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[Radiologically isolated syndrome: prognosis and predictors of conversion to multiple sclerosis]
A R Kabaeva1, A N Boyko1,2, O G Kulakova1,3
1Pirogov Russian National Research Medical University, Moscow, Russia.
Abstract:
Increased sensitivity and availability of magnetic resonance imaging (MRI) in neurological routine practice led to the fact that more and more experts began to encounter changes typical for multiple sclerosis (MS) according to MRI in the absence of anamnestic and clinical indications of damage to the central nervous system (CNS). This nosological form has been defined as a radiologically isolated syndrome (RIS). More and more RIS cases convert to MS (up to 30% in the first 5 years after RIS diagnosis). At the moment, there are no biological markers that allow combining RIS and MS into one pathological process and early treatment with disease-modifying drugs (DMT). Prospective studies are actively being conducted to identify demographic, clinical, neuroimaging and biochemical conversion predictors. The identification of the molecular biological RIS features, combining these changes with MS, is an urgent scientific task and will allow timely initiation of therapy of the pathological process already at the subclinical stage.
Insights
Radiologically isolated syndrome (RIS) shows MRI changes without symptoms, with up to 30% converting to multiple sclerosis (MS). Identifying biomarkers could enable early treatment for this early-stage neurological condition.
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- Increased MRI sensitivity reveals brain changes typical of multiple sclerosis (MS) without clinical symptoms, termed radiologically isolated syndrome (RIS).
- A significant proportion of RIS cases (up to 30% within 5 years) progress to clinically definite MS.
- Current diagnostic limitations prevent early intervention with disease-modifying therapies (DMTs) for RIS patients.
Purpose of the Study:
- To investigate predictors for the conversion of RIS to MS.
- To identify molecular biological features that link RIS and MS.
- To enable early therapeutic intervention at the subclinical stage of the disease.
Main Methods:
- Prospective studies are underway to analyze demographic, clinical, neuroimaging, and biochemical data.
- Ongoing research focuses on identifying specific molecular markers associated with RIS.
- Comparative analysis between RIS and MS patient cohorts is being conducted.
Main Results:
- RIS is increasingly diagnosed due to advanced MRI technology.
- Conversion rates from RIS to MS highlight the need for predictive markers.
- The absence of established biological markers hinders early treatment initiation.
Conclusions:
- RIS represents a pre-clinical stage of MS, necessitating further research into its underlying pathology.
- Identifying biomarkers is crucial for distinguishing between benign findings and early MS.
- Timely initiation of DMTs based on identified predictors could alter the disease course.
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