Adding the Optic Nerve in Multiple Sclerosis Diagnostic Criteria.

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
09 Jan 2024
Historique:
medline: 2 1 2024
pubmed: 2 1 2024
entrez: 2 1 2024
Statut: ppublish

Résumé

The optic nerve is not one of the areas of the CNS that can be used to demonstrate dissemination in space (DIS) within the 2017 McDonald criteria for the diagnosis of multiple sclerosis (MS). Objectives were (1) to assess whether optic nerve-MRI (ON-MRI), optical coherence tomography (OCT), and visual evoked potentials (VEP) detect optic nerve involvement in clinically isolated syndrome (CIS) and (2) to evaluate the contribution of the optic nerve topography to the current diagnostic criteria in a prospective, multicenter cohort. MAGNIMS centers were invited to provide prospective data on patients with CIS who underwent a visual assessment with at least 2 of 3 investigations (ON-MRI, OCT, or VEP) within 6 months of onset. Modified DIS criteria were constructed by adding the optic nerve topography, defined by each investigation separately and any combination of them, as the fifth area of the CNS. A risk assessment analysis and the performance of the different DIS criteria were analyzed using the diagnosis of MS according to the 2017 McDonald criteria as the primary outcome and new T2 lesions and/or a second relapse as the secondary outcome. We included 157 patients with CIS from 5 MAGNIMS centers; 60/157 (38.2%) patients presented with optic neuritis. Optic nerve involvement on ON-MRI was found in 40.2% patients at study entry and in 72.5% of those with optic neuritis.At follow-up (mean 27.9 months, SD 14.5), 111/157 patients (70.7%) were diagnosed with MS according to the 2017 McDonald criteria. Fulfilling either 2017 DIS or any modified DIS criteria conferred a similar high risk for reaching primary and secondary outcomes. The modified DIS criteria had higher sensitivity (92.5% [with ON-MRI] vs 88.2%), but slightly lower specificity (80.0% [with GCIPL IEA ≥4 μm] vs 82.2%), with overall similar accuracy (86.6% [with ON-MRI] vs 86.5%) than 2017 DIS criteria. Consistent results were found for secondary outcomes. In patients with CIS, the presence of an optic nerve lesion defined by MRI, OCT, or VEP is frequently detected, especially when presenting with optic neuritis. Our study supports the addition of the optic nerve as a fifth topography to fulfill DIS criteria.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
The optic nerve is not one of the areas of the CNS that can be used to demonstrate dissemination in space (DIS) within the 2017 McDonald criteria for the diagnosis of multiple sclerosis (MS). Objectives were (1) to assess whether optic nerve-MRI (ON-MRI), optical coherence tomography (OCT), and visual evoked potentials (VEP) detect optic nerve involvement in clinically isolated syndrome (CIS) and (2) to evaluate the contribution of the optic nerve topography to the current diagnostic criteria in a prospective, multicenter cohort.
METHODS METHODS
MAGNIMS centers were invited to provide prospective data on patients with CIS who underwent a visual assessment with at least 2 of 3 investigations (ON-MRI, OCT, or VEP) within 6 months of onset. Modified DIS criteria were constructed by adding the optic nerve topography, defined by each investigation separately and any combination of them, as the fifth area of the CNS. A risk assessment analysis and the performance of the different DIS criteria were analyzed using the diagnosis of MS according to the 2017 McDonald criteria as the primary outcome and new T2 lesions and/or a second relapse as the secondary outcome.
RESULTS RESULTS
We included 157 patients with CIS from 5 MAGNIMS centers; 60/157 (38.2%) patients presented with optic neuritis. Optic nerve involvement on ON-MRI was found in 40.2% patients at study entry and in 72.5% of those with optic neuritis.At follow-up (mean 27.9 months, SD 14.5), 111/157 patients (70.7%) were diagnosed with MS according to the 2017 McDonald criteria. Fulfilling either 2017 DIS or any modified DIS criteria conferred a similar high risk for reaching primary and secondary outcomes. The modified DIS criteria had higher sensitivity (92.5% [with ON-MRI] vs 88.2%), but slightly lower specificity (80.0% [with GCIPL IEA ≥4 μm] vs 82.2%), with overall similar accuracy (86.6% [with ON-MRI] vs 86.5%) than 2017 DIS criteria. Consistent results were found for secondary outcomes.
DISCUSSION CONCLUSIONS
In patients with CIS, the presence of an optic nerve lesion defined by MRI, OCT, or VEP is frequently detected, especially when presenting with optic neuritis. Our study supports the addition of the optic nerve as a fifth topography to fulfill DIS criteria.

Identifiants

DOI: 10.1212/WNL.0000000000207805 PMID: 38165378
pubmed: 38165378
doi: 10.1212/WNL.0000000000207805
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e200805

Auteurs

Angela Vidal-Jordana (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0002-7270-5507

Alex Rovira (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Willem Calderon (W)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0001-8285-5739

Georgina Arrambide (G)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0002-2657-5510

Joaquín Castilló (J)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Dulce Moncho (D)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Kimia Rahnama (K)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Sara Collorone (S)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Ahmed T Toosy (AT)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0002-4441-3750

Olga Ciccarelli (O)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0001-7485-1367

Athina Papadopoulou (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0002-0367-1008

Nuria Cerdá-Fuertes (N)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Johanna M Lieb (JM)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Serena Ruggieri (S)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0001-5287-3290

Carla Tortorella (C)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0001-9037-7300

Claudio Gasperini (C)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Alvino Bisecco (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Rocco Capuano (R)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Antonio Gallo (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Andrea De Barros (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Annalaura Salerno (A)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.

Cristina Auger (C)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0001-9846-4767

Jaume Sastre-Garriga (J)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0002-1589-2254

Mar Tintore (M)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0001-9999-5359

Xavier Montalban (X)

From the Hospital Universitari Vall d'Hebron (A.V.-J., A.R., G.A., J.C., D.M., K.R., A.D.B., A.S., C.A., J.S.-G., M.T., X.M.), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR) (W.C.), Universitat Autònoma de Barcelona, Spain; University College London (UCL) (S.C., A.T.T., O.C.), United Kingdom; Institute of Neurology (O.C.), London, United Kingdom; University Hospital Basel (A.P., N.C.-F., J.M.L.), Switzerland; San Camillo-Forlanini Hospital (S.R., C.T., C.G.), Rome, Italy; University of Campania Luigi Vanvitelli (A.B., R.C., A.G.), Naples, Italy.
ORCID: 0000-0002-0098-9918

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