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Radiologically isolated syndrome (RIS) is defined as the incidental finding of brain lesions typical of demyelination on MRI obtained for non-typical MS symptoms (eg, headaches) or other reasons (eg, as part of screening after a motor vehicle accident). The 2009 diagnostic criteria for RIS were mostly based on the 2005 McDonald criteria for MS. Since then, several revisions to the MS diagnostic criteria have been made. The most recent revisions are the 2017 revised McDonald criteria. Clinical trials showed that treating RIS (diagnosed based on the 2009 criteria) can significantly reduce progression to clinically definite MS. The current publication is a revision of the RIS diagnostic criteria to align with recent revisions of the diagnostic criteria for MS.
The revised evidence-based criteria will allow for an earlier diagnosis of RIS because the criteria now better align with the revised 2017 McDonald criteria. Furthermore, the new criteria emphasize the importance of CSF analysis and spinal cord imaging. These criteria will allow for a better selection of treatment candidates to delay or prevent the development of clinically definite MS.
The radiologically isolated syndrome (RIS) was defined in 2009 as the presence of asymptomatic, incidentally identified demyelinating-appearing white matter lesions in the central nervous system within individuals lacking symptoms typical of multiple sclerosis. 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.
The radiologically isolated syndrome: revised diagnostic criteria
Brain 2023 Mar 02;[EPub Ahead of Print], C Lebrun-Frénay, DT Okuda, A Siva, C Landes-Chateau, CJ Azevedo, L Mondot, C Carra-Dallière, H Zephir, C Louapre, F Durand-Dubief, E Le Page, C Bensa, A Ruet, J Ciron, DA Laplaud, O Casez, G Mathey, J de Seze, B Zeydan, N Makhani, M Tutuncu, M Levraut, M Cohen, E Thouvenot, D Pelletier, OH Kantarci