Risk Factors for Worsening Disability After a Clinically Isolated Syndrome

Picking the optimal early therapy for an individual with clinically isolated syndrome (CIS) is a major objective in slowing disease progression. However, studies designed to identify which patients are at risk for developing multiple sclerosis (MS) and worsening disability have been limited.

Now, investigators have conducted a large, prospective cohort study of 1015 CIS patients presenting with optic neuritis (37% of patients), brainstem symptoms (27%), transverse myelitis (26%), or other syndromes (11%). Of those who underwent lumbar puncture, 57% had cerebrospinal fluid (CSF) that was positive for oligoclonal bands. Of those who underwent brain magnetic resonance imaging (MRI), 31% had normal findings, 29% had 1 to 9 T2 lesions, and 40% ha…