Implementing the 2017 mcdonald criteria for the diagnosis of multiple sclerosis

ABSTRACT The latest revision of the McDonald criteria for the diagnosis of multiple sclerosis (MS) was published online in 2017. New features of the criteria, which were designed to

facilitate earlier diagnosis of MS, include the recognition of oligoclonal bands in the cerebrospinal fluid as a possible marker of dissemination of MS pathology in time, the introduction of

symptomatic lesions as a parameter to demonstrate spatial or temporal pathology dissemination, and the use of cortical lesions to demonstrate dissemination in space. In this Viewpoint, a

panel of world-renowned MS specialists share their personal experiences of the new criteria to date. Access through your institution Buy or subscribe This is a preview of subscription

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* Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS THE MULTIPLE SCLEROSIS PRODROME Article 21 June 2021 ADVANCED MRI

FEATURES IN RELAPSING MULTIPLE SCLEROSIS PATIENTS WITH AND WITHOUT CSF OLIGOCLONAL IGG BANDS Article Open access 13 August 2020 THE INFLUENCE OF MOGAD ON DIAGNOSIS OF MULTIPLE SCLEROSIS

USING MRI Article 03 September 2024 REFERENCES * Polman, C. H. et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. _Ann. Neurol._ 69, 292–302 (2011).

Article  Google Scholar  * Thompson, A. J. et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. _Lancet Neurol._ 17, 162–173 (2018). Article  Google Scholar  *

Nelson, F. et al. Improved identification of intracortical lesions in multiple sclerosis with phase-sensitive inversion recovery in combination with fast double inversion recovery MR

imaging. _AJNR Am. J. Neuroradiol._ 28, 1645–1649 (2007). Article  CAS  Google Scholar  * Kilsdonk, I. D. et al. Increased cortical grey matter lesion detection in multiple sclerosis with 7 

T MRI: a post-mortem verification study. _Brain_ 139, 1472–1481 (2016). Article  Google Scholar  * van der Vuurst de Vries, R. M. et al. Application of the 2017 revised McDonald criteria for

multiple sclerosis to patients with a typical clinically isolated syndrome. _JAMA Neurol._ 75, 1392–1398 (2018). Article  Google Scholar  * Nielsen, A. S. et al. Contribution of cortical

lesion subtypes at 7T MRI to physical and cognitive performance in MS. _Neurology_ 81, 641–649 (2013). Article  Google Scholar  * Krieger, S. C. & Sumowski, J. New insights into multiple

sclerosis clinical course from the topographical model and functional reserve. _Neurol. Clin._ 36, 13–25 (2018). Article  Google Scholar  * Gama, P. D. et al. Study of oligoclonal bands

restricted to the cerebrospinal fluid in multiple sclerosis patients in the city of São Paulo. _Arq. Neuropsiquiatr._ 67, 1017–1022 (2009). Article  Google Scholar  * da Gama, P. D. et al.

Oligoclonal bands in cerebrospinal fluid of black patients with multiple sclerosis. _Biomed. Res. Int._ 2015, 217961 (2015). Article  Google Scholar  * Fragoso, Y. D. & Brooks, J. B.

Encephalomyelitis associated with dengue fever. _JAMA Neurol._ 73, 1368 (2016). Article  Google Scholar  * Frederiksen, J. L. & Topsøe Mailand, M. Vaccines and multiple sclerosis. _Acta

Neurol. Scand._ 136(Suppl. 201), 49–51 (2017). Article  Google Scholar  * Larochelle, C., Uphaus, T., Prat, A. & Zipp, F. Secondary progression in multiple sclerosis: neuronal exhaustion

or distinct pathology? _Trends Neurosci._ 39, 325–339 (2016). Article  CAS  Google Scholar  * Bittner, S. & Zipp, F. AAN unveils new guidelines for MS disease-modifying therapy. _Nat.

Rev. Neurol._ 14, 384–386 (2018). Article  Google Scholar  * Leray, E. et al. Evidence for a two-stage disability progression in multiple sclerosis. _Brain_ 133, 1900–1913 (2010). Article 

Google Scholar  * PRISMS Study Group & The University of British Columbia MS/MRI Analysis Group. PRISMS-4: long-term efficacy of interferon-β-1a in relapsing MS. _Neurology_ 56,

1628–1636 (2001). Article  Google Scholar  * University of California, San Francisco MS-EPIC Team. Long-term evolution of multiple sclerosis disability in the treatment era. _Ann. Neurol._

80, 499–510 (2016). Article  Google Scholar  * Tintore, M. et al. Defining high, medium and low impact prognostic factors for developing multiple sclerosis. _Brain_ 138, 1863–1874 (2015).

Article  Google Scholar  * Solomon, A. J. et al. The contemporary spectrum of multiple sclerosis misdiagnosis: a multicenter study. _Neurology_ 87, 1393–1399 (2016). Article  Google Scholar

  * Preziosa, P. et al. Diagnosis of multiple sclerosis: a multicentre study to compare revised McDonald-2010 and Filippi-2010 criteria. _J. Neurol. Neurosurg. Psychiatry_ 89, 316–318

(2018). Article  Google Scholar  * Kolber, P. et al. Identification of cortical lesions using DIR and FLAIR in early stages of multiple sclerosis. _J. Neurol._ 262, 1473–1482 (2015). Article

  CAS  Google Scholar  * Harrison, D. M. et al. Association of cortical lesion burden on 7-T magnetic resonance imaging with cognition and disability in multiple sclerosis. _JAMA Neurol._

72, 1004–1012 (2015). Article  Google Scholar  * Ellwardt, E. et al. Maladaptive cortical hyperactivity upon recovery from experimental autoimmune encephalomyelitis. _Nat. Neurosci._ 21,

1392–1403 (2018). Article  CAS  Google Scholar  * Zipp, F., Gold, R. & Wiendl, H. Identification of inflammatory neuronal injury and prevention of neuronal damage in multiple sclerosis:

hope for novel therapies? _JAMA Neurol._ 70, 1569–1574 (2013). PubMed  Google Scholar  * Siller, N. et al. Serum neurofilament light chain is a biomarker of acute and chronic neuronal damage

in early multiple sclerosis. _Mult. Scler._ 25, 678–686 (2018). Article  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Neurology, Focus

Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine Mein Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany

Frauke Zipp * Division of Neurology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada Jiwon Oh * Department of Neurology, Universidade

Metropolitana de Santos, Santos, Sao Paulo, Brazil Yara Dadalti Fragoso * Department of Neurology, University of California–San Francisco, San Francisco, CA, USA Emmanuelle Waubant Authors *

Frauke Zipp View author publications You can also search for this author inPubMed Google Scholar * Jiwon Oh View author publications You can also search for this author inPubMed Google

Scholar * Yara Dadalti Fragoso View author publications You can also search for this author inPubMed Google Scholar * Emmanuelle Waubant View author publications You can also search for this

author inPubMed Google Scholar CORRESPONDING AUTHORS Correspondence to Frauke Zipp, Jiwon Oh, Yara Dadalti Fragoso or Emmanuelle Waubant. ETHICS DECLARATIONS COMPETING INTERESTS The authors

declare no competing interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Zipp, F., Oh, J., Fragoso, Y.D. _et al._ Implementing the 2017 McDonald

criteria for the diagnosis of multiple sclerosis. _Nat Rev Neurol_ 15, 441–445 (2019). https://doi.org/10.1038/s41582-019-0194-0 Download citation * Published: 13 May 2019 * Issue Date:

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