疑われる多発性硬化症の評価を受けている患者における2024年のマクドナルド基準のパフォーマンス
Wallace J Brownlee1,2, Davide Maccarrone1,3, Riccardo Nistri1,4
1Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, United Kingdom.
Neurology
|February 13, 2026
まとめ
2024年のマクドナルド基準は,2017年の基準と比較して,多発性硬化症 (MS) の早期かつより頻繁な診断を可能にします. この改訂された診断アプローチは,すべての年齢層で一貫したパフォーマンスを示しています.
科学分野:
- 神経学 神経学とは
- クリニカル診断士
背景:
- 2024年のマクドナルド基準は,多発性硬化症 (MS) の診断勧告を更新しています.
- これらの新しい基準を現実の臨床実務で検証することは不可欠です.
研究 の 目的:
- 2024 マクドナルド基準の適用と診断性能を評価する.
- MSの疑いのある患者の2024年の基準と2017年の基準を比較する.
主な方法:
- 2024年1月から12月の間に評価された,MSの疑いのある患者の遡及的分析.
- 2017年 (前向き) と2024年 (後向き) のマクドナルド基準の両方の適用.
- 2つの基準セットの間でMS診断率と診断までの時間の比較.
主要な成果:
- 2024年の基準では,2017年の基準よりも早く,多発性硬化症の患者が多く診断された (220人対172人当初,フォローアップでは237人対204人).
- 診断までの平均時間は,2024年基準 (40日 vs 84日) で著しく短縮されました.
- 2024年の基準は,高い感度 (92.6%) と正確性 (83.6%) を示したが,MS診断では中程度の特異性 (57.8%) を示した.
結論:
- 2024年のマクドナルド基準は,放射線学的に孤立した症候群を含む,早期かつより頻繁なMS診断を容易にする.
- 改訂された基準のパフォーマンスは,小児科および成人集団全体で一貫しています.
- 制限には,特定のバイオマーカーと視神経の評価に関するデータが欠けていることが含まれます.
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