Conversion of clinically isolated syndrome to multiple sclerosis: a prospective study

Kolčava, Jan; Kočica, Jan; Hulová, Monika; Dušek, Ladislav; Horáková, Magda; Keřkovský, Miloš; Stulík, Jakub; Dostál, Marek; Kuhn, Matyáš; Vlčková, Eva; Bednařík, Josef; Benešová, Yvonne

doi:10.1016/j.msard.2020.102262

Cited by 19 publications

(17 citation statements)

References 31 publications

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“…Thus electrophysiological measures of cognitive performance (unlike neuropsychological testing results) seemed to be associated with short-term activity of the disease. In other prospective studies including patients with CIS (10,11), multimodal EP abnormalities were found to predict earlier conversion from CIS to MS (with clinical and/or radiological signs of dissemination in time), independently from MRI or CSF baseline findings. Pelayo et al (34) demonstrated that individual EP scores did not significantly affect the risk of conversion, and the predictive value of multiple EP abnormalities was limited by their small proportion.…”

Section: Predictive Value Of Baseline Findingsmentioning

confidence: 78%

“…Multimodal EP were conducted using Viking Quest equipment (Viasys Healthcare Inc., Conshohocken, Pennsylvania, USA), following the International Federation of Clinical Neurophysiology (IFCN) guidelines (10)(11)(12). The session took place in a quiet and dimmed room at 22-24 • C. Superficial Ag/AgCl electrodes were placed on the scalp, according to the international 10-20 scheme and fixed using adhesive-conductive paste.…”

Section: Multimodal Epmentioning

confidence: 99%

“…Evoked potentials (EP), although recently degraded from McDonald's diagnostic criteria, provide a relevant measure of functional central nervous system (CNS) impairment and allow detection of subclinical neurological deficit in the course of MS (5). EP parameters were postulated to have some predictive value with regard to future disability (6)(7)(8)(9) and conversion from CIS into clinically definite MS (10,11). The application of multimodal EP corresponds with heterogeneity and dissemination in the space of MS-related CNS damage (12).…”

Section: Introductionmentioning

confidence: 99%

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Multimodal Evoked Potentials as Potential Biomarkers of Disease Activity in Patients With Clinically Isolated Syndrome

et al. 2022

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ObjectiveThere is an ongoing search for markers useful in monitoring and predicting disease activity at the early stage of multiple sclerosis (MS). The goals of this study were to prospectively evaluate the changes in parameters of multimodal evoked potentials (EP) and cognition within a 3-year follow-up period in patients with clinically isolated syndrome (CIS), and to assess the prognostic value of baseline findings with regard to the disease outcomes.MethodsIn 29 patients (20 women, nine men, mean age 31.1) multimodal (visual, brainstem auditory, somatosensory, event-related) EP and neuropsychological tests (NT) were performed at baseline (T0) and after 1 (T1) and 3 (T3) years. Their results were compared longitudinally between baseline, T1, and T3. Baseline results confirmed conversion of CIS into multiple sclerosis (MS) and disability level at T1 and T3 using multiple comparisons and a logistic regression model.ResultsApart from mean N13/P16 SEP (somatosensory evoked potentials) amplitude (lower at T1 and T3 than at baseline (T0 1.02 ± 0.37 μV, T1 0.90 ± 0.26 μV, T3 0.74 ± 0.32 μV, p < 0.05 for both comparisons), no significant changes of EP or NT parameters were found in longitudinal assessment. Baseline P300 Pz latency was longer for the patients with MS than for those with CIS at T1 (352.69 vs. 325.56 ms). No predictive value was shown for any of the analyzed baseline variables with regard to conversion from CIS into MS.SignificanceBaseline ERP abnormalities were associated with their short-term conversion into MS. ERP are worth considering in multimodal EP evaluation at the early stage of MS.

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Section: Predictive Value Of Baseline Findingsmentioning

confidence: 78%

Section: Multimodal Epmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multimodal Evoked Potentials as Potential Biomarkers of Disease Activity in Patients With Clinically Isolated Syndrome

et al. 2022

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“…The sample size was calculated based on the primary outcome. It was assumed that the sensitivity of baseline McDonald Criteria for determining MS at the end of the study is 70% ( Kolčava et al, 2020 ). Given that > 85% of MS lesions have a central vein on FLAIR* MRI, we estimate the sensitivity of CVS to be > 80%, or approximately 12% improved sensitivity for MS.…”

Section: Resultsmentioning

confidence: 99%

Central vein sign: A diagnostic biomarker in multiple sclerosis (CAVS-MS) study protocol for a prospective multicenter trial

Ontaneda

Sati

Raza

et al. 2021

NeuroImage: Clinical

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Highlights Approximately one in five patients with MS do not have the disease. The central vein differentiates multiple sclerosis from other white matter lesions. The central vein sign has not been evaluated in multi-center prospective studies. CAVS-MS is a prospective multicenter study to validate the central vein. CAVS-MS will useT2*-weighted, high-isotropic-resolution, segmented echo-planar MRI.

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“…Therefore, early prediction of the conversion of patients with CIS, and identification of risk factors for the advancement of CIS to MS, would be of significant value. Clinical studies have suggested that the confirmed potential predictors for the conversion of CIS patients to MS are an increased (> 10) baseline related to brain and spinal cord magnetic resonance imaging (MRI) T2-hyperintense lesions, oligoclonal band (OCB) positivity, and subclinical evoked potential (EP) abnormalities [3]. Patients with three or more MRI lesions were more likely to develop MS than those with fewer than three lesions [4].…”

Section: Introductionmentioning

confidence: 99%

Analysis of factors correlated with spinal clinically isolated syndrome conversion to multiple sclerosis

Sun

Zhao

2022

Neurol Neurochir Pol.

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Introduction. The present study aims to explore the factors influencing spinal clinically isolated syndrome (CIS) conversion to multiple sclerosis (MS).Material and methods. Sixty-one patients diagnosed with spinal CIS from January 2010 to November 2020 were divided into a non-progressing (CIS) group with 27 patients, and a conversion to MS (MS) group with 34 patients, based on whether they had converted to MS. The clinical presentation at onset, the Expanded Disability Status Scale (EDSS) before and after steroid therapy, the results of magnetic resonance imaging (MRI), the oligoclonal bands in cerebrospinal fluid (CSF-OCB), and the evoked potentials (EPs) were retrospectively analysed.Results. Differences in gender and age were not statistically significant between the MS and CIS groups. The median time to relapse was 12 months for the MS group, with an upper quartile of 23.7 months, and 91.2% of patients relapsed within three years. In univariate analysis, patients with CIS beginning with sensory symptoms had a lower level of progression to MS (OR = 0.311). Patients with Kurtzke Functional Systems Scores (FSSs) of pyramidal functions ≥ 2 (OR = 3.582) and positive CSF--OCB (OR = 5.208) quickly progressed to MS. There was no significant difference between the two groups in terms of spinal cord lesions < 3 vertebral segments, gadolinium enhancing lesions, or abnormal EPs. The difference in the EDSS scores before and after steroid therapy was higher in the MS group than in the CIS group (p = 0.001). Differences of ≥ 1.5 in the EDSS scores before and after steroid therapy were risk factors for CIS conversion to MS (OR = 9.333). Conclusions.Patients with spinal CIS with pure sensory abnormalities at onset were less likely to convert to MS (OR = 0.311), and the risk factors were, in order of risk, the difference in EDSS score before and after steroid therapy (≥ 1.5; OR = 9.333), positive CSF-OCB (OR = 5.208), and those with an FSS of the pyramidal functions score ≥ 2; OR = 3.582). The present study serves as a simple 'first step' . Any potential predictors identified should be validated via future prospective studies.

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Conversion of clinically isolated syndrome to multiple sclerosis: a prospective study

Cited by 19 publications

References 31 publications

Multimodal Evoked Potentials as Potential Biomarkers of Disease Activity in Patients With Clinically Isolated Syndrome

Multimodal Evoked Potentials as Potential Biomarkers of Disease Activity in Patients With Clinically Isolated Syndrome

Central vein sign: A diagnostic biomarker in multiple sclerosis (CAVS-MS) study protocol for a prospective multicenter trial

Analysis of factors correlated with spinal clinically isolated syndrome conversion to multiple sclerosis

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