The radiologically isolated syndrome: revised diagnostic criteria

Christine Lebrun-Frénay; Darin Okuda; Aksel Siva; Cassandre Landes-Chateau; Christina Azevedo; Lydiane Mondot; Clarisse Carra-Dallière; Helene Zephir; Celine Louapre; Françoise Durand-Dubief; Emmanuelle Le Page; Caroline Bensa; Aurélie Ruet; Jonathan Ciron; David Laplaud; Olivier Casez; Guillaume Mathey; Jerome de Seze; Burcu Zeydan; Naila Makhani; Melih Tutuncu; Michael Levraut; Mikael Cohen; Eric Thouvenot; Daniel Pelletier; Orhun Kantarci; Sabrina Sehaki; Nathalie Devys-Meyer; Mathieu Bereau; Chrystelle Cappe; Bruno Brochet; Jean-Christophe Ouallet; Katy-Kim Kounkou; Gilles Defer; Pierre Branger; Frédéric Taithe; Emilie Dumont; Edwige Lescieux; Agnès Fromont; Alexia Protin; Maty Diop Kane; Patrick Hautecoeur; Olivier Outteryck; Patrick Vermersch; Julie Boucher; Julie Petit; Irène Tabellah Kasonde; Aymeric de Vilmarrest; Laurent Magy; Marie Nicol; Muriel Malbezin; Javier Olaiz; Claire Rigaud-Bully; Nadine Debard; Sandra Vukusic François Cotton; Iuliana Ionescu; Amalle Abdelalli; Jean Pelletier; Bertrand Audoin; Adil Maarouf; Bernadette Di Lelio; Xavier Ayrignac; Pierre Labauge; Frédéric Pinna; Francis Guillemin; Marc Debouverie; Amandine Ziegler; Sandrine Wiertlevski; Saskia Bresch; Céline Callier; Elodie David; Giovanni Castelnovo; Caroline Papeix; Elisabeth Maillart; Catherine Lubetzki; Karima Zehrouni; Bertrand Fontaine; Claire Giannesini; Jérôme Hodel; Abir Wahab; Mickaël Zedet; Ombeline Fagniez; Clémence Laage; Corinne Pottier; Iuliana Slesari; Mathilde Sampaio; Emilie Rabois; Cédric Castex; Benjamin Hebant; Maxime Guillaume; Christine Vimont; Olivier Gout; Antoine Guegen; Laure Michel; Romain Muraz; Damien Le Port; Emmanuelle Leray; Carole Henry; Thomas de Broucker; Nicolas Collongues; Carole Berthe; Damien Biotti; Noellie Freitas; Vincent Visneux; Mélanie Forestier; Stéphane Beltran; Géraldine Meunier; Jérôme Servan; Fernando Pico; Virginie Chatagner; Fatai Radji; Nathalie Morel; Deborah Grosset-Jeannin; Aurelian Ungureanu; Latine Boyer; Laurent Suchet; Christine Lebrun-Frenay; Orhun Kantarci; Aksel Siva; Daniel Pelletier; Christina Azevedo; Naila Makhani; Darin Okuda

doi:10.1093/brain/awad073

Journal Articles Brain - A Journal of Neurology Year : 2023

The radiologically isolated syndrome: revised diagnostic criteria

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Christine Lebrun-Frénay

Function : Author
PersonId : 770285
ORCID : 0000-0002-3713-2416
IdRef : 074517929

Centre Hospitalier Universitaire de Nice

Université Côte d'Azur

Unité de Recherche Clinique de la Côte d’Azur

Darin Okuda

Function : Author
PersonId : 1235106
ORCID : 0000-0002-6499-1523

University of Texas Southwestern Medical Center [Dallas]

Aksel Siva

Function : Author

Cerrahpasa Faculty of Medicine

Cassandre Landes-Chateau

Function : Author

Centre Hospitalier Universitaire de Nice

Université Côte d'Azur

Unité de Recherche Clinique de la Côte d’Azur

Christina Azevedo

Function : Author

University of Southern California

Lydiane Mondot

Function : Author

Centre Hospitalier Universitaire de Nice

Université Côte d'Azur

Unité de Recherche Clinique de la Côte d’Azur

Clarisse Carra-Dallière

Function : Author

Centre Hospitalier Régional Universitaire [Montpellier]

Helene Zephir

Function : Author

Centre Hospitalier Régional Universitaire [CHU Lille]

Lille Neurosciences & Cognition - U 1172

Celine Louapre

Function : Author

CHU Pitié-Salpêtrière [AP-HP]

Sorbonne Université

Françoise Durand-Dubief

Function : Author
PersonId : 172702
IdHAL : francoise-durand-dubief
ORCID : 0000-0002-2860-1700
IdRef : 15778911X

Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]

Emmanuelle Le Page

Function : Author

Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]

Centre d'Investigation Clinique [Rennes]

Caroline Bensa

Function : Author

Fondation Ophtalmologique Adolphe de Rothschild [Paris]

Aurélie Ruet

Function : Author

Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale

CHU Bordeaux

Jonathan Ciron

Function : Author
PersonId : 795646
ORCID : 0000-0002-3386-6308
IdRef : 137599021

Institut Toulousain des Maladies Infectieuses et Inflammatoires

Centre Hospitalier Universitaire de Toulouse

David Laplaud

Function : Author

CIC Plurithématique de Nantes

Centre Hospitalier Universitaire de Nantes = Nantes University Hospital

Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology

Olivier Casez

Function : Author

Groupe de Recherche et d’Étude du Processus Inflammatoire

Centre Hospitalier Universitaire [CHU Grenoble]

Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525

Guillaume Mathey

Function : Author

Centre Hospitalier Régional Universitaire de Nancy

Adaptation, mesure et évaluation en santé. Approches interdisciplinaires

Jerome de Seze

Function : Author

Centre Hospitalier Universitaire [Strasbourg]

CIC Strasbourg

Burcu Zeydan

Function : Author
PersonId : 1235107
ORCID : 0000-0002-2270-9868

Mayo Clinic [Rochester]

Naila Makhani

Function : Author

Yale School of Medicine [New Haven, Connecticut]

Melih Tutuncu

Function : Author

Cerrahpasa Faculty of Medicine

Michael Levraut

Function : Author

Centre Hospitalier Universitaire de Nice

Université Côte d'Azur

Unité de Recherche Clinique de la Côte d’Azur

Mikael Cohen

Function : Author

Centre Hospitalier Universitaire de Nice

Université Côte d'Azur

Unité de Recherche Clinique de la Côte d’Azur

Eric Thouvenot

Function : Author

Service de Neurologie [CHU Nimes]

Institut de Génomique Fonctionnelle

Daniel Pelletier

Function : Author

University of Southern California

Orhun Kantarci

Function : Author

Mayo Clinic [Rochester]

Sabrina Sehaki

Function : Author

Nathalie Devys-Meyer

Function : Author

Mathieu Bereau

Function : Author

Chrystelle Cappe

Function : Author

Bruno Brochet

Function : Author

Jean-Christophe Ouallet

Function : Author

Katy-Kim Kounkou

Function : Author

Gilles Defer

Function : Author

Pierre Branger

Function : Author

Frédéric Taithe

Function : Author

Emilie Dumont

Function : Author

Edwige Lescieux

Function : Author

Agnès Fromont

Function : Author

Alexia Protin

Function : Author

Maty Diop Kane

Function : Author

Patrick Hautecoeur

Function : Author

Olivier Outteryck

Function : Author

Patrick Vermersch

Function : Author

Julie Boucher

Function : Author

Julie Petit

Function : Author

Irène Tabellah Kasonde

Function : Author

Aymeric de Vilmarrest

Function : Author

Laurent Magy

Function : Author

Marie Nicol

Function : Author

Muriel Malbezin

Function : Author

Javier Olaiz

Function : Author

Claire Rigaud-Bully

Function : Author

Nadine Debard

Function : Author

Sandra Vukusic François Cotton

Function : Author

Iuliana Ionescu

Function : Author

Amalle Abdelalli

Function : Author

Jean Pelletier

Function : Author

Bertrand Audoin

Function : Author

Adil Maarouf

Function : Author

Bernadette Di Lelio

Function : Author

Xavier Ayrignac

Function : Author

Pierre Labauge

Function : Author

Frédéric Pinna

Function : Author

Francis Guillemin

Function : Author

Marc Debouverie

Function : Author

Amandine Ziegler

Function : Author

Sandrine Wiertlevski

Function : Author

Saskia Bresch

Function : Author

Céline Callier

Function : Author

Elodie David

Function : Author

Giovanni Castelnovo

Function : Author

Caroline Papeix

Function : Author

Elisabeth Maillart

Function : Author

Catherine Lubetzki

Function : Author

Karima Zehrouni

Function : Author

Bertrand Fontaine

Function : Author

Claire Giannesini

Function : Author

Jérôme Hodel

Function : Author

Abir Wahab

Function : Author

Mickaël Zedet

Function : Author

Ombeline Fagniez

Function : Author

Clémence Laage

Function : Author

Corinne Pottier

Function : Author

Iuliana Slesari

Function : Author

Mathilde Sampaio

Function : Author

Emilie Rabois

Function : Author

Cédric Castex

Function : Author

Benjamin Hebant

Function : Author

Maxime Guillaume

Function : Author

Christine Vimont

Function : Author

Olivier Gout

Function : Author

Antoine Guegen

Function : Author

Laure Michel

Function : Author

Romain Muraz

Function : Author

Damien Le Port

Function : Author

Emmanuelle Leray

Function : Author
PersonId : 18386
IdHAL : emmanuelle-leray
ORCID : 0000-0001-8424-4499
IdRef : 099858185

Carole Henry

Function : Author

Thomas de Broucker

Function : Author

Nicolas Collongues

Function : Author

Carole Berthe

Function : Author

Damien Biotti

Function : Author

Noellie Freitas

Function : Author

Vincent Visneux

Function : Author

Mélanie Forestier

Function : Author

Stéphane Beltran

Function : Author

Géraldine Meunier

Function : Author

Jérôme Servan

Function : Author

Fernando Pico

Function : Author

Virginie Chatagner

Function : Author

Fatai Radji

Function : Author

Nathalie Morel

Function : Author
PersonId : 1212233
IdHAL : nathaliemorelcea
ORCID : 0000-0002-3223-2071

Deborah Grosset-Jeannin

Function : Author

Aurelian Ungureanu

Function : Author

Latine Boyer

Function : Author

Laurent Suchet

Function : Author

Christine Lebrun-Frenay

Function : Author

Orhun Kantarci

Function : Author

Aksel Siva

Function : Author

Daniel Pelletier

Function : Author

Christina Azevedo

Function : Author

Naila Makhani

Function : Author

Darin Okuda

Function : Author

Abstract

The radiologically isolated syndrome (RIS) was defined in 2009 as the presence of asymptomatic, incidentally identified demyelinating-appearing white matter lesions in the CNS within individuals lacking symptoms typical of multiple sclerosis (MS). The RIS criteria have been validated and predict the transition to symptomatic MS reliably. The performance of RIS criteria that require fewer MRI lesions is unknown. 2009-RIS subjects, by definition, fulfil three to four of four criteria for 2005 dissemination in space (DIS) and subjects fulfilling only one or two lesions in at least one 2017 DIS location were identified within 37 prospective databases. Univariate and multivariate Cox regression models were used to identify predictors of a first clinical event. Performances of different groups were calculated. Seven hundred and forty-seven subjects (72.2% female, mean age 37.7 ± 12.3 years at the index MRI) were included. The mean clinical follow-up time was 46.8 ± 45.4 months. All subjects had focal T2 hyperintensities suggestive of inflammatory demyelination on MRI; 251 (33.6%) fulfilled one or two 2017 DIS criteria (designated as Groups 1 and 2, respectively), and 496 (66.4%) fulfilled three or four 2005 DIS criteria representing 2009-RIS subjects. Group 1 and 2 subjects were younger than the 2009-RIS group and were more likely to develop new T2 lesions over time (P < 0.001). Groups 1 and 2 were similar regarding survival distribution and risk factors for transition to MS. At 5 years, the cumulative probability for a clinical event was 29.0% for Groups 1 and 2 compared to 38.7% for 2009-RIS (P = 0.0241). The presence of spinal cord lesions on the index scan and CSF-restricted oligoclonal bands in Groups 1-2 increased the risk of symptomatic MS evolution at 5 years to 38%, comparable to the risk of development in the 2009-RIS group. The presence of new T2 or gadolinium-enhancing lesions on follow-up scans independently increased the risk of presenting with a clinical event (P < 0.001). The 2009-RIS subjects or Groups 1 and 2 with at least two of the risk factors for a clinical event demonstrated better sensitivity (86.0%), negative predictive value (73.1%), accuracy (59.8%) and area under the curve (60.7%) compared to other criteria studied. This large prospective cohort brings Class I evidence that subjects with fewer lesions than required in the 2009 RIS criteria evolve directly to a first clinical event at a similar rate when additional risk factors are present. Our results provide a rationale for revisions to existing RIS diagnostic criteria.

Keywords

MRI diagnostic criteria multiple sclerosis prognosis radiologically isolated syndrome

Domains

Human health and pathology Neuroscience

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Lebrun-Frénay et al-2023-The radiologically isolated syndrome.pdf (2.7 Mo)

Leb_awad073_supplementary_data.pdf (825.08 Ko)

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https://hal.science/hal-04020134

Submitted on : Thursday, March 30, 2023-1:44:58 PM

Last modification on : Tuesday, April 30, 2024-2:12:02 PM

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hal-04020134 , version 1 (30-03-2023)

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HAL Id : hal-04020134 , version 1
DOI : 10.1093/brain/awad073
PUBMED : 36864688

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Christine Lebrun-Frénay, Darin Okuda, Aksel Siva, Cassandre Landes-Chateau, Christina Azevedo, et al.. The radiologically isolated syndrome: revised diagnostic criteria. Brain - A Journal of Neurology , 2023, 146 (8), pp.3431-3443. ⟨10.1093/brain/awad073⟩. ⟨hal-04020134⟩

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The radiologically isolated syndrome: revised diagnostic criteria

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