Skip to main content
SpringerLink
Log in

Evolution of the Diagnostic Criteria in Multiple Sclerosis

  • Chapter
  • First Online:
Neuroimmunology

  • 1599 Accesses

Abstract

The diagnostic criteria for multiple sclerosis provide a comprehensive framework to facilitate accurate diagnosis. The criteria have evolved since the original description of the syndrome by Charcot in 1868 into a multidimensional scheme that incorporates clinical presentation, imaging, and paraclinical evidence to aid in the diagnostic process. Additionally, the criteria were initially intended for use in research studies but are now intended for both research and clinical use. The key features of the criteria now include aspects of the clinical presentation, establishing dissemination in time and space, role of MRI, and utility of CSF and other paraclinical tests. There still are aspects that need refinement, including incorporation of the anterior visual system, applicability in diverse populations and presentations, and development of unique biomarkers and advanced imaging techniques. The development of the diagnostic criteria will continue to be an iterative process based on ongoing research with an emphasis on creating a practical approach facilitating early and accurate diagnosis of MS.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Charcot JM. Lectures on the diseases of the nervous system: delivered at La Salpêtrière. Lea, 1879, 1889.

    Google Scholar 

  2. Allison RS, Millar JH. Prevalence of disseminated sclerosis in Northern Ireland. Ulster Med J. 1954;23:1–27.

    CAS  PubMed  Google Scholar 

  3. Schumacher GA, Beebe G, Kibler RF, Kurland LT, Kurtzke JF, McDowell F, et al. Problems of experimental trials of therapy in multiple sclerosis: report by the panel on the evalaution of experimental trials of therapy in multiple sclerosis. Ann N Y Acad Sci. 1965;122:552–68.

    Article  CAS  PubMed  Google Scholar 

  4. McDonald WI, Halliday AM. Diagnosis and classification of multiple sclerosis. Br Med Bull. 1977;33:4–9.

    Article  CAS  PubMed  Google Scholar 

  5. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983;13:227–31.

    Article  CAS  PubMed  Google Scholar 

  6. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001;50:121–7.

    Article  CAS  PubMed  Google Scholar 

  7. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69:292–302.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278–86.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018 Feb;17(2):162–73.

    Article  PubMed  Google Scholar 

  10. Kurtzke JF. On the evaluation of disability in multiple sclerosis. Neurology. 1961;11:686–94.

    Article  CAS  PubMed  Google Scholar 

  11. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444–52.

    Article  CAS  PubMed  Google Scholar 

  12. Thompson AJ, Montalban X, Barkhof F, Brochet B, Filippi M, Miller DH, et al. Diagnostic criteria for primary progressive multiple sclerosis: a position paper. Ann Neurol. 2000;47:831–5.

    Article  CAS  PubMed  Google Scholar 

  13. Rudick R, Antel J, Confavreux C, Cutter G, Ellison G, Fischer J, et al. Recommendations from the national multiple sclerosis society clinical outcomes assessment task force. Ann Neurol. 1997;42:379–82.

    Article  CAS  PubMed  Google Scholar 

  14. Mcalpine D. Multiple sclerosis: a plea for a fresh outlook. Br Med J. 1957;1:475–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol. 2005;58:840–6.

    Article  PubMed  Google Scholar 

  16. Arrambide G, Tintore M, Espejo C, Auger C, Castillo M, Río J, et al. The value of oligoclonal bands in the multiple sclerosis diagnostic criteria. Brain. 2018;141:1075–84.

    Article  PubMed  Google Scholar 

  17. Barkhof F, Filippi M, Miller DH, Scheltens P, Campi A, Polman CH, et al. Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain. 1997;120(Pt 1):2059–69.

    Article  PubMed  Google Scholar 

  18. Tintoré M, Rovira A, Martínez MJ, Rio J, Díaz-Villoslada P, Brieva L, et al. Isolated demyelinating syndromes: comparison of different MR imaging criteria to predict conversion to clinically definite multiple sclerosis. AJNR Am J Neuroradiol. 2000;21:702–6.

    PubMed  PubMed Central  Google Scholar 

  19. Swanton JK, Rovira A, Tintore M, Altmann DR, Barkhof F, Filippi M, et al. MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study. Lancet Neurol. 2007;6:677–86.

    Article  PubMed  Google Scholar 

  20. Rovira A, Swanton J, Tintoré M, Huerga E, Barkhof F, Filippi M, et al. A single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis. Arch Neurol. 2009;66:587–92.

    Article  PubMed  Google Scholar 

  21. Montalban X, Tintore M, Swanton J, Barkhof F, Fazekas F, Filippi M, et al. MRI criteria for MS in patients with clinically isolated syndromes. Neurology. 2010;74:427–34.

    Article  CAS  PubMed  Google Scholar 

  22. Filippi M, Rocca MA, Ciccarelli O, De Stefano N, Evangelou N, Kappos L, et al. MAGNIMS Study Group. MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines. Lancet Neurol. 2016;15:292–303.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Filippi M, Preziosa P, Meani A, Ciccarelli O, Mesaros S, Rovira A, et al. Prediction of a multiple sclerosis diagnosis in patients with clinically isolated syndrome using the 2016 MAGNIMS and 2010 McDonald criteria: a retrospective study. Lancet Neurol. 2018;17:133–42.

    Article  PubMed  Google Scholar 

  24. Kang H, Metz LM, Traboulsee AL, Eliasziw M, Zhao GJ, Cheng Y, et al. Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes. Mult Scler. 2014;20:458–63.

    Article  CAS  PubMed  Google Scholar 

  25. D’Alessandro R, Vignatelli L, Lugaresi A, Baldin E, Granella F, Tola MR, et al. Risk of multiple sclerosis following clinically isolated syndrome: a 4-year prospective study. J Neurol. 2013;260:1583–93.

    Article  PubMed  Google Scholar 

  26. Runia TF, Jafari N, Hintzen RQ. Application of the 2010 revised criteria for the diagnosis of multiple sclerosis to patients with clinically isolated syndromes. Eur J Neurol. 2013;20:1510–6.

    Article  CAS  PubMed  Google Scholar 

  27. Gómez-Moreno M, Díaz-Sánchez M, Ramos-González A. Application of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Spanish cohort of patients with clinically isolated syndromes. Mult Scler. 2012;18:39–44.

    Article  PubMed  Google Scholar 

  28. Belova AN, Shalenkov IV, Shakurova DN, Boyko AN. Revised McDonald criteria for multiple sclerosis diagnostics in central Russia: sensitivity and specificity. Mult Scler. 2014;20:1896–9.

    Article  CAS  PubMed  Google Scholar 

  29. Hsueh CJ, Kao HW, Chen SY, Lo CP, Hsu CC, Liu DW, et al. Comparison of the 2010 and 2005 versions of the McDonald MRI criteria for dissemination-in-time in Taiwanese patients with classic multiple sclerosis. J Neurol Sci. 2013;329:51–4.

    Article  PubMed  Google Scholar 

  30. Piccolo L, Kumar G, Nakashima I, Misu T, Kong Y, Wakerley B, et al. Multiple sclerosis in Japan appears to be a milder disease compared to the UK. J Neurol. 2015;262:831–6.

    Article  CAS  PubMed  Google Scholar 

  31. Huh SY, Kim SH, Kim W, Lee SH, Park MS, Ahn SW, et al. Evaluation of McDonald MRI criteria for dissemination in space in Korean patients with clinically isolated syndromes. Mult Scler. 2014;20:492–5.

    Article  PubMed  Google Scholar 

  32. Yamout B, Alroughani R, Al-Jumah M, Khoury S, Abouzeid N, Dahdaleh M, et al. Consensus guidelines for the diagnosis and treatment of multiple sclerosis. Curr Med Res Opin. 2013;29:611–21.

    Article  CAS  PubMed  Google Scholar 

  33. Alroughani R, Al Hashel J, Lamdhade S, Ahmed SF. Predictors of conversion to multiple sclerosis in patients with clinical isolated syndrome using the 2010 revised McDonald criteria. ISRN Neurol. 2012;2012:792192.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Patrucco L, Rojas JI, Miguez JS, Cristiano E. Application of the McDonald 2010 criteria for the diagnosis of multiple sclerosis in an Argentinean cohort of patients with clinically isolated syndromes. Mult Scler. 2013;19:1297–301.

    Article  CAS  PubMed  Google Scholar 

  35. Patrucco L. Application of the McDonald criteria in Latin America. Mult Scler J - Exp Transl Clin. 2017;3:2055217317721943.

    PubMed  PubMed Central  Google Scholar 

  36. Sadaka Y, Verhey LH, Shroff MM, Branson HM, Arnold DL, Narayanan S, et al. Canadian Pediatric Demyelinating Disease Network. 2010 McDonald criteria for diagnosing pediatric multiple sclerosis. Ann Neurol. 2012;72:211–23.

    Article  PubMed  Google Scholar 

  37. Tardieu M, Banwell B, Wolinsky JS, Pohl D, Krupp LB. Consensus definitions for pediatric MS and other demyelinating disorders in childhood. Neurology. 2016;87:S8–S11.

    Article  PubMed  Google Scholar 

  38. Fadda G, Brown RA, Longoni G, Castro DA, O'Mahony J, Verhey LH, et al. Canadian Pediatric Demyelinating Disease Network. MRI and laboratory features and the performance of international criteria in the diagnosis of multiple sclerosis in children and adolescents: a prospective cohort study. Lancet Child Adolesc Health. 2018;2:191–204.

    Article  PubMed  Google Scholar 

  39. Roohani P, Emiru T, Carpenter A, Luzzio C, Freeman J, Scarberry S, et al. Late onset multiple sclerosis: is it really late onset? Mult Scler Relat Disord. 2014;3:444–9.

    Article  PubMed  Google Scholar 

  40. Lotti CB de C, Oliveira ASB, Bichuetti DB, Castro I, Oliveira EML. Late onset multiple sclerosis: concerns in aging patients. Arq Neuropsiquiatr. 2017;75:451–6.

    Article  Google Scholar 

  41. Freedman MS, Francis GS, Sanders EA, Rice GP, O'Connor P, Comi G, et al. Once weekly interferon beta-1alpha for Multiple Sclerosis Study Group; University of British Columbia MS/MRI Research Group. Randomized study of once-weekly interferon beta-1la therapy in relapsing multiple sclerosis: three-year data from the OWIMS study. Mult Scler. 2005;11:41–5.

    Article  CAS  PubMed  Google Scholar 

  42. Murray TJ, Murray SJ. Characteristics of patients found not to have multiple sclerosis. Can Med Assoc J. 1984;131:336–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Poser CM. Misdiagnosis of multiple sclerosis and β-interferon. Lancet. 1997;349:1916.

    Article  CAS  PubMed  Google Scholar 

  44. Carmosino MJ, Brousseau KM, Arciniegas DB, Corboy JR. Initial evaluations for multiple sclerosis in a university multiple sclerosis center: outcomes and role of magnetic resonance imaging in referral. Arch Neurol. 2005;62:585–90.

    Article  PubMed  Google Scholar 

  45. Solomon AJ, Bourdette DN, Cross AH, Applebee A, Skidd PM, Howard DB, et al. The contemporary spectrum of multiple sclerosis misdiagnosis. Neurology. 2016;87:1393–9.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Okuda DT, Mowry EM, Beheshtian A, Waubant E, Baranzini SE, Goodin DS, et al. Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome. Neurology. 2009;72:800–5.

    Article  CAS  PubMed  Google Scholar 

  47. Okuda DT, Siva A, Kantarci O, Inglese M, Katz I, Tutuncu M, et al. Radiologically Isolated Syndrome Consortium (RISC); Club Francophone de la Sclérose en Plaques (CFSEP). Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9:e90509.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  48. Amato MP, Hakiki B, Goretti B, Rossi F, Stromillo ML, Giorgio A, et al. Italian RIS/MS Study Group. Association of MRI metrics and cognitive impairment in radiologically isolated syndromes. Neurology. 2012;78:309–14.

    Article  CAS  PubMed  Google Scholar 

  49. Keegan BM, Kaufmann TJ, Weinshenker BG, Kantarci OH, Schmalstieg WF, Paz Soldan MM, et al. Progressive solitary sclerosis: gradual motor impairment from a single CNS demyelinating lesion. Neurology. 2016;87:1713–9.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Zimmermann HG, Knier B, Oberwahrenbrock T, Behrens J, Pfuhl C, Aly L, et al. Association of Retinal Ganglion Cell Layer Thickness with future disease activity in patients with clinically isolated syndrome. JAMA Neurol. 2018;75:1071–9.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Filippi M, Rocca MA, Calabrese M, Sormani MP, Rinaldi F, Perini P, et al. Intracortical lesions: relevance for new MRI diagnostic criteria for multiple sclerosis. Neurology. 2010;75:1988–94.

    Article  CAS  PubMed  Google Scholar 

  52. Preziosa P, Rocca MA, Mesaros S, Meani A, Montalban X, Drulovic J, et al. Diagnosis of multiple sclerosis: a multicentre study to compare revised McDonald-2010 and Filippi-2010 criteria. J Neurol Neurosurg Psychiatry. 2017;89:jnnp-2017-315863.

    Google Scholar 

  53. Faizy TD, Thaler C, Ceyrowski T, Broocks G, Treffler N, Sedlacik J, et al. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-criteria in multiple sclerosis patients within a 16-months period. PLoS One. 2017;12:e0172923.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  54. Sati P, Oh J, Constable RT, Evangelou N, Guttmann CR, Henry RG, et al. NAIMS Cooperative. The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative. Nat Rev Neurol. 2016;12:714–22.

    Article  PubMed  Google Scholar 

  55. Azevedo CJ, Overton E, Khadka S, Buckley J, Liu S, Sampat M, et al. Early CNS neurodegeneration in radiologically isolated syndrome. Neurol Neuroimmunol Neuroinflammation. 2015;2:e102.

    Article  Google Scholar 

  56. Zivadinov R, Havrdová E, Bergsland N, Tyblova M, Hagemeier J, Seidl Z, et al. Thalamic atrophy is associated with development of clinically definite multiple sclerosis. Radiology. 2013;268:831–41.

    Article  PubMed  Google Scholar 

  57. Trapp BD, Vignos M, Dudman J, Chang A, Fisher E, Staugaitis SM, et al. Cortical neuronal densities and cerebral white matter demyelination in multiple sclerosis: a retrospective study. Lancet Neurol. 2018;17:870–84.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Thouvenot É. Multiple sclerosis biomarkers: helping the diagnosis? Rev Neurol (Paris). 2018;174:364–71.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mellen Center, Neurologic Institute, Cleveland Clinic, Cleveland, OH, USA

    Marisa P. McGinley & Jeffrey A. Cohen

Authors
  1. Marisa P. McGinley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeffrey A. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marisa P. McGinley .

Editor information

Editors and Affiliations

  1. University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Amanda L. Piquet

  2. University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Enrique Alvarez

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McGinley, M.P., Cohen, J.A. (2021). Evolution of the Diagnostic Criteria in Multiple Sclerosis. In: Piquet, A.L., Alvarez, E. (eds) Neuroimmunology. Springer, Cham. https://doi.org/10.1007/978-3-030-61883-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-61883-4_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-61882-7

  • Online ISBN: 978-3-030-61883-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation