PMID- 28393349
OWN - NLM
STAT- MEDLINE
DCOM- 20180430
LR  - 20180430
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 136
IP  - 5
DP  - 2017 Nov
TI  - Multiple biomarkers improve the prediction of multiple sclerosis in clinically
      isolated syndromes.
PG  - 454-461
LID - 10.1111/ane.12761 [doi]
AB  - OBJECTIVES: Since its introduction, MRI had a major impact on the early and more 
      precise diagnosis of multiple sclerosis (MS), and the 2010 diagnostic criteria
      even allow a diagnosis to be made just after a single attack if stringent MRI
      criteria are met. Several other clinical and paraclinical markers have been
      reported to be associated with an increased risk of MS independently of MRI in
      patients with clinically isolated syndromes (CIS), but the incremental usefulness
      of adding them to the current criteria has not been evaluated. In this study, we 
      determined whether multiple biomarkers improved the prediction of MS in patients 
      with CIS in a real-world clinical practice. MATERIALS AND METHODS: This was a
      retrospective study involving patients with CIS admitted to our department
      between 2000 and 2013. We evaluated baseline clinical, MRI, neurophysiological,
      and cerebrospinal fluid (CSF) data. RESULTS: During follow-up (median, 7.2
      years), 127 of 243 participants (mean age, 31.6 years) developed MS. Cox
      proportional-hazards models adjusted for established MRI criteria, age at onset, 
      number of T1 lesions, and presence of CSF oligoclonal bands significantly
      predicted the risk of developing MS at 2 and 5 years. The use of multiple
      biomarkers led to 29% net reclassification improvement at 2 years (P<.001) and
      30% at 5 years (P<.001). CONCLUSIONS: The simultaneous addition of several
      biomarkers significantly improved the risk stratification for MS in patients with
      CIS beyond that of a model based only on established MRI criteria.
CI  - (c) 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Martinelli, V
AU  - Martinelli V
AUID- ORCID: http://orcid.org/0000-0002-5987-5739
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Dalla Costa, G
AU  - Dalla Costa G
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Messina, M J
AU  - Messina MJ
AD  - Department of Neurology, San Donato Hospital, Milan, Italy.
FAU - Di Maggio, G
AU  - Di Maggio G
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Sangalli, F
AU  - Sangalli F
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Moiola, L
AU  - Moiola L
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Rodegher, M
AU  - Rodegher M
AD  - Department of Neurology, San Donato Hospital, Milan, Italy.
FAU - Colombo, B
AU  - Colombo B
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Furlan, R
AU  - Furlan R
AD  - Institute of Experimental Neurology, San Raffaele Hospital, Milan, Italy.
FAU - Leocani, L
AU  - Leocani L
AD  - Institute of Experimental Neurophysiology, San Raffaele Hospital, Milan, Italy.
FAU - Falini, A
AU  - Falini A
AD  - Department of Neuroradiology, San Raffaele Hospital, Milan, Italy.
FAU - Comi, G
AU  - Comi G
AD  - Department of Neurology, San Raffaele Hospital, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20170409
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
RN  - 0 (Biomarkers)
SB  - IM
MH  - Adult
MH  - Age of Onset
MH  - Biomarkers/cerebrospinal fluid
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/cerebrospinal fluid/*diagnosis/diagnostic imaging
MH  - Proportional Hazards Models
OTO - NOTNLM
OT  - MRI
OT  - all clinical neurophysiology
OT  - cerebrospinal fluid
OT  - multiple sclerosis
OT  - prognosis
EDAT- 2017/04/11 06:00
MHDA- 2018/05/01 06:00
CRDT- 2017/04/11 06:00
PHST- 2017/03/07 00:00 [accepted]
PHST- 2017/04/11 06:00 [pubmed]
PHST- 2018/05/01 06:00 [medline]
PHST- 2017/04/11 06:00 [entrez]
AID - 10.1111/ane.12761 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2017 Nov;136(5):454-461. doi: 10.1111/ane.12761. Epub 2017 Apr
      9.