Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes

Kang, Heejun; Metz, Luanne M.; Traboulsee, Anthony; Eliasziw, Misha; Zhao, Guojun; Cheng, Yan; Zhao, Yinshan; Li, D K B

doi:10.1177/1352458513501230

Cited by 22 publications

(13 citation statements)

References 18 publications

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“…European and North American populations with a typical CIS 14 and age less than 50 years. The applicability of the 2010 McDonald Criteria has been reported in patients from Canada, 17 Italy, 18 the Netherlands, 19 Spain, 20 and Russia. 21 Additional studies concerning the applicability of the 2010 McDonald Criteria in Asian, [22][23][24] Middle Eastern, 25,26 and Latin American 27 populations have been published since 2010, though tended to be small.…”

Section: Development Of the Mcdonald Criteria Was Largely Based On Damentioning

confidence: 99%

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Thompson

Banwell

Barkhof

et al. 2018

The Lancet Neurology

5,373

4,012

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The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

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Section: Development Of the Mcdonald Criteria Was Largely Based On Damentioning

confidence: 99%

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Thompson

Banwell

Barkhof

et al. 2018

The Lancet Neurology

5,373

4,012

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“…Patients suspected of having MS include those with a CIS of optic neuritis, partial transverse myelitis, or brain stem syndromes. Patients with CIS with a brain MR imaging with ≥2 characteristic lesions (≥3 mm in diameter) have a high risk for MS. 23 One-third of patients with CIS (not treated with corticosteroids) will have asymptomatic gadolinium-enhancing lesions and will meet the 2010 McDonald diagnostic criteria for definite MS. 24 Detection of new T2 or gadolinium-enhancing lesions on a follow-up brain MR imaging can be sufficient evidence to fulfill dissemination in time and/or space criteria (Table 1). The recommended timing of the follow-up brain MR imaging is 6–12 months.…”

Section: Clinical Guidelines: Diagnostic Imaging For Suspected Msmentioning

confidence: 99%

Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis

Traboulsee

Simon

Stone

et al. 2015

AJNR Am J Neuroradiol

Self Cite

289

244

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SUMMARY An international group of neurologists and radiologists developed revised guidelines for standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS. A brain MR imaging with gadolinium is recommended for the diagnosis of MS. A spinal cord MR imaging is recommended if the brain MR imaging is nondiagnostic or if the presenting symptoms are at the level of the spinal cord. A follow-up brain MR imaging with gadolinium is recommended to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, to re-assess the original diagnosis, and as a new baseline before starting or modifying therapy. A routine brain MR imaging should be considered every 6 months to 2 years for all patients with relapsing MS. The brain MR imaging protocol includes 3D T1-weighted, 3D T2-FLAIR, 3D T2-weighted, post-single-dose gadolinium-enhanced T1-weighted sequences, and a DWI sequence. The progressive multifocal leukoencephalopathy surveillance protocol includes FLAIR and DWI sequences only. The spinal cord MR imaging protocol includes sagittal T1-weighted and proton attenuation, STIR or phase-sensitive inversion recovery, axial T2- or T2*-weighted imaging through suspicious lesions, and, in some cases, postcontrast gadolinium-enhanced T1-weighted imaging. The clinical question being addressed should be provided in the requisition for the MR imaging. The radiology report should be descriptive, with results referenced to previous studies. MR imaging studies should be permanently retained and available. The current revision incorporates new clinical information and imaging techniques that have become more available.

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“…These goals seem to have been realized; analyses of sample populations that compare the effectiveness of the 2005 and 2010 criteria have indicated that more patients receive diagnoses of CDMS earlier in the disease course when using the most recent revisions than when using the older versions (Fig. 2), and earlier diagnosis affords the possibility of earlier counselling and treatment (Kang et al, 2014;Runia et al, 2013;Brownlee et al, 2014). One of these studies, however, did note that up to one-third of patients with retrospective diagnoses of CDMS made using the 2010 criteria had experienced no further clinical events after 6 years of follow up (Brownlee et al, 2014).…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Variations in multiple sclerosis practice within Europe – Is it time for a new treatment guideline?

Marziniak

Ghorab

Kozubski

et al. 2016

Multiple Sclerosis and Related Disorders

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In the past 5 years, the combination of developments in diagnostic strategy and approval of new disease-modifying therapies has provided an opportunity to achieve dramatic improvements in patient outcomes in multiple sclerosis (MS). However, across Europe there are several factors that may prevent patients from receiving the best therapy at the appropriate time, and there is variation among countries in terms of which of these factors are most relevant. Here, we review current MS clinical practices in a number of countries in the European Union to identify differences regarding initiation of treatment in patients with clinically isolated syndrome or relapsing-remitting MS, and differences in the timing of treatment switch or escalation. While recognizing that policy is not static in any country, we believe that patients' interests would be better served if a European treatment guideline was developed. Such a guideline could both inform and be informed by national policies, facilitating the dissemination of best clinical practice internationally.

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Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes

Abstract: Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%.

Cited by 22 publications

References 18 publications

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis

Variations in multiple sclerosis practice within Europe – Is it time for a new treatment guideline?

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