miszkiel,C. E. Benton,R. Lanyon,Alan J. Thompson,David Miller +7 more
TL;DR: Lesion volume increases for at least 20 years in relapse-onset multiple sclerosis and the rate of lesion growth is three times higher in those who develop secondary progressive than inThose who remain relapsing remitting multiple sclerosis.
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Journal ArticleDOI
Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial
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TL;DR: The MRI results demonstrate that IFNB has made a significant impact on the natural history of MS in these patients and support the clinical results in showing a significant reduction in disease activity as measured by numbers of active scans and appearance of new lesions.
Journal ArticleDOI
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Frederik Barkhof,Massimo Filippi,David Miller,Philip Scheltens,Adriana Campi,Chris H. Polman,Giancarlo Comi,Herman J. Adèr,N. A. Losseff,Jacob Valk +9 more
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Journal ArticleDOI
MRI in the diagnosis of MS A prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT
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