Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Alan J Thompson; Brenda L Banwell; Frederik Barkhof; William M Carroll; Timothy Coetzee; Giancarlo Comi; Jorge Correale; Franz Fazekas; Massimo Filippi; Mark S Freedman; Kazuo Fujihara; Steven L Galetta; Hans Peter Hartung; Ludwig Kappos; Fred D Lublin; Ruth Ann Marrie; Aaron E Miller; David H Miller; Xavier Montalban; Ellen M Mowry; Per Soelberg Sorensen; Mar Tintoré; Anthony L Traboulsee; Maria Trojano; Bernard M J Uitdehaag; Sandra Vukusic; Emmanuelle Waubant; Brian G Weinshenker; Stephen C Reingold; Jeffrey A Cohen

doi:10.1016/S1474-4422(17)30470-2

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Alan J Thompson, Brenda L Banwell, Frederik Barkhof, William M Carroll, Timothy Coetzee, Giancarlo Comi, Jorge Correale, Franz Fazekas, Massimo Filippi, Mark S Freedman, Kazuo Fujihara, Steven L Galetta, Hans Peter Hartung, Ludwig Kappos, Fred D Lublin, Ruth Ann Marrie, Aaron E Miller, David H Miller, Xavier Montalban, Ellen M MowryPer Soelberg Sorensen, Mar Tintoré, Anthony L Traboulsee, Maria Trojano, Bernard M J Uitdehaag, Sandra Vukusic, Emmanuelle Waubant, Brian G Weinshenker, Stephen C Reingold, Jeffrey A Cohen

Department of Clinical Medicine

1528 Citations (Scopus)

Abstract

The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

Original language	English
Journal	Lancet Neurology
Volume	17
Issue number	2
Pages (from-to)	162-173
ISSN	1474-4422
DOIs	https://doi.org/10.1016/S1474-4422(17)30470-2
Publication status	Published - Feb 2018

Keywords

Adult
Aged
Cerebral Cortex/pathology
Demyelinating Diseases/diagnosis
Humans
Magnetic Resonance Imaging
Middle Aged
Multiple Sclerosis/diagnosis
Multiple Sclerosis, Relapsing-Remitting/diagnostic imaging
Neurologic Examination
Oligoclonal Bands/cerebrospinal fluid
Spinal Cord/pathology

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10.1016/S1474-4422(17)30470-2

Cite this

Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., Correale, J., Fazekas, F., Filippi, M., Freedman, M. S., Fujihara, K., Galetta, S. L., Hartung, H. P., Kappos, L., Lublin, F. D., Marrie, R. A., Miller, A. E., Miller, D. H., Montalban, X., ... Cohen, J. A. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurology, 17(2), 162-173. https://doi.org/10.1016/S1474-4422(17)30470-2

Thompson, AJ, Banwell, BL, Barkhof, F, Carroll, WM, Coetzee, T, Comi, G, Correale, J, Fazekas, F, Filippi, M, Freedman, MS, Fujihara, K, Galetta, SL, Hartung, HP, Kappos, L, Lublin, FD, Marrie, RA, Miller, AE, Miller, DH, Montalban, X, Mowry, EM, Sorensen, PS, Tintoré, M, Traboulsee, AL, Trojano, M, Uitdehaag, BMJ, Vukusic, S, Waubant, E, Weinshenker, BG, Reingold, SC & Cohen, JA 2018, 'Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria', Lancet Neurology, vol. 17, no. 2, pp. 162-173. https://doi.org/10.1016/S1474-4422(17)30470-2

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title = "Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria",

abstract = "The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.",

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AU - Carroll, William M

AU - Coetzee, Timothy

AU - Comi, Giancarlo

AU - Correale, Jorge

AU - Fazekas, Franz

AU - Filippi, Massimo

AU - Freedman, Mark S

AU - Fujihara, Kazuo

AU - Galetta, Steven L

AU - Hartung, Hans Peter

AU - Kappos, Ludwig

AU - Lublin, Fred D

AU - Marrie, Ruth Ann

AU - Miller, Aaron E

AU - Miller, David H

AU - Montalban, Xavier

AU - Mowry, Ellen M

AU - Sorensen, Per Soelberg

AU - Tintoré, Mar

AU - Traboulsee, Anthony L

AU - Trojano, Maria

AU - Uitdehaag, Bernard M J

AU - Vukusic, Sandra

AU - Waubant, Emmanuelle

AU - Weinshenker, Brian G

AU - Reingold, Stephen C

AU - Cohen, Jeffrey A

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N2 - The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

AB - The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

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KW - Aged

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KW - Demyelinating Diseases/diagnosis

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KW - Multiple Sclerosis/diagnosis

KW - Multiple Sclerosis, Relapsing-Remitting/diagnostic imaging

KW - Neurologic Examination

KW - Oligoclonal Bands/cerebrospinal fluid

KW - Spinal Cord/pathology

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VL - 17

SP - 162

EP - 173

JO - Lancet Neurology

JF - Lancet Neurology

IS - 2

ER -

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Abstract

Keywords

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