Evidence map›Paper›PMID 42538767›Full record

SynthesisEuropean journal of neurology2026

Predictors of Multiple Sclerosis After Clinically Isolated Syndrome: A Systematic Review and Meta-Analysis.

María Paula Zafra-Sierra, Carolina Ferreira-Atuesta, Daniela Sofía Rodríguez, Jairo Gaitán, Susana Otero, Mar Tintoré, Fred Lublin, Gavin Giovannoni, Jaime Toro, Saúl Reyes

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

María Paula Zafra-SierraDepartment of Neurology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.ORCID https://orcid.org/0000-0002-7793-0703
Carolina Ferreira-AtuestaDepartment of Neurology, University Hospital Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0003-0853-7163
Daniela Sofía RodríguezDepartment of Neurology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.ORCID https://orcid.org/0000-0002-2246-5883
Jairo GaitánSchool of Medicine, Universidad de los Andes, Bogotá, Colombia.
Susana OteroMultiple Sclerosis Centre of Catalonia (Cemcat), Vall D'hebron Barcelona Hospital, Barcelona, Spain.
Mar TintoréMultiple Sclerosis Centre of Catalonia (Cemcat), Vall D'hebron Barcelona Hospital, Barcelona, Spain.ORCID https://orcid.org/0000-0001-9999-5359
Fred LublinThe Corinne Goldsmith Dickinson Center for Multiple Sclerosis and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Gavin GiovannoniBlizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0001-9995-1700
Jaime ToroDepartment of Neurology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.ORCID https://orcid.org/0000-0001-7129-0058
Saúl ReyesDepartment of Neurology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.ORCID https://orcid.org/0000-0002-3230-3263

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMost people with multiple sclerosis (MS) present with a clinically isolated syndrome (CIS); however, not all individuals with CIS are subsequently diagnosed with MS.

methodsA systematic literature review was conducted until December 2025. Observational studies of adults with CIS that were later diagnosed with MS were included. Odds ratios (ORs) were pooled using random-effects meta-analysis. Heterogeneity was assessed with I

resultsSeventy-two studies with 9915 adults were included. In the meta-analysis, younger age (OR = 1.6, p < 0.01) and multifocal presentation (OR = 1.55, p = 0.02) were associated with a diagnosis of MS after a CIS. Magnetic resonance imaging findings, including a higher number of T2 lesions (OR = 7.46, p = 0.02), periventricular lesions (OR = 4.08, p < 0.01), corpus callosum lesions (OR = 14.89, p = 0.02), infratentorial lesions (OR = 2.16, p = 0.03), spinal cord lesions (OR = 1.4, p = 0.03), and gadolinium-enhancing lesions (OR = 1.91, p = 0.01), as well as cerebrospinal fluid inflammatory markers such as oligoclonal bands (OR = 3.57, p < 0.01) and pleocytosis (OR = 3.34, p = 0.02), were also associated with a subsequent diagnosis of MS.

conclusionsThis meta-analysis identified factors associated with an increased likelihood of MS after a CIS. These findings may help identify high-risk individuals and guide personalized treatment strategies.

Indexed as

Demyelinating DiseasesMultiple SclerosisHumansMagnetic Resonance Imagingclinically isolated syndromemultiple sclerosisprogressionrisk factors

Identifiers

PMID42538767
PMCPMC13428175

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.