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Letter
Performance of 2010 McDonald criteria and 2016 MAGNIMS guidelines in the diagnosis of primary progressive multiple sclerosis
  1. Alberto Gajofatto1,
  2. Bardia Nourbakhsh2,
  3. Maria Donata Benedetti1,
  4. Emmanuelle Waubant3
  1. 1Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
  2. 2Department of Neurology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  3. 3Department of Neurology, University of California, San Francisco, California, USA
  1. Correspondence to Dr Alberto Gajofatto, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy; alberto.gajofatto{at}univr.it

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Introduction

The aim of the present study was to assess sensitivity and specificity of McDonald criteria 2010 revision for primary progressive multiple sclerosis (PPMS),1 since this was not done in previous studies. In addition, the performance of MRI guidelines for dissemination in space (DIS) demonstration proposed in 2016 by the MRI in multiple sclerosis (MAGNIMS) group was evaluated.2

Methods

The study was approved by the ethics committee of participating institutions as required.

Patients who were seen at University of California San Francisco and University of Verona multiple sclerosis (MS) centres for suspected PPMS after 1997 were retrospectively identified from existing databases. Data were obtained from review of charts with adequate documentation of clinical, MRI and cerebrospinal fluid (CSF) status to determine the fulfilment of 2010 McDonald criteria. Cases with less than 1-year interval between clinical onset and last follow-up visit were excluded. One-year disease progression demonstration as required by diagnostic criteria was based on documented worsening of neurological disability unrelated to relapse. First available brain and spinal cord MRI of adequate quality performed after symptom onset was used to determine criteria fulfilment at time of initial visit. MRI scans were reviewed by a single experienced reader (AG) who was not blinded to clinical data. CSF data were taken from the lumbar puncture performed by the time of first visit if available. Exclusion of a …

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