rss
J Neurol Neurosurg Psychiatry 2006;77:830-833 doi:10.1136/jnnp.2005.073247
  • Paper

Modification of MRI criteria for multiple sclerosis in patients with clinically isolated syndromes

  1. J K Swanton1,
  2. K Fernando1,
  3. C M Dalton1,
  4. K A Miszkiel2,
  5. A J Thompson1,
  6. G T Plant3,
  7. D H Miller1
  1. 1NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, UK
  2. 2Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square
  3. 3Physician’s Clinic, Moorfields Eye Hospital, City Road, London
  1. Correspondence to:
 Professor D H Miller
 NMR Research Unit, 6th Floor, Institute of Neurology, Queen Square, London WC1N 3BG, UK; d.miller{at}ion.ucl.ac.uk
  • Received 1 June 2005
  • Accepted 15 July 2005
  • Revised 1 June 2005
  • Published Online First 25 July 2005

Abstract

Background: The McDonald criteria include MRI evidence for dissemination in space and dissemination in time for the diagnosis of multiple sclerosis in young adult patients who present with clinically isolated syndromes (CIS) typical of the disease. Although a major advance, the criteria have limited sensitivity for making an early diagnosis.

Objective: To compare the performance of McDonald criteria and modified McDonald criteria for dissemination in space and time for assessing the development of clinically definite multiple sclerosis.

Methods: McDonald criteria were modified using the combination of a less stringent definition for dissemination in space and allowing a new T2 lesion per se after three months as evidence for dissemination in time. Modified and McDonald criteria were applied in 90 CIS patients at baseline and at three month follow up scans.

Results: Both criteria were highly specific (>90%) but the modified criteria were more sensitive (77% v 46%) and more accurate (86% v 73%).

Conclusions: These modified criteria should be evaluated in other CIS cohorts.

Footnotes

  • Published Online First 25 July 2005

  • Competing interests: DHM has received grant support from Biogen Idec, Elan, Schering, and GlaxoSmithKline for performance of MRI analyses in clinical trials; honoraria for advisory or consultancy work, lectures, and related travel and accommodation expenses from Aventis, Biogen Idec, Bristol Myers Squibb, GlaxoSmithKline, Schering, Serono, UCB Pharma, and Wyeth. KF received salary support from Biogen Idec. CMD received salary support from Elan. GTP has received travel and accommodation expenses from Alcon. AJT has received honoraria for lecturing from Aventis and Schering. JS and KM have nothing to declare. The organisations mentioned in this conflict of interest statement did not participate in any aspect of the study design, execution, analysis, or write up.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. jnnp.2005.073247v1
    2. 77/7/830 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

BMJ Careers - Latest neurology and neurosurgery jobs