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2017 revisions of McDonald criteria shorten the time to diagnosis of multiple sclerosis in clinically isolated syndromes



To investigate the impact of the 2017 revisions of McDonald criteria on the diagnosis of multiple sclerosis (MS) in a cohort of patients with clinically isolated syndrome (CIS) and dissemination in space (DIS) of demyelinating lesions.


We retrospectively analyzed 137 patients with CIS + DIS from two Italian MS centers.


Application of the 2017 revisions of McDonald criteria in our cohort led to a diagnosis of MS in 82.5% of the patients who could have not been diagnosed with MS according to the previous criteria at the time of the first demyelinating event. After a follow-up of 3.8 ± 2.9 years, 85.8% of these patients eventually satisfied also the previous (2010) criteria.


Application of the 2017 revisions of McDonald criteria results in an earlier diagnosis of MS in a large percentage of CIS patients destined to convert to MS.

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  1. 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

    Article  Google Scholar 

  2. Thompson AJ, Banwell BL, Barkhof F et al (2018) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 17:162–173

    Article  Google Scholar 

  3. Rovira A, Swanton J, Tintoré M et al (2009) A single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis. Arch Neurol 66:587–592

    Article  Google Scholar 

  4. Filippi M, Rocca MA, Ciccarelli O et al (2016) MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines. Lancet Neurol 15:292–303

    Article  Google Scholar 

  5. Brownlee WJ, Swanton JK, Miszkiel KA et al (2016) Should the symptomatic region be included in dissemination in space in MRI criteria for MS? Neurology 87(7):680–683

    Article  Google Scholar 

  6. Gaetani L, Fanelli F, Riccucci I et al (2017) High risk of early conversion to multiple sclerosis in clinically isolated syndromes with dissemination in space at baseline. J Neurol Sci 379:236–240

    Article  Google Scholar 

  7. Filippi M, Rocca MA, Bastianello S et al (2013) Guidelines from the Italian Neurological and Neuroradiological Societies for the use of magnetic resonance imaging in daily life clinical practice of multiple sclerosis patients. Neurol Sci 34:2085–2093

    Article  Google Scholar 

  8. Link H, Huang YM (2006) Oligoclonal bands in multiple sclerosis cerebrospinal fluid: an update on methodology and clinical usefulness. J Neuroimmunol 180:17–28

    CAS  Article  Google Scholar 

  9. McNicholas N, Lockhart A, Yap SM et al (2018) New versus old: implications of evolving diagnostic criteria for relapsing–remitting multiple sclerosis. Mult Scler 21:1352458518770088

    Google Scholar 

  10. Beesley R, Anderson V, Harding KE et al (2018) Impact of the 2017 revisions to McDonald criteria on the diagnosis of multiple sclerosis. Mult Scler 1:1352458518778007

    Google Scholar 

  11. Filippi M, Preziosa P, Meani A et al (2017) 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 4422:1–10

    Google Scholar 

  12. Kuhle J, Disanto G, Dobson R et al (2015) Conversion from clinically isolated syndrome to multiple sclerosis: a large multicentre study. Mult Scler 21:1013–1024

    CAS  Article  Google Scholar 

  13. Swanton JK, Rovira A, Tintore M et al (2007) MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study. Lancet Neurol 6(8):677–686

    Article  Google Scholar 

  14. Metz LM, Eliasziw M (2017) Trial of minocycline in clinically isolated syndrome of multiple sclerosis. N Engl J Med 377(8):789

    Article  Google Scholar 

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Correspondence to Massimiliano Di Filippo.

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Conflicts of interest

LG received travel grants from Biogen, Novartis, Teva, Sanofi Genzyme and Almirall to attend national and international conferences. LP has received research grant from Associazione Italiana Sclerosi Multipla (AISM) and Genzyme; consulting and/or lecture fees and travel grants from Biogen, Genzyme, Novartis and Teva. AM received travel grants from Teva and Sanofi Genzyme to attend national conferences. CP has received consulting and/or lecture fees and/or research funding and travel grant from Almirall, Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, Roche and Teva. PC received/receive research support from Bayer Schering, Biogen-Dompé, Boehringer Ingelheim, Eisai, Lundbeck, Merck-Serono, Novartis, Sanofi-Aventis, Sigma-Tau, and UCB Pharma. MDF participated to advisory boards and received speaker/writing honoraria and funding for traveling from: Bayer, Biogen Idec, Genzyme, Merck, Novartis, Roche and Teva. PE, PS, MCC report no conflicts of interests.

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Gaetani, L., Prosperini, L., Mancini, A. et al. 2017 revisions of McDonald criteria shorten the time to diagnosis of multiple sclerosis in clinically isolated syndromes. J Neurol 265, 2684–2687 (2018).

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  • Clinically isolated syndrome
  • Multiple sclerosis
  • Conversion
  • Diagnostic criteria
  • Dissemination in space
  • Dissemination in time
  • Symptomatic gadolinium enhancing lesion
  • Oligoclonal bands