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Primary Progressive Multiple Sclerosis Evolving From Radiologically Isolated Syndrome.

Orhun H Kantarci1, Christine Lebrun2, Aksel Siva3

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|November 25, 2015
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Summary
This summary is machine-generated.

Radiologically isolated syndrome (RIS) can progress to primary progressive multiple sclerosis (PPMS) in a manner similar to general multiple sclerosis populations. Male sex and spinal cord lesions in the preprogressive phase predict this evolution.

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Area of Science:

  • Neurology
  • Neuroimmunology
  • Radiology

Background:

  • Radiologically isolated syndrome (RIS) is a condition characterized by white matter lesions suggestive of multiple sclerosis (MS) but without clinical symptoms.
  • Understanding the evolution of RIS is crucial for predicting disease course and developing early interventions.

Purpose of the Study:

  • To investigate the preprogressive phase of radiologically isolated syndrome (RIS) in individuals who develop primary progressive multiple sclerosis (PPMS).
  • To compare the characteristics of RIS patients evolving to PPMS with those developing a relapsing disease course and with established PPMS cohorts.

Main Methods:

  • A multicenter cohort of RIS subjects was analyzed.
  • Demographic, clinical, and radiological data were compared between RIS subjects who evolved to PPMS, those who developed a relapsing course (clinically isolated syndrome [CIS] or relapsing-remitting MS), and PPMS cohorts.

Main Results:

  • Of 453 RIS subjects, 15 (3.3%) evolved to PPMS, with a prevalence comparable to general PPMS populations.
  • Evolution to PPMS occurred more frequently in men and at older ages compared to those developing CIS/MS.
  • The presence of spinal cord lesions before symptomatic onset was significantly higher in those who evolved to PPMS (100%) compared to CIS/MS (64%) and asymptomatic individuals (23%).

Conclusions:

  • RIS progresses to PPMS at an age-dependent rate consistent with general MS epidemiology.
  • Male sex and the presence of spinal cord lesions during the preprogressive phase are predictors of PPMS evolution from RIS.
  • These findings support the concept that RIS is an early manifestation within the spectrum of multiple sclerosis.