Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study.
Journal article

Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study.

  • Kuhle J Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK/ Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland.
  • Disanto G Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Dobson R Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Adiutori R Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Bianchi L Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Topping J Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Bestwick JP Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and the London School for Medicine and Dentistry, UK.
  • Meier UC Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Marta M Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK.
  • Dalla Costa G Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy.
  • Runia T Department of Neurology, Erasmus MC University Medical Center, The Netherlands.
  • Evdoshenko E Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia.
  • Lazareva N Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia.
  • Thouvenot E Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France.
  • Iaffaldano P Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy.
  • Direnzo V Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy.
  • Khademi M Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
  • Piehl F Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
  • Comabella M Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
  • Sombekke M Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network.
  • Killestein J Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network.
  • Hegen H Department of Neurology, Innsbruck Medical University, Austria.
  • Rauch S Department of Radiology, Innsbruck Medical University, Austria.
  • D'Alfonso S Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy.
  • Alvarez-Cermeño JC Department of Neurology and Immunology, Hospital Ramón y Cajal, Spain.
  • Kleinová P Department of Neurology, Charles University in Prague, Czech Republic.
  • Horáková D Department of Neurology, Charles University in Prague, Czech Republic.
  • Roesler R Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany.
  • Lauda F Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany.
  • Llufriu S Center for Neuroimmunology and Department of Neurology. Institut d'investigacions Biomèdiques August Pi Sunyer (IDIBAPS) - Hospital Clinic of Barcelona, Spain.
  • Avsar T Dr Orhan Öcalgiray Molecular Biology-Biotechnology and Genetics Research Centre, Istanbul Technical University, Turkey.
  • Uygunoglu U Department of Neurology, Istanbul University, Turkey.
  • Altintas A Department of Neurology, Istanbul University, Turkey.
  • Saip S Department of Neurology, Istanbul University, Turkey.
  • Menge T Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany.
  • Rajda C Department of Neurology, University of Szeged, Hungary.
  • Bergamaschi R C. Mondino National Neurological Institute, Italy.
  • Moll N Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d'histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France.
  • Khalil M Department of Neurology, Medical University of Graz, Austria.
  • Marignier R Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France.
  • Dujmovic I Clinic of Neurology, Belgrade University School of Medicine, Serbia.
  • Larsson H Unit of Functional Imaging, Glostrup Hospital, University of Copenhagen, Denmark.
  • Malmestrom C Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
  • Scarpini E Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico.
  • Fenoglio C Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico.
  • Wergeland S KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway.
  • Laroni A Department of Neurology, University of Genoa, Italy.
  • Annibali V Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy.
  • Romano S Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy.
  • Martínez AD Department of Neurology of Hospital Británico of Buenos Aires, Argentina.
  • Carra A Department of Neurology of Hospital Británico of Buenos Aires, Argentina.
  • Salvetti M Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy.
  • Uccelli A Department of Neurology, University of Genoa, Italy.
  • Torkildsen Ø KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway.
  • Myhr KM Department of Neurology, University of Genoa, Italy.
  • Galimberti D Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico.
  • Rejdak K Department of Neurology, Medical University of Lublin, Poland.
  • Lycke J Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
  • Frederiksen JL Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.
  • Drulovic J Clinic of Neurology, Belgrade University School of Medicine, Serbia.
  • Confavreux C Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France.
  • Brassat D Department of Neurology, University of Toulouse, France.
  • Enzinger C Department of Neurology, Medical University of Graz, Austria.
  • Fuchs S Department of Neurology, Medical University of Graz, Austria.
  • Bosca I MS Unit, Neurology Department, La Fe University and Polytechnic Hospital, Instituto de investigación Sanitaria La Fe, Spain.
  • Pelletier J Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d'histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France.
  • Picard C Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d'histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France.
  • Colombo E C. Mondino National Neurological Institute, Italy.
  • Franciotta D C. Mondino National Neurological Institute, Italy.
  • Derfuss T Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland.
  • Lindberg R Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland.
  • Yaldizli Ö Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland.
  • Vécsei L Department of Neurology, University of Szeged, Hungary.
  • Kieseier BC Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany.
  • Hartung HP Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany.
  • Villoslada P Center for Neuroimmunology and Department of Neurology. Institut d'investigacions Biomèdiques August Pi Sunyer (IDIBAPS) - Hospital Clinic of Barcelona, Spain.
  • Siva A Department of Neurology, Istanbul University, Turkey.
  • Saiz A Center for Neuroimmunology and Department of Neurology. Institut d'investigacions Biomèdiques August Pi Sunyer (IDIBAPS) - Hospital Clinic of Barcelona, Spain.
  • Tumani H Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany.
  • Havrdová E Department of Neurology, Charles University in Prague, Czech Republic.
  • Villar LM Department of Neurology and Immunology, Hospital Ramón y Cajal, Spain.
  • Leone M MS Centre, SCDU Neurology, Head and Neck Department, AOU Maggiore della Carità, Italy.
  • Barizzone N Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy.
  • Deisenhammer F Department of Neurology, Innsbruck Medical University, Austria.
  • Teunissen C Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network.
  • Montalban X Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
  • Tintoré M Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
  • Olsson T Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
  • Trojano M Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy.
  • Lehmann S Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France.
  • Castelnovo G Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France.
  • Lapin S Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia.
  • Hintzen R Department of Neurology, Erasmus MC University Medical Center, The Netherlands.
  • Kappos L Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland.
  • Furlan R Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy.
  • Martinelli V Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy.
  • Comi G Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy.
  • Ramagopalan SV Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unit, University of Oxford, UK.
  • Giovannoni G Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK g.giovannoni@qmul.ac.uk.
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  • 2015-02-15
Published in:
  • Multiple sclerosis (Houndmills, Basingstoke, England). - 2015
English BACKGROUND AND OBJECTIVE
We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort.


METHODS
Thirty-three centres provided serum samples from 1047 CIS cases with at least two years' follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS.


RESULTS
At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71-2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52-2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04-3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98-0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres.


CONCLUSIONS
We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/109822
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