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Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review.

Rahn, AC; Köpke, S; Stellmann, J-P; Schiffmann, I; Lukas, C; Chard, D; Heesen, C; (2018) Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review. [Review]. Acta Neurol Scand 10.1111/ane.13010. (In press). Green open access

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Abstract

Magnetic resonance imaging (MRI) is the key prognostic tool in people with a clinically isolated syndrome (CIS). There is increasing interest in treating people following a CIS in the hope that conversion to multiple sclerosis (MS) will be prevented and future disability reduced. So far, the prognostic value of MRI for disability following a CIS has not been evaluated systematically. We systematically searched MEDLINE and EMBASE. Cohort studies were selected if they reported associations of MRI and disability following a CIS, included at least 50 people with a CIS at baseline, had at least 5 years of follow-up and obtained at least one structural MRI measurement (T1 lesions, T2 lesions, T1 contrast enhancing lesions or brain atrophy). We assessed the studies for quality and rated the completeness of MRI reporting. In total, 13 studies were identified reporting on the following: T2 lesion number and volume, T2 infratentorial lesion number and volume, T1 contrast enhancing lesions and grey matter fraction. T2 brain lesion number determined soon after the occurrence of a CIS was associated with disability progression after 5 - 7 years, with an increased risk when 10 or more lesions were present. Infratentorial lesions were also associated with a higher risk of subsequent disability. The number and distribution of MRI-visible lesions soon after a CIS is associated with disability later on, and may offer additional useful information when making treatment decisions in people with early MS. Further work is required to determine if other measures have a higher predictive potential. This article is protected by copyright. All rights reserved.

Type: Article
Title: Magnetic resonance imaging as a prognostic disability marker in clinically isolated syndrome: A systematic review.
Location: Denmark
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ane.13010
Publisher version: https://doi.org/10.1111/ane.13010
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: MRI, Clinically isolated syndrome, disability, multiple sclerosis, prognosis, systematic review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10054328
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