Journal ArticleDOI
New diagnostic criteria for multiple sclerosis: guidelines for research protocols.
Charles M. Poser,Donald W. Paty,Labe C. Scheinberg,W I McDonald,F A Davis,George C. Ebers,Kenneth P. Johnson,William A. Sibley,Donald H. Silberberg,Wallace W. Tourtellotte +9 more
TLDR
Today there is a need for more exact criteria than existed earlier in order to conduct therapeutic trials in multicenter programs, to compare epidemiological surveys, to evaluate new diagnostic procedures, and to estimate the activity of the disease process in MS.Abstract:
Several schemes for the diagnosis and clinical classification of multiple sclerosis (MS) have been advanced [l}. The best known is that published by Schumacher et alC31. The criteria for this scheme were established in order to select patients for participation in therapeutic trials, and pertain only to what might be called definite MS. No provision was made for incorporating supportive laboratory data into the diagnostic criteria. As no reliable specific laboratory test for the diagnosis of MS has been discovered, the diagnosis remains a clinical one, and there is still a need for clinical diagnostic criteria. However, several laboratory and clinical procedures have been developed within the last decade which aid greatly in demonstrating neurological dysfunction attributable to lesions, and even the lesions themselves. One problem with the various published diagnostic classifications is their discrepant terminology: what is considered “probable” in one is called “definite” in another. Another problem is that all the proposed schemes require much subjective judgment, a difficulty which cannot be completely overcome but can be diminished by adding to the clinical evaluation the results of laboratory, neuroimaging, neuropsychological, and neurophysiological procedures. Today there is a need for more exact criteria than existed earlier in order to conduct therapeutic trials in multicenter programs, to compare epidemiological surveys, to evaluate new diagnostic procedures, and to estimate the activity of the disease process in MS. Method and Procedureread more
Citations
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Journal ArticleDOI
Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria
Chris H. Polman,Stephen C. Reingold,Brenda Banwell,Michel Clanet,Jeffrey A. Cohen,Massimo Filippi,Kazuo Fujihara,Eva Havrdova,Michael Hutchinson,Ludwig Kappos,Fred D. Lublin,Xavier Montalban,Paul L. O’Connor,Magnhild Sandberg-Wollheim,Alan J. Thompson,Emmanuelle Waubant,Brian G. Weinshenker,Jerry S. Wolinsky +17 more
TL;DR: These revisions simplify the McDonald Criteria, preserve their diagnostic sensitivity and specificity, address their applicability across populations, and may allow earlier diagnosis and more uniform and widespread use.
Journal ArticleDOI
Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
W. Ian McDonald,A Compston,Gilles Edan,Donald E. Goodkin,Hans-Peter Hartung,Fred D. Lublin,Henry F. McFarland,Donald W. Paty,Chris H. Polman,Stephen C. Reingold,Magnhild Sandberg-Wollheim,William A. Sibley,Alan J. Thompson,Stanley van den Noort,Brian Y. Weinshenker,Jerry S. Wolinsky +15 more
TL;DR: The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including “monosymptomatic” disease suggestive of MS, disease with a typical relapsing‐remitting course, and disease with insidious progression, without clear attacks and remissions.
Journal ArticleDOI
Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria
Alan J. Thompson,Brenda Banwell,Frederik Barkhof,Frederik Barkhof,William M. Carroll,Timothy Coetzee,Giancarlo Comi,Jorge Correale,Franz Fazekas,Massimo Filippi,Mark S. Freedman,Kazuo Fujihara,Steven L. Galetta,Hans-Peter Hartung,Ludwig Kappos,Fred D. Lublin,Ruth Ann Marrie,Aaron E. Miller,David Miller,Xavier Montalban,Xavier Montalban,Ellen M. Mowry,Per Soelberg Sørensen,Mar Tintoré,Anthony Traboulsee,Maria Trojano,Bernard M. J. Uitdehaag,Sandra Vukusic,Sandra Vukusic,Emmanuelle Waubant,Brian G. Weinshenker,Stephen C. Reingold,Jeffrey A. Cohen +32 more
TL;DR: The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation.
Journal ArticleDOI
Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination.
Claudia F. Lucchinetti,Wolfgang Brück,Joseph E. Parisi,Bernd W. Scheithauer,Moses Rodriguez,Hans Lassmann +5 more
TL;DR: At a given time point of the disease, the patterns of demyelination were heterogeneous between patients, but were homogenous within multiple active lesions from the same patient, suggesting that MS may be a disease with heterogeneous pathogenetic mechanisms.
Journal ArticleDOI
A serum autoantibody marker of neuromyelitis optica : distinction from multiple sclerosis
Vanda A. Lennon,Dean M. Wingerchuk,Thomas J. Kryzer,Sean J. Pittock,C. F. Lucchinetti,Kazuo Fujihara,Ichiro Nakashima,Brian G. Weinshenker +7 more
TL;DR: NMO-IgG is a specific marker autoantibody of neuromyelitis optica and binds at or near the blood-brain barrier that distinguishes neuromyleitis opticas from multiple sclerosis.
References
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Journal ArticleDOI
Problems of experimental trials of therapy in multiple sclerosis: report by the panel on the evaluation of experimental trials of therapy in multiple sclerosis.
George A. Schumacher,Gilbert Beebe,Robert F. Kibler,Leonard T. Kurland,John F. Kurtzke,Fletcher McDowell,Benedict Nagler,William A. Sibley,Wallace W. Tourtellotte,Thomas L. Willmon +9 more
TL;DR: Since its etiology and pathogenesis have eluded detection, it is not surprising that therapeutic attempts have been empiric and often unscientific.
Journal ArticleDOI
The design of clinical studies to assess therapeutic efficacy in multiple sclerosis.
Joe R. Brown,Gilbert W. Beebe,John F. Kurtzke,Ruth B. Loewenson,Donald H. Silberberg,Wallace W. Tourtellotte +5 more
TL;DR: The diagnosis, clinical course, and definitions of the stages of MS are discussed as they relate to trials of therapy, and specific strategies and design considerations be applied to preliminary, pilot, and full trials.
Book
The Diagnosis of multiple sclerosis
TL;DR: The Diagnosis of multiple sclerosis is described in detail in the book “Diagnosis of Multiple Sclerosis: A Beginner’s Guide” (2003).
Related Papers (5)
Rating neurologic impairment in multiple sclerosis An expanded disability status scale (EDSS)
Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
Defining the clinical course of multiple sclerosis Results of an international survey
Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria
Chris H. Polman,Stephen C. Reingold,Brenda Banwell,Michel Clanet,Jeffrey A. Cohen,Massimo Filippi,Kazuo Fujihara,Eva Havrdova,Michael Hutchinson,Ludwig Kappos,Fred D. Lublin,Xavier Montalban,Paul L. O’Connor,Magnhild Sandberg-Wollheim,Alan J. Thompson,Emmanuelle Waubant,Brian G. Weinshenker,Jerry S. Wolinsky +17 more