Prognostic value of magnetic resonance imaging in patients with clinically isolated syndrome conversion to multiple sclerosis: A meta-analysis

Zhang, Weiyan; Hou, Yuli

doi:10.4103/0028-3886.115058

Cited by 8 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, MRI brain lesion evaluation in Lithuania is not defined by a specific protocol. As reported in our results, only spinal cord lesions were more prevalent in the MS group, even though evidence exists that periventricular, juxtacortical, [13] infratentorial [21], and spinal cord [22] lesions could predict the development of MS. This suggests that obtaining a spinal cord MRI could aid those whose diagnosis remains unclear.…”

Section: Discussionsupporting

confidence: 72%

“…DIT, however, could be established by experiencing another clinical attack, having positive CSF oligoclonal bands (OCBs) or having both Gadolinium-enhanced and non-enhanced lesions in MRI [5]. MS-specific MRI lesions are usually associated with development of MS [20,21]. According to our results, lesions specific to MS occurred at the same rate both in the MS and non-MS group, however, non-specific MRI lesions were observed more often among the non-MS group.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors Related to the Progression of Clinically Isolated Syndrome to Multiple Sclerosis: A Retrospective Study in Lithuania

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Multiple sclerosis (MS) is a demyelinating disease which usually manifests as clinically isolated syndrome (CIS). Approximately 70% of patients with CIS progress to MS. Therefore, there is a pressing need to identify the most accurate predictive factors of CIS developing into MS, some of which could be a clear clinical phenotype of early MS as well as lesions in magnetic resonance imaging (MRI), pathological findings in cerebrospinal fluid (CSF) and evoked potentials (EP) tests. The problem is of outstanding importance since early MS diagnosis and treatment prevents long-term disability. The aim of our study is to analyze the factors that could influence the progression of CIS to MS. Materials and Methods: This study is a retrospective data analysis which included patients with their primary CIS diagnosis between 1st January 2015 and 1st January 2020. The prevalence and predictive value of clinical symptoms, MRI lesions, pathological CSF and EP findings were evaluated in accordance with the final diagnosis and compared between the sexes and age groups. Results: Out of 138 CIS patients, 49 (35.5%) patients progressed to MS. MS patients were more likely to have a diminished sense of vibration and proprioception (χ2 = 9.033, p = 0.003) as well as spinal cord MRI lesions (χ2 = 7.209, p = 0.007) in comparison with the non-MS group. Positive oligoclonal bands (OCBs) in CSF (χ2 = 34.859, p ≤ 0.001) and pathological brainstem auditory evoked potential (BAEP) test findings (χ2 = 10.924, p ≤ 0.001) were more prevalent in the MS group. Diminished sense of vibration and proprioception increased the risk for developing MS by 13 times (p = 0.028), whereas positive OCBs in CSF increased the risk by 100 times (p < 0.001). MS patients that were older than 50 years were more likely to exhibit positive Babinski’s reflex (χ2 = 6.993, p = 0.03), decreased muscle strength (χ2 = 13.481, p = 0.001), ataxia (χ2 = 8.135, p = 0.017), and diminished sense of vibration and proprioception (χ2 = 7.918, p = 0.019) in comparison with both younger age groups. Conclusions: Diminished sense of vibration and proprioception, spinal cord MRI lesions, positive OCBs and pathological BAEP test findings were more common among patients that developed MS. Diminished sense of vibration and proprioception along with positive CSF OCBs are predictors of CIS progressing to MS. Older patients that develop MS have more symptoms in general, such as positive Babinski’s reflex, decreased muscle strength, ataxia, and diminished sense of vibration and proprioception.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Factors Related to the Progression of Clinically Isolated Syndrome to Multiple Sclerosis: A Retrospective Study in Lithuania

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Together with the onset of clinical symptoms, this can be used to diagnose MS. Previous studies have confirmed that patients presenting with CIS and abnormal MRI findings in baseline scans have higher risk for conversion to MS (Zhang and Hou, 2013) and this risk is associated with the number of lesions (Fisniku et al, 2008; Tintoré et al, 2006).…”

Section: Introductionmentioning

confidence: 85%

Predicting conversion from clinically isolated syndrome to multiple sclerosis–An imaging-based machine learning approach

Zhang

Alberts

Pongratz

et al. 2019

NeuroImage: Clinical

View full text Add to dashboard Cite

Magnetic resonance imaging (MRI) scans play a pivotal role in the evaluation of patients presenting with a clinically isolated syndrome (CIS), as these may depict brain lesions suggestive of an inflammatory cause. We hypothesized that it is possible to predict the conversion from CIS to multiple sclerosis (MS) based on the baseline MRI scan by studying image features of these lesions. We analyzed 84 patients diagnosed with CIS from a prospective observational single center cohort. The patients were followed up for at least three years. Conversion to MS was defined according to the 2010 McDonald criteria. Brain lesions were segmented based on 3D FLAIR and 3D T1 images. We generated brain lesion masks by a computer assisted manual segmentation. We also generated a set of automated segmentations using the Lesion Segmentation Toolbox for SPM to assess the influence of different segmentation methods. Shape and brightness features were automatically calculated from the segmented masks and used as input data to train an oblique random forest classifier. Prediction accuracies of the resulting model were validated through a three-fold cross-validation. Conversion from CIS to MS occurred in 66 of 84 patients (79%). The conversion or non-conversion was predicted correctly in 71 patients based on shape features derived from the computer assisted manual segmentation masks (84.5% accuracy). This predictor was more accurate than predicting conversion using dissemination in space at baseline according to the 2010 McDonald criteria (75% accuracy). While shape features strongly contributed to the accuracy of the predictor, including intensity features did not further improve performance. As patients who convert to definite MS benefit from early treatment, an early classification model is highly desirable. Our study shows that shape parameters of lesions can contribute to predicting the future course of CIS patients more accurately.

show abstract

“…La RMN es la herramienta de pronóstico más utilizada, ya que la presencia de lesiones desmielinizantes sugestivas de EM sería un factor de riesgo. La localización de las mismas también es importante, ya que si se presentan en región infratentorial, la posibilidad de progresar a EM es mayor que si estuvieran en otro sitio (10)(11) . La búsqueda de BOC en LCR ha sido destacado a la hora de determinar la posibilidad de conversión de SCA a EM con alta sensibilidad y especificidad (12)(13) .…”

Section: Discussionunclassified

Presentación clínica de primer evento desmielinizante en pediatría

Sbruzzi

Nasif

Coloski

et al. 2023

Rev Fac Cien Med Univ Nac Cordoba

View full text Add to dashboard Cite

Introducción: El síndrome Clínico Aislado (SCA) hace referencia al primer evento clínico con características sugestivas de esclerosis múltiple (EM). Caso clínico: Se comunica el caso de un paciente masculino de 8 años previamente sano internado por alteración de la marcha con sospecha de mielitis transversa. Se realiza RMN medular donde se evidencia lesión en D3-D5 hiperintensa en T2. Recibe tratamiento con corticoterapia endovenosa y con resultado de bandas oligoclonales en suero y LCR se realiza diagnóstico de SCA. Conclusión: El objetivo es describir una forma poco frecuente de manifestación de enfermedad desmielinizante en la edad pediátrica y valorar la importancia del diagnóstico y tratamiento oportuno.

show abstract

Prognostic value of magnetic resonance imaging in patients with clinically isolated syndrome conversion to multiple sclerosis: A meta-analysis

Cited by 8 publications

References 24 publications

Factors Related to the Progression of Clinically Isolated Syndrome to Multiple Sclerosis: A Retrospective Study in Lithuania

Factors Related to the Progression of Clinically Isolated Syndrome to Multiple Sclerosis: A Retrospective Study in Lithuania

Predicting conversion from clinically isolated syndrome to multiple sclerosis–An imaging-based machine learning approach

Presentación clínica de primer evento desmielinizante en pediatría

Contact Info

Product

Resources

About