ArticleNeurology2016
The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study.
Abstract readMulticenter Study
In one paragraph
Article in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
129citing papers in PubMed, 2 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
129 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap.Journal of neurology · 2022Pooled it
- The "Central Vein Sign" on T2*-weighted Images as a Diagnostic Tool in Multiple Sclerosis: A Systematic Review and Meta-analysis using Individual Patient Data.Scientific reports · 2019Pooled it
- Application of the 2024 McDonald Criteria: Earlier Diagnosis and Avoiding Misdiagnosis of Multiple Sclerosis in a Global Setting.Neurology · 2026Review
- Challenges and future directions for multiple sclerosis after the 2024 McDonald diagnostic criteria.Nature medicine · 2026Article
- Application of the 2024 McDonald Criteria in Individuals With Nonspecific Symptoms or Incidental Imaging Findings in a Multicenter Study.Neurology · 2026Observational
- Language Model Embedding Classifiers Enable Identification of Multiple Sclerosis-Associated BCRs and Repertoires.bioRxiv : the preprint server for biology · 2026Article
- Central Vein Sign and Paramagnetic Rim Lesions in Patients with Relapsing-Remitting Multiple Sclerosis: An Assessment of Prevalence and Anatomical Location.Neurology international · 2026Article
- Diagnosis of Multiple Sclerosis Using Multimodal Deep Learning Integrating Lesion and Normal-Appearing White Matter: A Retrospective Study with International Multicentre External Validation.medRxiv : the preprint server for health sciences · 2026Article
- When is the Radiologically Isolated Syndrome already Multiple Sclerosis According to the 2024 McDonald Criteria?Current neurology and neuroscience reports · 2026Review
- Neurodegeneration and energy depletion in MS: Links between tissue integrity loss and microvascular changes in white matter disease.Neuroimage. Reports · 2026Article
- Spino-cerebellar Ataxia 31 presenting as a demyelinating disease: a case report.Acta neurologica Belgica · 2026Article
- The evolution of disease criteria in multiple sclerosis: underlying motives and broader implications.BMC neurology · 2026Article
- Instrumented Timed Up and Go Test as a Tool to Early Detection of Gait and Functional Mobility Impairments in Multiple Sclerosis.Journal of clinical medicine · 2026Article
- Bridging the gap between guidelines and practice: neurologists' readiness for the updated McDonald criteria in Egypt.BMJ neurology open · 2026Article
- Evolving MS criteria and the interpretation of research.Therapeutic advances in neurological disorders · 2026Article
- The Value of Oligoclonal Bands in Multiple Sclerosis Compared to Other Neurological Disorders: A Retrospective Data Analysis From an Austrian Tertiary Center.European journal of neurology · 2025Article
- Current imaging applications, radiomics, and machine learning modalities of CNS demyelinating disorders and its mimickers.Journal of neurology · 2025Review
- Article
- Clinical Spectrum of Acquired Demyelinating Syndromes in Children: A Tertiary Hospital Experience.Neurology and therapy · 2025Article
- Diagnostic accuracy of inter-eye difference of ganglion cell layer alone in identifying optic neuritis in multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
69 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
24 authors.
Andrew J SolomonFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN. andrew.solomon@uvm.edu.
Dennis N BourdetteFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Anne H CrossFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Angela ApplebeeFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Philip M SkiddFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Diantha B HowardFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Rebecca I SpainFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Michelle H CameronFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Edward KimFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Michele K MassFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Vijayshree YadavFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Ruth H WhithamFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Erin E LongbrakeFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Robert T NaismithFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Gregory F WuFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Becky J ParksFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Dean M WingerchukFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Brian L RabinFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Michel ToledanoFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
W Oliver TobinFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Orhun H KantarciFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Jonathan L CarterFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
B Mark KeeganFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Brian G WeinshenkerFrom the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Funding
Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4MNCATS NIH HHS UL1 TR000448
Abstract
objectiveTo characterize patients misdiagnosed with multiple sclerosis (MS).
methodsNeurologists at 4 academic MS centers submitted data on patients determined to have been misdiagnosed with MS.
resultsOf 110 misdiagnosed patients, 51 (46%) were classified as "definite" and 59 (54%) "probable" misdiagnoses according to study definitions. Alternate diagnoses included migraine alone or in combination with other diagnoses 24 (22%), fibromyalgia 16 (15%), nonspecific or nonlocalizing neurologic symptoms with abnormal MRI 13 (12%), conversion or psychogenic disorders 12 (11%), and neuromyelitis optica spectrum disorder 7 (6%). Duration of misdiagnosis was 10 years or longer in 36 (33%) and an earlier opportunity to make a correct diagnosis was identified for 79 patients (72%). Seventy-seven (70%) received disease-modifying therapy and 34 (31%) experienced unnecessary morbidity because of misdiagnosis. Four (4%) participated in a research study of an MS therapy. Leading factors contributing to misdiagnosis were consideration of symptoms atypical for demyelinating disease, lack of corroborative objective evidence of a CNS lesion as satisfying criteria for MS attacks, and overreliance on MRI abnormalities in patients with nonspecific neurologic symptoms.
conclusionsMisdiagnosis of MS leads to unnecessary and potentially harmful risks to patients. Misinterpretation and misapplication of MS clinical and radiographic diagnostic criteria are important contemporary contributors to misdiagnosis.
Indexed as
Diagnostic ErrorsAcademic Medical CentersBiomarkersClinical Trials as TopicFemaleHumansImmunomodulationMaleMiddle AgedMultiple SclerosisUnited StatesBiomarkers
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