A Comparison of the Validity of the McDonald Diagnostic Criteria for Multiple Sclerosis 2005 vs 2010 in the Clinical Practice

Czech version

Authors: M. Daňová ^1,2; E. Klímová ³
Authors‘ workplace: Pro Magnet, s. r. o, Pracovisko magnetickej rezonancie Prešov, FNsP J. A. Reimana v Prešove ¹; Fakulta zdravotníctva a sociálnej práce Trnavskej univerzity v Trnave ²; Klinika neurológie Fakulty zdravotníckych odborov Prešovskej univerzity v Prešove a FNsP J. A. Reimana v Prešove ³
Published in: Cesk Slov Neurol N 2014; 77/110(2): 181-185
Category: Original Paper

Overview

Background:
We aimed to compare the validity of the second and third version of the McDonald’s Diagnostic Criteria for MS: 2005 versus 2010, based on the evidence of lesions dissemination in space and time using magnetic resonanse imaging (MRI), in predicting the conversion clinically isolated syndrome (CIS) to Clinically Definite Multiple Sclerosis (CDMS).

Method:
From 06/ 2005 to 12/ 2010, the radiologist retrospectively evaluated according to both criteria MRI findings of all patients who completed the first brain MRI examination from the physician indication as suspect CIS ‑⁠ MS. Each of these patients were subsequently monitored by the neurologist for at least two years and had at least two controls of brain MRI. Both criteria sensitivity, specificity, positive and negative predictive value (PPV, NPV) were determined.

Results:
Altogether 76 patients were included, of these, 60 were (78.95%) women, the average age at the time of CIS was 29.46 ± 8.55 years. Thirty one patients (40.80%) converted to MS, of these 21 were women (27.63%) and 10 men (13.17 %). The sensitivity of the McDonald’s criteria (2005) was 70.97%, specificity 86.67%, PPV 78.57 % and NPV 81.25%. According to the third revision of McDonald’s criteria (2010), the sensitivity was 93.55%, specificity 84.44%, PPV 80.56% and NPV 95.00%.

Conclusion:
New McDonald’s criteria (2010) have higher sensitivites and comparable specificity than previous criteria (2005) in prediction conversion from CIS to CDMS. Their use significantly shortened the time needed to the disease diagnose in comparison with those of 2005, or the criteria by Poser (1983).

Key words:
multiple sclerosis –⁠ diagnostic criteria –clinically isolated syndrome –⁠ clinically definite MS –⁠ magnetic resonance imaging

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Sources

1. Horáková D. Léčba klinicky izolovaného syndromu a remitentní roztroušené sklerózy –⁠ aktuální doporučení zohledňující nové etiopategenetické poznatky. Neurol Prax 2012; 13 (Suppl 5): 11 –⁠ 14.

2. Havrdová E. Časná diagnostika a diferenciální diagnostika roztroušené sklerózy. Neurol Prax 2012; 13 (Suppl 5): 8 –⁠ 10.

3. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011; 69(2): 292 –⁠ 302.

4. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L et al. Diagnostic criteria for multiple sclerosis: 2005 revision to the “McDonald Criteria”. Ann Neurol 2005; 58(6): 840 –⁠ 846.

5. Vaněčková M, Seidl Z, Hřebíková T. Protokol vyšetření magnetickou rezonancí pro diagnostiku roztroušené sklerózy mozkomíšní. Praktická radiologie 2008; 4(2): 31 –⁠ 33.

6. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 1983; 13(3): 227 –⁠ 231.

7. Montalban X, Tintore M, Swanton J, Barkhof F, Fazekas F, Filippi M et al. MRI criteria for MS in patients with clinically isolated syndromes. Neurology 2010; 74(5): 427 –⁠ 434.

8. Kornek B, Schmitl B, Vass K, Zehetmayer S, Pritsch M,Penzien J et al.Evaluation of the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome. Mult Scler 2012; 18(12): 1768 –⁠ 1774.

9. Díaz ‑⁠ Sánchez M, Mayra Gómez ‑⁠ Moreno S, Asunción Morales ‑⁠ Otal M, Ramos ‑⁠ González A, Benito ‑⁠ León J. Accuracy of MRI criteria for dissemination in space for the diagnosis of multiple sclerosis in patients with clinically isolated syndromes. Mult Scler 2010; 16(5): 576 –⁠ 580.

10. Gómez ‑⁠ Moreno M, Díaz ‑⁠ Sánchez M, Ramos ‑⁠ González A. Application of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Spanish cohort of patients with clinically isolated syndromes. Mult Scler 2012; 18(1): 39 –⁠ 44.

11. Rovira A, Swanton JK, Tintoré M, Huerga E, Barkhof F, Filippi M et al. A single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis. Arch Neurol 2009; 66(5): 587 –⁠ 592.

12. Lövblad KO, Anzalone N, Dörfler A, Essig M, Hurwitz B, Kappos L et al. MR Imaging in multiple sclerosis: review and recommendations for current practice. AJNR Am J Neuroradiology 2010; 31(6): 983 –⁠ 989.