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Letter
Diagnosis of multiple sclerosis: a multicentre study to compare revised McDonald-2010 and Filippi-2010 criteria
  1. Paolo Preziosa1,2,
  2. Maria A Rocca1,2,
  3. Sarlota Mesaros3,
  4. Alessandro Meani1,
  5. Xavier Montalban4,
  6. Jelena Drulovic3,
  7. Amgad Droby5,
  8. Frauke Zipp5,
  9. Massimiliano Calabrese6,
  10. Jaume Sastre-Garriga4,
  11. Irena Dujmovic-Basuroski3,
  12. Alex Rovira7,
  13. Massimo Filippi1,2
  1. 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
  2. 2Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
  3. 3Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  4. 4Department of Neurology-Neuroimmunology, Cemcat, Vall d'Hebron University Hospital, Barcelona, Spain
  5. 5Department of Neurology, Focus Program Translational Neuroscience and Immunotherapy, Rhine-Main Neuroscience Network, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  6. 6Neurology B, Department of Neurosciences, Biomedicine and Movement, University of Verona, Italy
  7. 7Section of Neuroradiology (Department of Radiology), Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
  1. Correspondence to Prof Massimo Filippi, Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132 Milan, Italy; filippi.massimo{at}hsr.it

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Introduction

MRI has been formally included in the diagnostic work-up of patients with a suspicion of multiple sclerosis (MS) in 2001, to demonstrate disease dissemination in space (DIS) and time (DIT) and to exclude alternative diagnoses.1 Over time, these criteria have been modified to simplify their use and to clarify specific aspects (eg, spinal cord findings).2

One aspect marginally analysed in the diagnostic work-up of patients with clinically isolated syndrome (CIS) is the role of intracortical lesions (ICLs), which are a prominent feature of MS and contribute to disability and cognitive impairment.2 A single-centre study3 showed that inclusion of ICL for the evaluation of DIS in CIS increased the accuracy of MRI diagnostic criteria, with an improvement of specificity.3

The aim of this study was to compare revised McDonald-20101 and Filippi-20103 criteria with respect to development of clinically definite MS (CDMS) in a multicentric cohort of patients with CIS.

Methods

Institutional review board approval and written informed consent were obtained.

Subjects

Consecutive patients with CIS suggestive of MS were prospectively recruited from 2008 to 2013 from five European centres within the MAGNIMS network (http://www.magnims.eu/) (see online supplementary file 1, Supplementary Methods).

Supplementary Material

Supplementary material 1
[JNNP-2017-315863-R1-Supplementary_material.pdf]

Inclusion criteria were a typical CIS syndrome, exclusion of alternative diagnoses and previous events, a baseline brain (including double inversion recovery (DIR)) and spinal cord MRI scan acquired ≤3 months from CIS onset, a follow-up brain scan acquired ≤12 months from CIS onset and a clinical follow-up ≥3 years or until CDMS conversion (defined as occurrence of a second relapse ≥1 month after the first attack) if ≤3 years.

MRI acquisition and analysis

Using 1.5 (two centres) or 3.0 Tesla (three centres) scanners, brain (including DIR) and spinal cord sequences for lesion identification were acquired. Online supplementary material shows parameters and examples of MRI …

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