Skip to main content

Advertisement

Springer Nature Link
Log in

Criteria improving multiple sclerosis diagnosis at the first MRI

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

The introduction of the McDonald criteria has enabled earlier diagnosis of multiple sclerosis (MS). However, even with the 2010 revised criteria, nearly 50 % of patients remain classified as “possible MS” following the first MRI. The present study aimed to demonstrate that time to MS diagnosis could be shorter than 2010 revised criteria, and established after a single early MRI in most patients with the association of the symptomatic lesion and at least one suggestive asymptomatic lesion. We also evaluated the short-term predictive capacity of an individual suggestive lesion on disease activity. We analyzed initial MRI results from 146 patients with MS from a multicenter retrospective study. Visualization of the symptomatic lesion was used as a primary criterion. Secondary criteria included one suggestive lesion (SL) aspect or topography on MRI, or one non-specific lesion associated with positive CSF. The proposed criteria led to a positive diagnosis of MS in 100 % of cases, from information available from the time of the first MRI for 145 patients (99.3 %). At least one SL was observed for 143 patients (97.9 %), and positive CSF for the 3 others. Compared to the McDonald criteria, the proposed criteria had 100 % sensitivity, with a significantly shorter mean time to reach a positive diagnosis. Furthermore, the simultaneous presence of corpus callosum, temporal horn, and ovoid lesions was associated with radiological or clinical activity after a year of follow-up. The proposed diagnostic criteria are easy to apply, have a good sensitivity, and allow an earlier diagnosis than the 2010 McDonald criteria. Nevertheless, prospective studies are needed to establish specificity and to confirm these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. McDonald WI, Compston A, Edan G et al (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 50:121–127

    Article  CAS  PubMed  Google Scholar 

  2. Polman CH, Reingold SC, Edan G et al (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol 58:840–846

    Article  PubMed  Google Scholar 

  3. Polman CH, Reingold SC, Banwell B et al (2011) Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria. Ann Neurol 69:292–302. doi:10.1002/ana.22366

    Article  PubMed Central  PubMed  Google Scholar 

  4. Miller DH, Chard DT, Ciccarelli O (2012) Clinically isolated syndromes. Lancet Neurol 11:157–169

    Article  PubMed  Google Scholar 

  5. Brownlee WJ, Swanton JK, Altmann DR et al (2014) Earlier and more frequent diagnosis of multiple sclerosis using the McDonald criteria. J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2014-308675

    PubMed Central  PubMed  Google Scholar 

  6. Di Legge S, Piattella MC, Pozzilli C et al (2003) Longitudinal evaluation of depression and anxiety in patients with clinically isolated syndrome at high risk of developing early multiple sclerosis. Mult Scler Houndmills Basingstoke Engl 9:302–306

    Article  Google Scholar 

  7. Swanton JK (2006) Modification of MRI criteria for multiple sclerosis in patients with clinically isolated syndromes. J Neurol Neurosurg Psychiatry 77:830–833. doi:10.1136/jnnp.2005.073247

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Barkhof F, Filippi M, Miller DH et al (1997) Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain 120:2059–2069. doi:10.1093/brain/120.11.2059

    Article  PubMed  Google Scholar 

  9. Bosque-Freeman L, Sedel F, Papeix C et al (2009) Validation of MR criteria to diagnose different types of leukoencephalopathies in a series of 75 consécutives patients. Mult Scler 15:CO16

    Google Scholar 

  10. Dobson R, Ramagopalan S, Davis A, Giovannoni G (2013) Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude. J Neurol Neurosurg Psychiatry 84:909–914. doi:10.1136/jnnp-2012-304695

    Article  PubMed  Google Scholar 

  11. Gout O, Lebrun-Frenay C, Labauge P et al (2011) Prior suggestive symptoms in one-third of patients consulting for a “first” demyelinating event. J Neurol Neurosurg Psychiatry 82:323–325. doi:10.1136/jnnp.2008.166421

    Article  CAS  PubMed  Google Scholar 

  12. Wingerchuk DM, Lennon VA, Pittock SJ et al (2006) Revised diagnostic criteria for neuromyelitis optica. Neurology 66:1485–1489. doi:10.1212/01.wnl.0000216139.44259.74

    Article  CAS  PubMed  Google Scholar 

  13. Andersson M, Alvarez-Cermeño J, Bernardi G et al (1994) Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report. J Neurol Neurosurg Psychiatry 57:897–902. doi:10.1136/jnnp.57.8.897

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Young IR, Hall AS, Pallis CA et al (1981) Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancet 2:1063–1066

    Article  CAS  PubMed  Google Scholar 

  15. Fazekas F, Offenbacher H, Fuchs S et al (1988) Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology 38:1822–1825

    Article  CAS  PubMed  Google Scholar 

  16. Wattjes MP, Harzheim M, Lutterbey GG et al (2008) Does high field MRI allow an earlier diagnosis of multiple sclerosis? J Neurol 255:1159–1163. doi:10.1007/s00415-008-0861-3

    Article  PubMed  Google Scholar 

  17. Thorpe JW, Kidd D, Moseley IF et al (1996) Spinal MRI in patients with suspected multiple sclerosis and negative brain MRI. Brain 119:709–714

    Article  PubMed  Google Scholar 

  18. Patrucco L, Rojas JI, Cristiano E (2012) Assessing the value of spinal cord lesions in predicting development of multiple sclerosis in patients with clinically isolated syndromes. J Neurol 259:1317–1320. doi:10.1007/s00415-011-6345-x

    Article  CAS  PubMed  Google Scholar 

  19. Korteweg T, Tintoré M, Uitdehaag B et al (2006) MRI criteria for dissemination in space in patients with clinically isolated syndromes: a multicentre follow-up study. Lancet Neurol 5:221–227

    Article  PubMed  Google Scholar 

  20. Swanton JK, Fernando KT, Dalton CM et al (2009) Early MRI in optic neuritis: the risk for disability. Neurology 72:542–550. doi:10.1212/01.wnl.0000341935.41852.82

    Article  CAS  PubMed  Google Scholar 

  21. Tintore M, Rovira A, Arrambide G et al (2010) Brainstem lesions in clinically isolated syndromes. Neurology 75:1933–1938

    Article  CAS  PubMed  Google Scholar 

  22. Minneboo A, Barkhof F, Polman CH et al (2004) Infratentorial lesions predict long-term disability in patients with initial findings suggestive of multiple sclerosis. Arch Neurol 61:217–221. doi:10.1001/archneur.61.2.217

    Article  PubMed  Google Scholar 

  23. Friese SA, Bitzer M, Freudenstein D et al (2000) Classification of acquired lesions of the corpus callosum with MRI. Neuroradiology 42:795–802

    Article  CAS  PubMed  Google Scholar 

  24. Susac JO, Murtagh FR, Egan RA et al (2003) MRI findings in Susac’s syndrome. Neurology 61:1783–1787

    Article  CAS  PubMed  Google Scholar 

  25. Maarouf A, Hadj-Henni L, Caucheteux N et al (2011) Neuro-Behçet avec atteinte du corps calleux. Rev Neurol (Paris) 167:533–536. doi:10.1016/j.neurol.2010.10.010

    Article  CAS  Google Scholar 

  26. Dawson J (1916) The histology of disseminated sclerosis. Trans R Soc Edinb 50:517–740

    Article  Google Scholar 

  27. Hackmack K, Weygandt M, Wuerfel J et al (2012) Can we overcome the “clinico-radiological paradox” in multiple sclerosis? J Neurol 259:2151–2160. doi:10.1007/s00415-012-6475-9

    Article  PubMed  Google Scholar 

  28. Kincses ZT, Ropele S, Jenkinson M et al (2011) Lesion probability mapping to explain clinical deficits and cognitive performance in multiple sclerosis. Mult Scler J 17:681–689. doi:10.1177/1352458510391342

    Article  CAS  Google Scholar 

  29. Wybrecht D, Reuter F, Zaaraoui W et al (2012) Voxelwise analysis of conventional magnetic resonance imaging to predict future disability in early relapsing–remitting multiple sclerosis. Mult Scler J 18:1585–1591. doi:10.1177/1352458512442991

    Article  Google Scholar 

Download references

Conflicts of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Ethical standard

Data were collected from university hospital database, and all patients gave their informed consent for inclusion in the database before their admission. The study was performed in accordance with local ethical standards and French law.

Author information

Authors and Affiliations

  1. Service de Neurologie, CHU Reims, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092, Reims Cedex, France

    Nathalie Caucheteux, Adil Maarouf, Marie P. Chaunu, Laure Daelman & Ayman Tourbah

  2. Faculté de Médecine de Reims, URCA, Reims, France

    Adil Maarouf, Laure Daelman, Laurent Pierot & Ayman Tourbah

  3. Service de Neurologie, CHU Rennes, Hôpital Pontchaillou, 35000, Rennes, France

    Margaux Genevray & Gilles Edan

  4. Département EPI-BIOSTAT, EHESP Sorbonne Paris Cité, 35033, Rennes, France

    Emmanuelle Leray

  5. Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 75019, Paris, France

    Romain Deschamps & Olivier Gout

  6. Service de Radiologie, CHU Rennes, Hôpital Pontchaillou, 35000, Rennes, France

    Jean C. Ferré

  7. Service de Neurologie, Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, 13385, Marseille, France

    Jean Pelletier

  8. CHU Reims, Service de Radiologie, 51092, Reims, France

    Laurent Pierot

  9. Laboratoire de Psychopathologie et de Neuropsychologie, Université Paris VIII, Saint-Denis, France

    Ayman Tourbah

Authors
  1. Nathalie Caucheteux
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Adil Maarouf
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Margaux Genevray
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Emmanuelle Leray
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Romain Deschamps
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Marie P. Chaunu
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Laure Daelman
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Jean C. Ferré
    View author publications

    You can also search for this author inPubMed Google Scholar

  9. Olivier Gout
    View author publications

    You can also search for this author inPubMed Google Scholar

  10. Jean Pelletier
    View author publications

    You can also search for this author inPubMed Google Scholar

  11. Laurent Pierot
    View author publications

    You can also search for this author inPubMed Google Scholar

  12. Gilles Edan
    View author publications

    You can also search for this author inPubMed Google Scholar

  13. Ayman Tourbah
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Ayman Tourbah.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Caucheteux, N., Maarouf, A., Genevray, M. et al. Criteria improving multiple sclerosis diagnosis at the first MRI. J Neurol 262, 979–987 (2015). https://doi.org/10.1007/s00415-015-7668-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-015-7668-9

Keywords