Treatment Considerations in the Radiologically Isolated Syndrome

This review provides the reader with updated information needed to make an accurate diagnosis of radiologically isolated syndrome (RIS), discusses controversies and considerations related to therapeutic intervention in RIS, and summarizes ongoing clinical intervention trials.

Individuals with RIS lack clinical neurological symptoms but are at risk for the subsequent development of a first clinical neurological event consistent with a diagnosis of multiple sclerosis. There are two ongoing clinical intervention trials to determine whether disease-modifying treatments for multiple sclerosis can delay or prevent a first clinical event in individuals with RIS. If clinical trials demonstrate a beneficial effect of disease-modifying therapy, such interventions should be considered in individuals with RIS.