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Sensitivity and specificity of 2017 McDonald criteria for multiple sclerosis in patients with clinically isolated syndrome
Author(s): ,
F. Gobbin
Affiliations:
AOUI Verona | Neurologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
,
A. Marangi
Affiliations:
AOUI Verona | Neurologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
,
R. Orlandi
Affiliations:
AOUI Verona | Neurologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
,
S. Monaco
Affiliations:
AOUI Verona | Neurologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
,
M.D. Benedetti
Affiliations:
AOUI Verona | Neurologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
A. Gajofatto
Affiliations:
AOUI Verona | Neurologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
ECTRIMS Online Library. Gobbin F.
Oct 12, 2018; 228814
Francesca Gobbin
Francesca Gobbin
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Abstract: P972

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis

Introduction: In 2017 the McDonald criteria for multiple sclerosis (MS) diagnosis were revised in order to update them based on the most recent medical evidence. According to the revised criteria, symptomatic and cortical lesions on MRI can be used to demonstrate dissemination in space and time (DIS and DIT). In addition, the presence of cerebrospinal fluid (CSF)-specific oligoclonal bands allows a diagnosis of MS in patients fulfilling DIS requirements at any time. The purpose of our study is to evaluate and compare the sensitivity and specificity of 2017 McDonald criteria and 2010 McDonald criteria in patients presenting with a clinically isolated syndrome (CIS).
Methods: To do this we included patients with a first demyelinating event suggestive of MS (i.e. CIS) who were followed at Verona University Hospital MS Centre up to April 2018. Inclusion criteria were: CIS onset after 2007; no more than 12 months between onset of symptoms and first clinical evaluation at study Centre; brain and spinal cord MRI with gadolinium and CSF analysis for oligoclonal bands performed within 9 months from onset; follow up brain MRI less than 24 months from onset. Study patients data were retrospectively collected from available database and medical records. Fulfilment of 2010 and 2017 McDonald criteria was assessed for each patient using baseline MRI to demonstrate DIS and both baseline and follow-up MRI plus CSF analysis to demonstrate DIT. Sensitivity and specificity of diagnostic criteria were calculated using conversion to clinically definite MS (CDMS) as the gold standard.
Results: As of April 2018, 55 eligible patients were included. Of these 33 were female (60%). Median age at onset was 30 years (range 34-38). Onset location was optic nerve in 2 patients, brainstem/cerebellum in 11, cerebral hemisphere in 14, and spinal cord in 28. Median follow up time was 51 months (38-81).Twenty-six patients (47.3%) converted to CDMS. 2010 McDonald criteria showed a sensitivity of 80.8% (95% confidence interval: 60.7-93.5%) and a specificity of 44.8% (26.5-64.3%). 2017 McDonald criteria had 100% (86.8-100%) sensitivity and 13.8% (3.9-31.7%) specificity.
Discussion: the preliminary data of our study show that 2017 McDonald criteria substantially increase sensitivity for MS diagnosis in CIS patients, compared to McDonald 2010 criteria. However, the revised criteria seem to significantly reduce specificity.
Disclosure: Gobbin Francesca: nothing to disclose
Marangi Antonio: nothing to disclose
Orlandi Riccardo: nothing to disclose
Monaco Salvatore: nothing to disclose
Benedetti Maria Donata: nothing to disclose
Gajofatto Alberto: nothing to disclose

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