High risk of early conversion to multiple sclerosis in clinically isolated syndromes with dissemination in space at baseline

Paolo Calabresi, Lorenzo Gaetani, Fulvia Fanelli, Ilenia Riccucci, Paolo Eusebi, Paola Sarchielli, Carlo Pozzilli, Luca Prosperini, Massimiliano Di Filippo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

5 Citazioni (Scopus)

Abstract

Introduction Multiple sclerosis (MS) usually presents at onset with a clinically isolated syndrome (CIS). According to 2010 McDonald criteria, a diagnosis of MS can be made if CIS patients satisfy clinical/MRI criteria of both dissemination in time (DIT) and space (DIS). Objective The aim of this study was to analyze the follow-up data and possible prognostic factors of CIS patients satisfying DIS MRI criteria. Patients and methods We performed a retrospective, multicenter study across 2 Italian centers. Clinical, MRI, and laboratory assessments were performed according to real-life clinical workup. Results Out of the 137 enrolled patients, during a median follow-up time of 3.1 years, 116 (84.7%) converted to MS with the large majority (78.4%) of the converters developing MS within 1 year. In multivariate analysis, baseline predictors of an earlier conversion were a cerebellar/brainstem CIS (HR 2.00, 95% CI: 1.3–3.0, p = 0.001) and the presence of all the Barkhof-Tintore MRI criteria (HR 1.67, 95% CI: 1.1–2.6, p = 0.028). Conclusions Patients with CIS and DIS are at very high risk of an early conversion to MS. The onset with cerebellar/brainstem symptoms and the evidence of a higher MRI lesion load at baseline are the strongest independent predictors of an early conversion to MS.
Lingua originaleEnglish
pagine (da-a)236-240
Numero di pagine5
RivistaJournal of the Neurological Sciences
Volume379
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Adult
  • Clinically isolated syndrome
  • Conversion
  • Demyelinating Diseases
  • Dissemination in space
  • Dissemination in time
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Magnetic resonance imaging
  • Male
  • Multiple Sclerosis
  • Multiple sclerosis
  • Neuroimaging
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Young Adult

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