A prospective, observational study on conversion of Clinically Isolated Syndrome to Multiple Sclerosis during 4-year period (MS NEO study) in Taiwan

Autor: Kon-Ping Lin, Kuo-Hsuan Chang, Li-Chieh Huang, Long-Sun Ro, Tzung-Chang Tsai, Ching-Piao Tsai, Rong-Kuo Lyu, Chih-Chao Yang, Shiang-Ru Lu
Rok vydání: 2018
Předmět:
Male
Pathology and Laboratory Medicine
Logistic regression
Nervous System
Diagnostic Radiology
Geographical Locations
0302 clinical medicine
Infectious Diseases of the Nervous System
Medicine and Health Sciences
Prospective Studies
Enzyme-Linked Immunoassays
Young adult
Child
Prospective cohort study
First episode
education.field_of_study
Multidisciplinary
Clinically isolated syndrome
Radiology and Imaging
Brain
Neurodegenerative Diseases
Myelitis
Middle Aged
Prognosis
Magnetic Resonance Imaging
Infectious Diseases
Neurology
Spinal Cord
Disease Progression
Medicine
Female
Anatomy
Research Article
Adult
medicine.medical_specialty
Multiple Sclerosis
Asia
Adolescent
Imaging Techniques
Science
Immunology
Population
Taiwan
Research and Analysis Methods
Autoimmune Diseases
Young Adult
03 medical and health sciences
Signs and Symptoms
Diagnostic Medicine
Internal medicine
medicine
Humans
Immunoassays
education
Aged
business.industry
Clinical events
Multiple sclerosis
Biology and Life Sciences
medicine.disease
Demyelinating Disorders
Clinical trial
Neuroanatomy
People and Places
Lesions
Immunologic Techniques
030221 ophthalmology & optometry
Clinical Immunology
Observational study
Clinical Medicine
business
030217 neurology & neurosurgery
Neuroscience
Demyelinating Diseases
Zdroj: PLoS ONE
PLoS ONE, Vol 14, Iss 7, p e0202453 (2019)
DOI: 10.1101/385898
Popis: ImportanceCIS to MS conversion rates vary depending on population cohorts, initial manifestations, and durations of follow-up.ObjectiveTo investigate conversion rate of patients from CIS to MS and the prognostic significance of demographic and clinical variables in Taiwanese population.DesignNationwide, prospective, multi-centric, observational study from November 2008 to November 2014 with 4 years follow-up.SettingMulti-centre setting at 5 institutions in Taiwan.Participants152 patients having single clinical event potentially suggestive of MS in last 2 years were enrolled as consecutive sample. 33 patients were lost to follow-up and 16 patients did not complete the study.103 patients completed the study.Intervention(s) (for clinical trials) or Exposure(s) (for observational studies)Natural progression from first episode of CIS to MS or NMO was observed.Main Outcome(s) and Measure(s)Variables analysed were ‘proportion of patients converting to MS or NMO after first episode of CIS’, ‘duration between first episode of neurological event and diagnosis of MS’, ‘status of anti-AQP4 IgG’ and ‘length of longest contiguous spinal cord lesion in MS patients’. Association between baseline characteristics and progression to MS from CIS was analyzed using multiple logistic regression. Multivariate time dependent effect of baseline characteristics on progression to MS was plotted.Results14.5% patients with CIS converted to MS after 1.1 ± 1.0 years with greater predisposition (18.8%) in those having syndromes referable to the cerebral hemispheres. Conversion rate from ON to MS was 9.7%. 90.9% patients had benign disease course. 46.7% patients had abnormal MRIs at baseline, with 0.6±0.5 contrast enhanced lesions. ‘Below normal BMI’ and ‘MRI lesion load (≥ 4 lesions)’ were identified as risk indicators for the development of MS. Only 4.5% were positive for anti-AQP4 antibody in MS patients and amongst them, 80% were NMO patients as diagnosed by modern criteria.Conclusions and Relevance‘Below normal BMI’ and ‘number of demyelinating lesions (≥4)’ are significant predictors of conversion from CIS to MS. A low conversion rate to MS in Taiwanese CIS patients and majority of them having a benign course and minimal disability suggest the roles of geographic, genetic and ethnic factors.Trial RegistrationNon-trial observational study.
Databáze: OpenAIRE
Externí odkaz: