Oligoclonal bands increase the specificity of MRI criteria to predict multiple sclerosis in children with radiologically isolated syndrome

Naila Makhani (1, 2) , Christine Lebrun (3) , Aksel Siva (4) , Sona Narula (5) , Evangeline Wassmer (6) , David Brassat (7) , J Nicholas Brenton (8) , Philippe Cabre (9) , Clarisse Carra Dallière (10) , Jérôme de Seze (11) , Francoise Durand Dubief (12) , Matilde Inglese (13, 14) , Megan Langille (15) , Guillaume Mathey (16) , Rinze Neuteboom (17) , Jean Pelletier (18, 19, 20) , Daniela Pohl (21) , Daniel Reich (22) , Juan Ignacio Rojas (23) , Veronika Shabanova (1) , Eugene Shapiro (24) , Robert Stone (25) , Silvia Tenembaum (26) , Mar Tintoré (27) , Ugur Uygunoglu (4) , Wendy Vargas (28) , Sunita Venkateswaren (21) , Patrick Vermersch (29) , Orhun Kantarci (30) , Darin Okuda (31) , Daniel Pelletier (32)

1 Department of Pediatrics, Yale University School of Medicine
2 Department of Neurology, Yale University School of Medicine
3 CRCSEP Nice Hopital Pasteur
4 University of Istanbul, Cerrahpasa School of Medicine
5 Children's Hospital of Philadelphia, University of Pennsylvania
6 Department of Neurology, The Birmingham Children's Hospital NHS Trust
7 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
8 Department of Neurology, University of Virginia
9 Centre Hospitalo Universitaire Fort de France
10 CHU Montpellier - Centre Hospitalier Universitaire de Montpellier
11 Centre Hospitalo Universitaire Strasbourg
12 Centre Hospitalo-Universitaire de Lyon
13 Department of Neurology and Neuroscience, Icahn School of Medicine
14 Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, (DINOGMI) University of Genova and IRCCS
15 Harbor UCLA Medical Center [Torrance, Ca.]
16 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
17 Department of Pediatric Neurology, Sophia's Children's Hospital
18 AP-HM, CHU Timone, Pole de Neurosciences Cliniques, Department of Neurology, Marseille, France.
19 CRMBM - Centre de résonance magnétique biologique et médicale
20 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - AP-HM]
21 Division of Neurology, Children's Hospital of Eastern Ontario
22 Translational Neuroradiology Section, National Institutes of Health
23 Multiple Sclerosis Center of Buenos Aires, Hospital Italiano de Buenos Aires
24 Department of Pediatrics, Yale University School of Medicine, USA and Yale School of Public Health
25 Department of Neurology, University of Rochester Medical Center
26 Department of Neurology, National Pediatric Hospital Dr Juan P Garrahan
27 MS Center of Catalunya Cemcat
28 Department of Pediatric Neurology, Columbia University Medical Center
29 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
30 Department of Neurology, Mayo Clinic College of Medicine
31 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center
32 Department of Neurology, Keck School of Medicine of University of Southern California

Background Steps towards the development of diagnostic criteria are needed for children with the radiologically isolated syndrome to identify children at risk of clinical demyelination. Objectives To evaluate the 2005 and 2016 MAGNIMS magnetic resonance imaging criteria for dissemination in space for multiple sclerosis, both alone and with oligoclonal bands in cerebrospinal fluid added, as predictors of a first clinical event consistent with central nervous system demyelination in children with radiologically isolated syndrome. Methods We analysed an international historical cohort of 61 children with radiologically isolated syndrome (≤18 years), defined using the 2010 magnetic resonance imaging dissemination in space criteria (Ped-RIS) who were followed longitudinally (mean 4.2 ± 4.7 years). All index scans also met the 2017 magnetic resonance imaging dissemination in space criteria. Results Diagnostic indices (95% confidence intervals) for the 2005 dissemination in space criteria, with and without oligoclonal bands, were: sensitivity 66.7% (38.4–88.2%) versus 72.7% (49.8–89.3%); specificity 83.3% (58.6–96.4%) versus 53.9% (37.2–69.9%). For the 2016 MAGNIMS dissemination in space criteria diagnostic indices were: sensitivity 76.5% (50.1–93.2%) versus 100% (84.6–100%); specificity 72.7% (49.8–89.3%) versus 25.6% (13.0–42.1%). Conclusions Oligoclonal bands increased the specificity of magnetic resonance imaging criteria in children with Ped-RIS. Clinicians should consider testing cerebrospinal fluid to improve diagnostic certainty. There is rationale to include cerebrospinal fluid analysis for biomarkers including oligoclonal bands in planned prospective studies to develop optimal diagnostic criteria for radiologically isolated syndrome in children.

Domains: Life Sciences [q-bio]; Human health and pathology

Naila Makhani, Christine Lebrun, Aksel Siva, Sona Narula, Evangeline Wassmer, et al.. Oligoclonal bands increase the specificity of MRI criteria to predict multiple sclerosis in children with radiologically isolated syndrome. Multiple Sclerosis Journal - Experimental, Translational and Clinical, 2019, 5 (1), pp.205521731983666. ⟨10.1177/2055217319836664⟩. ⟨hal-03541917⟩