Related Experiment Video
Updated: Jul 8, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Unexpected multiple sclerosis: follow-up of 30 patients with magnetic resonance imaging and clinical conversion
C Lebrun1, C Bensa, M Debouverie
1Neurology, CHU de Nice, France. lebrun.c@chu-nice.fr
Abstract:
The concept of preclinical multiple sclerosis is now well recognised, and a diagnosis of silent brain T2 lesions is frequent because of the ease of performing MRI. Nevertheless, patients with incidental brain MRI fulfilling Barkhof- Tintoré criteria are more rare. We report a descriptive retrospective study of clinical and 5 year MRI follow-up in patients with subclinical demyelinating lesions fulfilling MRI Barkhof-Tintoré criteria with a normal neurological examination. 30 patients were identified and the first brain MRI was performed for various medical events: headaches (n = 14), migraine with (n = 2) or without (n = 4) aura, craniocerebral trauma (n = 3), depression (n = 3), dysmenorrhoea (n = 2), epilepsy (n = 1) and cognitive changes (n = 1). Mean time for the second brain MRI was 6 months (range 3-30). 23 patients had temporospatial dissemination (eight with gadolinium enhancement). 11 patients had clinical conversion: optic neuritis (n = 5), brainstem (n = 3), sensitive symptoms (n = 2) and cognitive deterioration (n = 1). Eight (72%) already had criteria of dissemination to space and time before the clinical event. Mean time between the first brain MRI and clinically isolated syndrome (CIS) was 2.3 years. To our knowledge, this is the first cohort of CIS with preclinical follow-up. Early treatment should be discussed in view of the predictive value on conversion of the MRI burden of the disease.
Insights
Preclinical multiple sclerosis (MS) patients with MRI lesions meeting Barkhof-Tintoré criteria often convert to clinically isolated syndrome (CIS). Early treatment may be beneficial given MRI
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- Preclinical multiple sclerosis (MS) is increasingly recognized, with silent brain T2 lesions frequently detected via MRI.
- Identifying patients with incidental MRI findings meeting Barkhof-Tintoré criteria is less common.
Purpose of the Study:
- To describe the clinical and 5-year MRI follow-up of patients with subclinical demyelinating lesions fulfilling Barkhof-Tintoré criteria and normal neurological exams.
- To assess the conversion rate and time to clinically isolated syndrome (CIS) in this cohort.
Main Methods:
- Retrospective descriptive study of 30 patients with incidental MRI findings meeting Barkhof-Tintoré criteria.
- Analysis of clinical data and 5-year serial brain MRI follow-up, including gadolinium enhancement.
- Tracking of neurological examination findings and conversion to CIS events.
Main Results:
- 23 out of 30 patients showed evidence of temporospatial dissemination on MRI, with 8 having gadolinium enhancement.
- 11 patients experienced clinical conversion to CIS, including optic neuritis, brainstem, sensitive symptoms, and cognitive deterioration.
- The mean time from the first MRI to CIS was 2.3 years, with 72% already showing dissemination criteria before clinical onset.
Conclusions:
- This study presents the first cohort of CIS patients with preclinical MRI follow-up.
- The high rate of conversion and early dissemination suggests a potential role for early treatment discussions.
- MRI burden of disease is a valuable predictor for conversion to clinically evident MS.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:24Magnetic Resonance Imaging