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Prognostic Factors for Multiple Sclerosis Symptoms in Radiologically Isolated Syndrome
Nicolás Fissolo1,2, Sabine Schaedelin3,4,5, Luisa M Villar6
1Servei de Neurologia and Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain.
Identifying risk factors for multiple sclerosis (MS) symptoms in people with radiologically isolated syndrome (pwRIS) is crucial. Biomarkers like oligoclonal bands and neurofilament light chain, along with environmental factors, significantly predict MS symptom development.
Area of Science:
- Neurology
- Immunology
- Biomarker Discovery
Background:
- Radiologically isolated syndrome (RIS) is a precursor to multiple sclerosis (MS).
- Understanding prognostic factors for symptom development in people with RIS (pwRIS) is vital for early intervention.
- Current stratification methods require refinement to predict MS onset accurately.
Purpose of the Study:
- To identify prognostic factors at RIS diagnosis associated with the development of MS symptoms.
- To enhance the stratification of pwRIS for tailored management strategies.
Main Methods:
- A multi-center cohort study including 273 pwRIS diagnosed between 2004 and 2022.
- Analysis of body fluid biomarkers (oligoclonal bands, neurofilament light chain) and environmental factors (UV exposure).
- Utilized univariable and multivariable Cox proportional hazards models to assess risk factors.
Main Results:
- 37% of pwRIS developed MS symptoms during a median 5-year follow-up.
- Immunoglobulin G and M oligoclonal bands, elevated kappa free light chain index, and high neurofilament light chain levels (CSF and serum) were associated with increased MS risk.
- High anti-cytomegalovirus titers and significant UV radiation exposure were associated with reduced MS risk.
Conclusions:
- Specific biomarkers and environmental factors at RIS diagnosis can predict MS symptom development.
- These findings enable more effective risk stratification and personalized management for pwRIS.
- Further research into protective factors like UV exposure may offer novel therapeutic avenues.
