scholarly journals Use (and misuse) of the McDonald criteria to diagnose multiple sclerosis

2017 ◽  
Vol 25 (2) ◽  
pp. 209-210 ◽  
Author(s):  
W. J. Brownlee
Keyword(s):  
Multiple Sclerosis ◽  
Mcdonald Criteria

scholarly journals MRI of the Entire Spinal Cord—Worth the While or Waste of Time? A Retrospective Study of 74 Patients with Multiple Sclerosis

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1424
Author(s):  
Esben Nyborg Poulsen ◽  
Anna Olsson ◽  
Stefan Gustavsen ◽  
Annika Reynberg Langkilde ◽  
Annette Bang Oturai ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Brain Mri ◽  
Anatomical Location ◽  
Spinal Cord Lesions ◽  
Chi Square ◽  
Exact Test ◽  
Mcdonald Criteria ◽  
Chi Square Test

Spinal cord lesions are included in the diagnosis of multiple sclerosis (MS), yet spinal cord MRI is not mandatory for diagnosis according to the latest revisions of the McDonald Criteria. We investigated the distribution of spinal cord lesions in MS patients and examined how it influences the fulfillment of the 2017 McDonald Criteria. Seventy-four patients with relapsing-remitting MS were examined with brain and entire spinal cord MRI. Sixty-five patients received contrast. The number and anatomical location of MS lesions were assessed along with the Expanded Disability Status Scale (EDSS). A Chi-square test, Fischer’s exact test, and one-sided McNemar’s test were used to test distributions. MS lesions were distributed throughout the spinal cord. Diagnosis of dissemination in space (DIS) was increased from 58/74 (78.4%) to 67/74 (90.5%) when adding cervical spinal cord MRI to brain MRI alone (p = 0.004). Diagnosis of dissemination in time (DIT) was not significantly increased when adding entire spinal cord MRI to brain MRI alone (p = 0.04). There was no association between the number of spinal cord lesions and the EDSS score (p = 0.71). MS lesions are present throughout the spinal cord, and spinal cord MRI may play an important role in the diagnosis and follow-up of MS patients.

Еarly diagnosis of multiple sclerosis: experience with the use of class G oligoclonal immunoglobulin

2021 ◽  
Vol 26 (3) ◽  
pp. 34-39
Author(s):  
Z. A. Goncharova ◽  
Y. Y. Pogrebnova ◽  
N. M. Yarosh ◽  
S. M.M. Sehweil
Keyword(s):  
Multiple Sclerosis ◽  
Early Diagnosis ◽  
Literature Review ◽  
Demyelinating Disease ◽  
Mcdonald Criteria ◽  
Mri Features ◽  
Oligoclonal Igg ◽  
Relationship Of ◽  
The Relationship

The article presents the literature review and our experience in early diagnosis of multiple sclerosis based on the updated McDonald criteria of 2017. The study included 256 patients with clinic symptoms of probable idiopathic infl ammatory demyelinating disease, including rare and atypical forms of demyelination. As a result of the study the sensitivity and specifi city of the determination of oligoclonal immunoglobulin G in the population of Rostov-on-Don was described for the fi rst time, including dependence of the duration of the disease. The relationship of clinical and MRI features of the fi rst attack of the disease with the probability of determining oligoclonal IgG in the cerebrospinal fl uid is refl ected

Familial multiple sclerosis: literature review, own data analysis

2020 ◽  
Vol 18 (5) ◽  
pp. 69-75
Author(s):  
Z. A. GONCHAROVA ◽  
◽  
Yu. Yu. POGREBNOVA ◽  
Yu. V. TRINITATSKIY ◽  
T. V. SYCHEVA ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Data Analysis ◽  
Average Rate ◽  
Family Risk ◽  
Risk Of Recurrence ◽  
Mcdonald Criteria ◽  
Rostov Region ◽  
The Family ◽  
Course Material ◽  
Student’S T

To optimize the management of patients with familial multiple sclerosis (MS) by identifying the clinical and epidemiological features of the disease course. Material and methods. The object of the study was 2253 patients with clinically reliable MS according to McDonald criteria (2010, 2017) living in the Rostov region. Statistical analysis of the results was processed using the application package Excel, Statistics 13.0 MacOSX (Apple Inc., USA). Data analysis was carried out using the 𝜒2 criterion. The significance of differences was assessed using the Student’s t-test; the differences were considered statistically significant at p < 0,05. Results. 108 family cases were identified in the analyzed population of the Rostov region (2 or more MS patients in a family). The overall risk of recurrence among the population of the Rostov region was 4,8%, the family risk of recurrence was 2,7%. The M:F ratio is 1:3,5, the age of debut in the first generation exceeded the age of debut in subsequent generations on average by 5,9 (0,1) years. The duration of the first remission in the family MS group (2,4 (1,0) years), and the average rate of progression was 0.5 (0,1) points per year. Conclusions. In most families, the «ancestor» of MS was a woman, this fact indicates a possible role of mitochondria in the pathogenesis of the disease. Genealogical analysis of the evidence in favor of non-mendelian types of inheritance. A burdened family history is an unfavorable prognostic factor for the course of MS, which should be taken into account when determining the patient’s management tactics.

scholarly journals Validation survey of the impact of urinary incontinence (IIQ-7) and inventory of distress urogenital (UDI-6) – the short scales – in patients with multiple sclerosis

2015 ◽  
Vol 73 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Lívia Palma Stievano ◽  
Guilherme Sciascia do Olival ◽  
Raquel Ataíde Peres da Silva ◽  
Vania Balardin Toller ◽  
Eduardo Gregorin Carabetta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Incontinence ◽  
Cultural Adaptation ◽  
Cross Cultural ◽  
Control Group ◽  
Alpha Coefficient ◽  
Urogenital Distress Inventory ◽  
Mcdonald Criteria ◽  
The Impact ◽  
Review Criteria

Cross-cultural adaptation and validation of the Impact Questionnaire of Urinary Incontinence (IIQ-7) and Urogenital Distress Inventory (UDI-6) - short scale - in the Brazilian population with multiple sclerosis. The IIQ-7 and UDI-6 were translated into Portuguese, called IIQ-7-BR and UDI-6-BR. The questionnaires were administered in 211 individuals selected randomly. Of these, 140 had MS according to McDonald criteria and 71 were included in the control group. In both questionnaires, the Cronbach’s alpha coefficient was above 0.7. The IIQ-7-BR showed 94.31% concordance between the evaluated studies and UDI-6-BR, 93.33%. Thus, the instruments of this study were presented according to the standards proposed by the Instrument Review Criteria, reliability, validity and sensitivity, maintaining the original scales characteristics.

scholarly journals Lesion topographies in multiple sclerosis diagnosis

Neurology ◽  
2017 ◽  
Vol 89 (23) ◽  
pp. 2351-2356 ◽  
Author(s):  
Georgina Arrambide ◽  
Mar Tintore ◽  
Cristina Auger ◽  
Jordi Río ◽  
Joaquín Castilló ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Consensus Recommendation ◽  
Mcdonald Criteria ◽  
Lesion Topography ◽  
Periventricular Lesions ◽  
Periventricular Lesion ◽  
Multiple Sclerosis Diagnosis

Objectives:To assess the contributions of cortico-juxtacortical and corpus callosum lesions to multiple sclerosis diagnosis and to compare the value of ≥1 vs ≥3 periventricular lesions in clinically isolated syndromes (CIS).Methods:Step 1: We evaluated lesion topography classifications in 657 patients with CIS with stepwise Cox proportional hazards regression models considering second attack as the outcome. Step 2: We established 2 dissemination in space (DIS) versions according to the periventricular lesion cutoffs of ≥1 and ≥3 and assessed their performance at 10 years with second attack as the outcome, first individually and then combined with dissemination in time (DIT) in all cases (n = 326), by age, and by CIS topography.Results:Step 1: The models (hazard ratios [95% confidence interval]) favored ≥1 over ≥3 periventricular lesions (2.5 [1.7–3.6]) and cortico-juxtacortical over juxtacortical lesions (1.4 [1.0–1.8]). Callosal lesions were not selected. Step 2: DIS specificity with ≥1 periventricular lesions was slightly lower than with ≥3 (59.1 vs 61.4) and the same after adding DIT (88.6). Regarding age, ≥3 periventricular lesions improved DIS specificity over ≥1 lesions in the 40–49 years of age bracket (66.7 vs 58.3). This difference disappeared when adding DIT (83.3). Optic neuritis had a similar pattern when evaluating CIS topographies.Conclusions:Our results comply with the Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) consensus recommendation of combining cortical and juxtacortical lesions into a single term when possible. Concerning periventricular lesions, maintaining the current ≥1 cutoff in the McDonald criteria does not compromise specificity in typical CIS cases, but attention should be paid to older patients or optic neuritis cases.

Early predictors of multiple sclerosis after a typical clinically isolated syndrome

2014 ◽  
Vol 20 (13) ◽  
pp. 1721-1726 ◽  
Author(s):  
Aurélie Ruet ◽  
Georgina Arrambide ◽  
Bruno Brochet ◽  
Cristina Auger ◽  
Eva Simon ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
At Risk ◽  
High Specificity ◽  
Clinically Isolated Syndrome ◽  
Oligoclonal Bands ◽  
Mcdonald Criteria ◽  
Early Predictors ◽  
Patients At Risk ◽  
Magnetic Resonance Imaging Mri ◽  
Periventricular Lesions

Background: The 2010 McDonald criteria allow diagnosing multiple sclerosis (MS) with one magnetic resonance imaging (MRI) scan. Nevertheless, not all patients at risk fulfil criteria at baseline. Other predictive factors (PFs) are: age ≤40 years, positive oligoclonal bands (OBs), and ≥3 periventricular lesions. Objective: The purpose of this study was to evaluate the 2010 McDonald criteria performance and to assess other PFs in patients without dissemination in space (DIS). Methods: Patients with clinically isolated syndrome (CIS) underwent baseline MRI and OB determination with clinical and radiological follow-up. Adjusted hazard ratios (aHRs) for clinically definite MS were estimated for DIS, dissemination in time (DIT), and DIS+DIT. Diagnostic properties at two years were calculated. In cases without DIS, combinations of ≥2 PFs were assessed. Results: A total of 652 patients were recruited; aHRs were 3.8 (2.5–5.8) for DIS, 4.2 (1.9–9.2) for DIT, and 8.6 (5.4–13.8) for DIS+DIT. Sensitivities were 69.6%, 42.3%, and 36.4%, and specificities were 67.3%, 87.9%, and 90.2%, respectively. In patients without DIS, aHRs varied between 2.7–5.5 and specificities ranged from 73.5–89.7% for PF combinations. Conclusion: The high specificity of the 2010 McDonald criteria is confirmed. In patients without DIS, PF combinations could be helpful in identifying those at risk for MS.

The McDonald Criteria for Multiple Sclerosis: time for clarification

2010 ◽  
Vol 16 (5) ◽  
pp. 566-575 ◽  
Author(s):  
Christopher H Hawkes ◽  
Gavin Giovannoni
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Evidence ◽  
Progressive Multiple Sclerosis ◽  
Cervical Cord ◽  
Primary Progressive Multiple Sclerosis ◽  
Drug Trials ◽  
Mcdonald Criteria ◽  
Skill Groups ◽  
Definition Of ◽  
Consistent Response

The McDonald Criteria for Multiple Sclerosis in general have replaced the Poser criteria. Despite this, many consider that there are still areas of ambiguity. In this study, neurologists completed a questionnaire about familiarity with, usefulness and applicability of the McDonald Criteria for Multiple Sclerosis. Understanding of ‘attack’; objective clinical evidence; ‘two or more lesions’ and their ability to interpret case scenarios was evaluated. Responses were analysed overall and by skill group. Ninety-seven consultants and 30 trainees responded, of whom 37 operated a multiple sclerosis clinic (‘experts’). Some (62%) thought the McDonald Criteria for Multiple Sclerosis were useful, and 31% found them confusing or difficult to apply; 38% thought the criteria should be applied universally, others (14—28%) favoured their use for drug trials/research, and 17% rarely used them. Thirty-six (29.1%) thought the McDonald Criteria for Multiple Sclerosis specified two categories: ‘MS and not MS’, but others considered ‘possible’ or ‘probable’ multiple sclerosis were permitted. Experts understood better ‘an attack’ and ‘objective clinical evidence’. All skill groups comprehended poorly what constituted an episode of demyelination, and whether Lhermitte’s phenomenon was acceptable as evidence for cervical cord demyelination. A consistent response was given by 44—50% to ‘two or more lesions’, although this is not well defined. Criteria for primary progressive multiple sclerosis were understood well. We conclude that the McDonald Criteria for Multiple Sclerosis have improved diagnosis but areas of misinterpretation remain, particularly the definition of ‘an attack’, ‘objective clinical evidence’ and ‘two or more lesions’. There was uncertainty about how many multiple sclerosis categories were permitted and whether the terms ‘possible’ and ‘probable’ were allowable. Further clarification might allow the criteria to be applied more consistently.

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