A high lesion burden across multiple central nervous system regions could allow diagnosis without requiring dissemination in time or cerebrospinal fluid testing.
The 2017 McDonald criteria for multiple sclerosis (MS) diagnosis require dissemination in space (DIS) and time (DIT), or cerebrospinal fluid (CSF)-specific oligoclonal bands as a substitute for DIT. To assess whether extensive DIS alone could reliably predict MS diagnosis, researchers prospectively followed 244 patients with a first demyelinating event for a mean of 11.2 years.
DIS involving all four CNS regions classically affected in MS (periventricular, juxtacortical, infratentorial, spinal cord) had 100% specificity and positive predictive value for MS diagnosis, although sensitivity was modest (26%). Including the optic nerve as a fifth region improved sensitivity to 30% while maintaining 100% specificity.
Reviewing Author
DisclosuresConsultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics
Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense
Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)
DisclosuresConsultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics
Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense
Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)