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Criteria improving multiple sclerosis diagnosis at the first MRI

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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.

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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.

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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
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  2. Adil Maarouf
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  3. Margaux Genevray
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  4. Emmanuelle Leray
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  5. Romain Deschamps
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  6. Marie P. Chaunu
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  7. Laure Daelman
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  8. Jean C. Ferré
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  9. Olivier Gout
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  10. Jean Pelletier
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  11. Laurent Pierot
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  12. Gilles Edan
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  13. Ayman Tourbah
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Corresponding author

Correspondence to Ayman Tourbah.

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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

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

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