When Quiet Brain Scans Lead to MS Labels

The body may start an immune attack in the brain before a person feels sick. MRI scans and spinal fluid tests can show this. The 2024 versions of the McDonald criteria did something new. They let some people with radiologically isolated syndrome get an MS diagnosis. This was only for chosen cases. The study wanted to know how often that change happened.

Grown ups aged 18 and older took part. They had to meet the 2023 Lebrun Frenay criteria. The study drew from 22 Italian MS centers. It used real world registry information. It looked at the start and later times. The 2024 rules allowed an MS label with two typical brain regions. It also needed spread over time. Or a positive spinal fluid test. Or a positive central vein sign.

The group had 236 people with RIS. Their average age was 38.9. The typical person was 39. About 70.3 percent were women. The middle follow up time was 3 years. The interquartile range was 1.1 to 6. At the start, 228 people, or 96.6 percent, had signs in two regions. 51 people, or 21.6 percent, had spread over time. Of 201 people with spinal fluid data, 152 were positive. That was 75.6 percent. Five people had central vein sign data. None were positive. The 2024 rules led to an MS diagnosis for 159 people. That was 67.4 percent.

During follow up, 42 people had a clinical event. Doctors would have given an MS diagnosis about two years sooner. The middle time was two years. Later, 18 more people met the rules through spread over time. The study used real world data from many centers.