High risk of early conversion to multiple sclerosis in clinically isolated syndromes with dissemination in space at baseline

Lorenzo Gaetani, Fulvia Fanelli, Ilenia Riccucci, Paolo Eusebi, Paola Sarchielli, Carlo Pozzilli, Paolo Calabresi, Luca Prosperini, Massimiliano Di Filippo

Research output: Contribution to journalArticle

Abstract

Introduction Multiple sclerosis (MS) usually presents at onset with a clinically isolated syndrome (CIS). According to 2010 McDonald criteria, a diagnosis of MS can be made if CIS patients satisfy clinical/MRI criteria of both dissemination in time (DIT) and space (DIS). Objective The aim of this study was to analyze the follow-up data and possible prognostic factors of CIS patients satisfying DIS MRI criteria. Patients and methods We performed a retrospective, multicenter study across 2 Italian centers. Clinical, MRI, and laboratory assessments were performed according to real-life clinical workup. Results Out of the 137 enrolled patients, during a median follow-up time of 3.1 years, 116 (84.7%) converted to MS with the large majority (78.4%) of the converters developing MS within 1 year. In multivariate analysis, baseline predictors of an earlier conversion were a cerebellar/brainstem CIS (HR 2.00, 95% CI: 1.3–3.0, p = 0.001) and the presence of all the Barkhof-Tintore MRI criteria (HR 1.67, 95% CI: 1.1–2.6, p = 0.028). Conclusions Patients with CIS and DIS are at very high risk of an early conversion to MS. The onset with cerebellar/brainstem symptoms and the evidence of a higher MRI lesion load at baseline are the strongest independent predictors of an early conversion to MS.

Original languageEnglish
Pages (from-to)236-240
Number of pages5
JournalJournal of the Neurological Sciences
Volume379
DOIs
Publication statusPublished - Aug 15 2017

Keywords

  • Clinically isolated syndrome
  • Conversion
  • Dissemination in space
  • Dissemination in time
  • Magnetic resonance imaging
  • Multiple sclerosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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