SavedAdd your journal

Journals / Nöropsikiyatri Arşivi / 2018 / Cilt: 55 - Sayı: 1

Prediction of Conversion from Clinically Isolated Syndrome to Multiple Sclerosis According to Baseline Characteristics: A Prospective Study

Klinik İzole Sendromdan Multipl Skleroza Dönüşümü Temel Özelliklere Bağlı Olarak Öngörebilme

Serkan ÖZAKBAŞ
Bilge PİRİ ÇINAR
Pages
15–21
Publication Date
2022-10-19
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In terms of localization, presence of callosal lesion (71.4%),periventricular lesion (97.1%), Gd-enhanced lesion (48.6%), black hole(54.2%) and brainstem lesion (57.1%) was statistically significant in termsof conversion to MS.Conclusion: A carefully performed neurological assessment ofsymptoms and signs, and evaluation of lesions on MR combined withCSF findings are important for identifying the risk of conversion to MS.This information may be useful when considering treatment in CISpatients instead of waiting for conversion to MS.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Clinically isolated syndrome (CIS) is a clinical state thatproceeds with inflammation and demyelination, suggestive of multiplesclerosis (MS) in the central nervous system in the absence of otheralternative diagnoses.
📊
Key Findings & Data:A greater presenceof oligoclonal bands in CSF was identified in the converted group(92.8%).
💡
Conclusion & Impact:In terms of localization, presence of callosal lesion (71.4%),periventricular lesion (97.1%), Gd-enhanced lesion (48.6%), black hole(54.2%) and brainstem lesion (57.1%) was statistically significant in termsof conversion to MS.Conclusion: A carefully performed neurological assessment ofsymptoms and signs, and evaluation of lesions on MR combined withCSF findings are important for identifying the risk of conversion to MS.This information may be useful when considering treatment in CISpatients instead of waiting for conversion to MS.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: Clinically isolated syndrome (CIS) is a clinical state thatproceeds with inflammation and demyelination, suggestive of multiplesclerosis (MS) in the central nervous system in the absence of otheralternative diagnoses. The purpose of this study was to determine ina prospective cohort, the predictor factors in conversion from CISto MS on the basis of clinical, magnetic resonance (MR) imaging andcerebrospinal fluid (CSF) findings.Methods: Forty-one CIS patients were included in this study andfollowed up for at least two years.Results: Clinically, polysymptomatic or sensorial involvement, goodprognostic factors and complete response to pulse therapy were foundto be of prognostic value in conversion to MS. A greater presenceof oligoclonal bands in CSF was identified in the converted group(92.8%). In terms of localization, presence of callosal lesion (71.4%),periventricular lesion (97.1%), Gd-enhanced lesion (48.6%), black hole(54.2%) and brainstem lesion (57.1%) was statistically significant in termsof conversion to MS.Conclusion: A carefully performed neurological assessment ofsymptoms and signs, and evaluation of lesions on MR combined withCSF findings are important for identifying the risk of conversion to MS.This information may be useful when considering treatment in CISpatients instead of waiting for conversion to MS.

Özet

Amaç: Klinik izole sendrom, diğer alternatif tanıların yokluğunda multipl sklerozu (MS) düşündüren, santral sinir sisteminin inflamasyonu ve demiyelinizasyonu ile giden bir klinik durumdur. Bu çalışmada amacımız; klinik izole sendrom (KİS)’dan MS’e dönüşümü etkileyen öngörü etmenlerini klinik, MR görüntüleme ve beyin omurilik sıvısı (BOS) bulguları temelinde tanımlamaktır. Yöntem: Çalışmaya 41 KİS hastası alındı ve en az iki yıl süreyle takip edildi. Bulgular: Klinik olarak, polisemptomatik ve duyusal tutulum, iyi prognostik faktörler ve puls tedaviye tam yanıtın, MS’e dönüşümde prognostik değere sahip oldukları bulundu. BOS’ta oligoklonal bant (OKB) varlığı, MS’e dönen grupta daha fazla saptandı (%92,8). Beyinde lezyon lokalizasyonları incelendiğinde; korpus kallosum (%71,4), periventriküler lezyon (%97,1), beyin sapında lezyonu varlığı (%57,1), kara delik (%54,2) ve kontrast tutan lezyon varlığı (%48,6), MS’e dönüşümde anlamlı olarak değerlendirilmiştir. Sonuç: Hastanın semptom ve bulgularının nörolojik değerlendirmesinin dikkatlice yapılması ve MR’daki lezyonların ve BOS bulgularının değerlendirilmesi, KİS’ten MS’e dönüşüm riskinin tanımlanmasında oldukça önemlidir. Bu bilgiler, KİS hastalarında MS’e dönüşümü beklemeden tedavi planlanmasında kullanılabilir.

🔖

Cite This Article

ÖZAKBAŞ, S., ÇINAR, B. P. (2022). Prediction of Conversion from Clinically Isolated Syndrome to Multiple Sclerosis According to Baseline Characteristics: A Prospective Study. Nöropsikiyatri Arşivi, Cilt: 55 - Sayı: 1, 15–21. https://ajindex.com/articles/584697

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (3)

  1. Brex PA, O’Riordan JI, Miszkiel KA, Moseley IF, Thompson AJ, Plant GT, Miller DH. Multisequence MRI in clinically isolated syndromes and the early development of MS. Neurology 1999;53;1184–1190.
  2. Miller D, Barkhof F, Montalban X, Thompson A, Filippi M. Clinically isolated syndromes suggestive of multiple sclerosis, part I. natural history, pathogenesis, diagnosis, and prognosis. Lancet Neurol 2005;4:281–288. [CrossRef] Jacobi C, Hähnel S, Martinez-Torres F, Rieger S, Jüttler E, Heiland S, Jarius S, Meyding-Lamadè U, Storch-Hagenlocher B, Wildemann B. Prospective combined brain and spinal cord MRI in clinically isolated syndromes and possible early multiple sclerosis: impact on dissemination in space and time. Eur J Neurol 2008;15:1359–1364. [CrossRef] Noseworthy JH, Lucchinetti C, Rodrı´guez M, Weinshenker BG. Multiple sclerosis. N Engl J Med 2000;343:938–952. [CrossRef] Jacobs LD, Beck RW, Simon JH, Kinkel RP, Brownscheidle CM, Murray TJ, Simonian NA, Slasor PJ, Sandrock AW. Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. CHAMPS Study Group. N Engl J Med 2000;343:898–904. [CrossRef] Kappos L, Polman CH, Freedman MS, Edan G, Hartung HP, Miller DH, Montalban X, Barkhof F, Bauer L, Jakobs P, Pohl C, Sandbrink R. Treatment with interferon beta-1b delays conversion to clinically definite MS in clinically isolated syndromes. Neurology 2006;67:1242–1249. [CrossRef] Miller D, Barkhof F, Montalban X, Thompson A, Filippi M. Clinically isolated syndromes suggestive of multiple sclerosis, part 2: non-conventional MRI, recovery processes, and management. Lancet Neurol 2005;4:341–348. [CrossRef] McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001;50:121–127.
  3. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O’Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Critera”. Ann Neurol 2005;58:840–846. [CrossRef] Brex PA, Ciccarelli O, O’Riordan JI, Sailer M, Thompson AJ, Miller DH. A longitudinal study of abnormalities on MRI and disability from multiple sclerosis. N Engl