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Pàgina inicial > Articles > Articles publicats > Lesion topographies in multiple sclerosis diagnosis |
Data: | 2017 |
Resum: | To assess the contributions of cortico-juxtacortical and corpus callosum lesions to multiple sclerosis diagnosis and to compare the value of ≥1 vs ≥3 periventricular lesions in clinically isolated syndromes (CIS). Step 1: We evaluated lesion topography classifications in 657 patients with CIS with stepwise Cox proportional hazards regression models considering second attack as the outcome. Step 2: We established 2 dissemination in space (DIS) versions according to the periventricular lesion cutoffs of ≥1 and ≥3 and assessed their performance at 10 years with second attack as the outcome, first individually and then combined with dissemination in time (DIT) in all cases (n = 326), by age, and by CIS topography. Step 1: The models (hazard ratios [95% confidence interval]) favored ≥1 over ≥3 periventricular lesions (2. 5 [1. 7-3. 6]) and cortico-juxtacortical over juxtacortical lesions (1. 4 [1. 0-1. 8]). Callosal lesions were not selected. Step 2: DIS specificity with ≥1 periventricular lesions was slightly lower than with ≥3 (59. 1 vs 61. 4) and the same after adding DIT (88. 6). Regarding age, ≥3 periventricular lesions improved DIS specificity over ≥1 lesions in the 40-49 years of age bracket (66. 7 vs 58. 3). This difference disappeared when adding DIT (83. 3). Optic neuritis had a similar pattern when evaluating CIS topographies. Our results comply with the Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) consensus recommendation of combining cortical and juxtacortical lesions into a single term when possible. Concerning periventricular lesions, maintaining the current ≥1 cutoff in the McDonald criteria does not compromise specificity in typical CIS cases, but attention should be paid to older patients or optic neuritis cases. |
Ajuts: | Ministerio de Economía y Competitividad FIS/PI14-01439 Ministerio de Economía y Competitividad FIS/CM10-00032 Ministerio de Economía y Competitividad FIS/RD07-0060 Ministerio de Economía y Competitividad FIS/RD12-0032 Agència de Gestió d'Ajuts Universitaris i de Recerca 2009/SGR-0793 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-1082 |
Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. |
Llengua: | Anglès |
Document: | Article de revisió ; Article ; Versió publicada |
Publicat a: | Neurology, Vol. 89 (december 2017) , p. 2351-2356, ISSN 1526-632X |
6 p, 152.3 KB |