Chaloulos-Iakovidis, Panagiotis; Wagner, Franca; Weber, Lea; Diem, Lara; Chan, Andrew; Salmen, Anke; Friedli, Christoph; Hoepner, Robert (2021). Predicting conversion to multiple sclerosis in patients with radiologically isolated syndrome: a retrospective study. Therapeutic advances in neurological disorders, 14, p. 17562864211030664. Sage 10.1177/17562864211030664
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Aims
To retrospectively analyse the Bernese radiologically isolated syndrome (RIS) cohort with the goal of developing a prediction score for conversion to multiple sclerosis (MS).
Methods
A total of 31 patients with RIS were identified by screening medical records of neurological patients seen at the University Hospital of Bern between 2004 and 2017 for the diagnoses 'radiologically isolated syndrome' and 'RIS' adhering to 2009 Okuda recommendations. We analysed clinical, paraclinical and magnetic resonance imaging data during a maximum follow-up period of 3 years and identified significant predictors of conversion to MS.
Results
Data were available for 31 patients meeting 2009 Okuda RIS criteria. During the 3 years of follow up, 5/31 RIS patients converted to relapsing-remitting (RR) MS. In our univariate analysis, gadolinium (Gd) enhancement, brainstem and cerebellar hemisphere lesions, immune cell count and albumin concentration in cerebrospinal fluid (CSF), and anti-nuclear antibody (ANA) positivity in serum were identified as significant predictors of conversion to MS. Integrating these factors into our 'RIS-MS prediction score' enabled us to calculate a cut-off for prediction of conversion to MS within 3 years with high specificity [1.0, 95% confidence interval (CI) 0.84-1.00) and acceptable sensitivity (0.6, 95% CI 0.17-0.93)].
Conclusion
Our RIS-MS prediction score, if validated in an independent cohort, integrating radiological (Gd enhancement, brainstem and cerebellar hemisphere lesions) and paraclinical factors (ANA in serum, cell count and albumin in CSF) could be a useful prognostic tool for early recognition of RIS patients with a high risk of clinical progression to MS.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology |
UniBE Contributor: |
Chaloulos-Iakovidis, Panagiotis, Wagner, Franca, Weber, Lea, Diem, Lara, Chan, Andrew Hao-Kuang, Salmen, Anke, Friedli, Christoph Daniel, Hoepner, Robert |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1756-2856 |
Publisher: |
Sage |
Language: |
English |
Submitter: |
Martin Zbinden |
Date Deposited: |
01 Oct 2021 16:11 |
Last Modified: |
05 Dec 2022 15:53 |
Publisher DOI: |
10.1177/17562864211030664 |
PubMed ID: |
34349838 |
Uncontrolled Keywords: |
conversion multiple sclerosis prediction score radiologically isolated syndrome |
BORIS DOI: |
10.48350/159378 |
URI: |
https://boris.unibe.ch/id/eprint/159378 |
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