ArticleAnnals of clinical and translational neurology2024
Improving criteria for dissemination in space in multiple sclerosis by including additional regions.
Article in Annals of clinical and translational neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- AI-Based Classification of Multiple Sclerosis Using OCT Retinal Layer Thickness Across Two Centers.Biomedicines · 2026Article
- Subclinical Optic Nerve Involvement in Radiologically Isolated Syndrome: Multimodal Detection and Diagnostic Impact.Annals of clinical and translational neurology · 2026Article
- Understanding Further the Phenotypic Spectrum of Central Nervous System Inflammatory Demyelinating Disorders Using Unsupervised Clustering.Annals of clinical and translational neurology · 2026Article
- Diagnostic performance of the 2010, 2017, and 2024 McDonald criteria: clinical implications in multiple sclerosis.Journal of neurology · 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
- The epidemiology, pathology and pathogenesis of MS: Therapeutic implications.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Added value of optic nerve lesions for multiple sclerosis diagnostic criteria.Journal of neurology · 2025Article
- Investigating Whether Dissemination in Time Is Essential to Diagnose Relapsing Multiple Sclerosis.Neurology · 2025Article
- From demyelination to neurodegeneration in multiple sclerosis: reassessing the role of visual evoked potential P100-N145 amplitudes: a missing piece of the puzzle?Frontiers in neurology · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectiveWe investigated the effects of adding regions to current dissemination in space (DIS) criteria for multiple sclerosis (MS).
methodsParticipants underwent brain, optic nerve, and spinal cord MRI. Baseline DIS was assessed by 2017 McDonald criteria and versions including optic nerve, temporal lobe, or corpus callosum as a fifth region (requiring 2/5), a version with all regions (requiring 3/7) and optic nerve variations requiring 3/5 and 4/5 regions. Performance was evaluated against MS diagnosis (2017 McDonald criteria) during follow-up.
resultsEighty-four participants were recruited (53F, 32.8 ± 7.1 years). 2017 McDonald DIS criteria were 87% sensitive (95% CI: 76-94), 73% specific (50-89), and 83% accurate (74-91) in identifying MS. Modified criteria with optic nerve improved sensitivity to 98% (91-100), with specificity 33% (13-59) and accuracy 84% (74-91). Criteria including temporal lobe showed sensitivity 94% (84-98), specificity 50% (28-72), and accuracy 82% (72-90); criteria including corpus callosum showed sensitivity 90% (80-96), specificity 68% (45-86), and accuracy 85% (75-91). Criteria adding all three regions (3/7 required) had sensitivity 95% (87-99), specificity 55% (32-76), and accuracy 85% (75-91). When requiring 3/5 regions (optic nerve as the fifth), sensitivity was 82% (70-91), specificity 77% (55-92), and accuracy 81% (71-89); with 4/5 regions, sensitivity was 56% (43-69), specificity 95% (77-100), and accuracy 67% (56-77).
interpretationOptic nerve inclusion increased sensitivity while lowering specificity. Increasing required regions in optic nerve criteria increased specificity and decreased sensitivity. Results suggest considering the optic nerve for DIS. An option of 3/5 or 4/5 regions preserved specificity, and criteria adding all three regions had highest accuracy.
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