January 04, 2022; 98 (1) Research Article
Performance of the 2017 and 2010 Revised McDonald Criteria in Predicting MS Diagnosis After a Clinically Isolated Syndrome
A MAGNIMS Study
View ORCID ProfileMassimo Filippi, View ORCID ProfilePaolo Preziosa, Alessandro Meani, Gloria Dalla Costa, Sarlota Mesaros, Jelena Drulovic, Jovana Ivanovic, Alex Rovira, View ORCID ProfileMar Tintorè, Xavier Montalban, View ORCID ProfileOlga Ciccarelli, Wallace Brownlee, Katherine Miszkiel, Christian Enzinger, View ORCID ProfileMichael Khalil, View ORCID ProfileFrederik Barkhof, Eva M.M. Strijbis, Jette L. Frederiksen, View ORCID ProfileStig P. Cramer, Enrico Fainardi, Maria Pia Amato, Claudio Gasperini, View ORCID ProfileSerena Ruggieri, Vittorio Martinelli, Giancarlo Comi, View ORCID ProfileMaria A. Rocca, on behalf of the MAGNIMS Study Group
First published October 29, 2021, DOI: https://doi.org/10.1212/WNL.0000000000013016
Massimo Filippi
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Paolo Preziosa
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Alessandro Meani
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Gloria Dalla Costa
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Sarlota Mesaros
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Jelena Drulovic
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Jovana Ivanovic
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Alex Rovira
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Mar Tintorè
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Xavier Montalban
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Olga Ciccarelli
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Wallace Brownlee
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Katherine Miszkiel
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Christian Enzinger
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Michael Khalil
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Frederik Barkhof
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Eva M.M. Strijbis
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Jette L. Frederiksen
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Stig P. Cramer
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Enrico Fainardi
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Maria Pia Amato
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Claudio Gasperini
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Serena Ruggieri
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Vittorio Martinelli
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Giancarlo Comi
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Maria A. Rocca
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
From the Neuroimaging Research Unit, Division of Neuroscience (M.F., P.P., A.M., M.A.R.), Neurology Unit (M.F., P.P., M.A.R., V.M.), Neurorehabilitation Unit (M.F., G.D.C.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (M.F., G.D.C., G.C., M.A.R.), Milan, Italy; Clinic of Neurology, Faculty of Medicine (S.M., J.D., J.I.), University of Belgrade, Serbia; Section of Neuroradiology, Department of Radiology (A.R.), and Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia (M.T., X.M.), Hospital Universitari Vall d’Hebron, Barcelona, Spain; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (O.C., W.B., K.M.), UCL Institute of Neurology, London, UK; Department of Neurology (C.E., M.K.), Medical University of Graz, Austria; Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (E.M.M.S.), MS Center Amsterdam, Amsterdam Neuroscience Amsterdam UMC, location VUmc, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology (J.L.F.), and Department of Clinical Physiology, Nuclear Medicine and PET, FIU Unit (S.P.C.), Rigshospitalet Glostrup, University of Copenhagen; Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research (S.P.C.), Hvidovre Hospital, Denmark; Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” (E.F.), and Department of Neurofarba (M.P.A.), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (M.P.A.), Florence, Italy; and Department of Neurosciences (C.G., S.R.), San Camillo Forlanini Hospital, Rome, Italy.
Performance of the 2017 and 2010 Revised McDonald Criteria in Predicting MS Diagnosis After a Clinically Isolated Syndrome
A MAGNIMS Study
Massimo Filippi, Paolo Preziosa, Alessandro Meani, Gloria Dalla Costa, Sarlota Mesaros, Jelena Drulovic, Jovana Ivanovic, Alex Rovira, Mar Tintorè, Xavier Montalban, Olga Ciccarelli, Wallace Brownlee, Katherine Miszkiel, Christian Enzinger, Michael Khalil, Frederik Barkhof, Eva M.M. Strijbis, Jette L. Frederiksen, Stig P. Cramer, Enrico Fainardi, Maria Pia Amato, Claudio Gasperini, Serena Ruggieri, Vittorio Martinelli, Giancarlo Comi, Maria A. Rocca, on behalf of the MAGNIMS Study Group
Neurology Jan 2022, 98 (1) e1-e14; DOI: 10.1212/WNL.0000000000013016
Citation Manager Formats
Make Comment
See Comments
Downloads
768
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Background and Objectives To compare the performance of the 2017 revisions to the McDonald criteria with the 2010 McDonald criteria in establishing multiple sclerosis (MS) diagnosis and predicting prognosis in patients with clinically isolated syndrome (CIS) suggestive of MS.
Methods CSF examination and brain and spinal cord MRI obtained ≤5 months from CIS onset and a follow-up brain MRI acquired within 15 months from CIS onset were evaluated in 785 patients with CIS from 9 European centers. Date of second clinical attack and of reaching Expanded Disability Status Scale score (EDSS) ≥3.0, if they occurred, were also collected. Performance of the 2017 and 2010 McDonald criteria for dissemination in space (DIS), dissemination in time (DIT) (including oligoclonal bands assessment), and DIS plus DIT for predicting a second clinical attack (clinically definite MS [CDMS]) and EDSS ≥3.0 at follow-up was evaluated. Time to MS diagnosis for the different criteria was also estimated.
Results At follow-up (median 69.1 months), 406/785 patients with CIS developed CDMS. At 36 months, the 2017 DIS plus DIT criteria had higher sensitivity (0.83 vs 0.66), lower specificity (0.39 vs 0.60), and similar area under the curve values (0.61 vs 0.63). Median time to MS diagnosis was shorter with the 2017 vs the 2010 or CDMS criteria (2017 revision, 3.2; 2010 revision, 13.0; CDMS, 58.5 months). The 2 sets of criteria similarly predicted EDSS ≥3.0 milestone. Three periventricular lesions improved specificity in patients ≥45 years.
Discussion The 2017 McDonald criteria showed higher sensitivity, lower specificity, and similar accuracy in predicting CDMS compared to 2010 McDonald criteria, while shortening time to diagnosis of MS.
Classification of Evidence This study provides Class II evidence that the 2017 McDonald Criteria more accurately distinguish CDMS in patients early after a CIS when compared to the 2010 McDonald criteria.
Glossary
- aHR=
- adjusted hazard ratio;
- AUC=
- area under the curve;
- CDMS=
- clinically definite multiple sclerosis;
- CI=
- confidence interval;
- CIS=
- clinically isolated syndrome;
- DE=
- dual-echo;
- DIR=
- double inversion recovery;
- DIS=
- dissemination in space;
- DIT=
- dissemination in time;
- DMT=
- disease-modifying treatment;
- EDSS=
- Expanded Disability Status Scale;
- FLAIR=
- fluid-attenuated inversion recovery;
- Gd=
- gadolinium;
- MS=
- multiple sclerosis;
- OCB=
- oligoclonal band;
- STIR=
- short tau inversion recovery;
- WM=
- white matter
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
MAGNIMS Study Group coinvestigators are listed in the appendix at the end of the article.
Editorial, page 12
Class of Evidence: NPub.org/coe
- Received March 8, 2021.
- Accepted in final form September 30, 2021.
- © 2021 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
No comments have been published for this article.
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
