TY - JOUR
T1 - Diagnosis of multiple sclerosis
T2 - 2017 revisions of the McDonald criteria
AU - Thompson, Alan J.
AU - Banwell, Brenda L.
AU - Barkhof, Frederik
AU - Carroll, William M.
AU - Coetzee, Timothy
AU - Comi, Giancarlo
AU - Correale, Jorge
AU - Fazekas, Franz
AU - Filippi, Massimo
AU - Freedman, Mark S.
AU - Fujihara, Kazuo
AU - Galetta, Steven L.
AU - Hartung, Hans Peter
AU - Kappos, Ludwig
AU - Lublin, Fred D.
AU - Marrie, Ruth Ann
AU - Miller, Aaron E.
AU - Miller, David H.
AU - Montalban, Xavier
AU - Mowry, Ellen M.
AU - Sorensen, Per Soelberg
AU - Tintoré, Mar
AU - Traboulsee, Anthony L.
AU - Trojano, Maria
AU - Uitdehaag, Bernard M.J.
AU - Vukusic, Sandra
AU - Waubant, Emmanuelle
AU - Weinshenker, Brian G.
AU - Reingold, Stephen C.
AU - Cohen, Jeffrey A.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. 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. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.
AB - The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. 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. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.
UR - http://www.scopus.com/inward/record.url?scp=85038826113&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S1474-4422(17)30470-2
DO - https://doi.org/10.1016/S1474-4422(17)30470-2
M3 - Review article
SN - 1474-4422
VL - 17
SP - 162
EP - 173
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 2
ER -