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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 
Abstract : 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.
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https://hal-amu.archives-ouvertes.fr/hal-03541917
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Submitted on : Tuesday, January 25, 2022 - 8:47:42 AM
Last modification on : Wednesday, September 28, 2022 - 5:43:44 AM

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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⟩

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