A prospective, observational study on conversion of clinically isolated syndrome to multiple sclerosis during 4-year period (MS NEO study) in Taiwan.

A prospective, observational study on conversion of clinically isolated syndrome to multiple sclerosis during 4-year period (MS NEO study) in Taiwan.

Publication date: Aug 01, 2018

CIS to MS conversion rates vary depending on population cohorts, initial manifestations, and durations of follow-up.

To investigate conversion rate of patients from CIS to MS and the prognostic significance of demographic and clinical variables in Taiwanese population.

Nationwide, prospective, multi-centric, observational study from November 2008 to November 2014 with 4 years follow-up.

Multi-centre setting at 5 institutions in Taiwan.

152 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.

Natural progression from first episode of CIS to MS or NMO was observed.

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.

14.5% 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 mild 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. Amongst the patients who developed NMO as diagnosed by modern criteria, 80% were positive for anti-AQP4 IgG antibody.

‘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 mild course and minimal disability suggest the roles of geographic, genetic and ethnic factors.

Non-trial observational study.

Open Access PDF

Ro, L.S., Yang, C.C., Lyu, R.K., Lin, K.P., Tsai, T.C., , Lu, Chang, K.H., Huang, L.C., and Tsai, C.P. A prospective, observational study on conversion of clinically isolated syndrome to multiple sclerosis during 4-year period (MS NEO study) in Taiwan. 18593. 2018 PLoS One (14):7.

Concepts Keywords
Antibody Syndrome multiple sclerosis
BMI MS
Cerebral Hemispheres Multiple sclerosis
CIS Organ systems
Conversion Rate Neurological disorders
Demographic Nervous system
Disability Aquaporin 4
Genetic Clinically isolated syndrome
IgG Cis
Lesion Neuromyelitis optica
Logistic Regression MRI
Modern Criteria
MRI
Multiple Sclerosis
Neurological
Observational Study
Spinal Cord
Taiwan
Taiwanese

Semantics

Type Source Name
gene UNIPROT ELL
disease MESH men
gene UNIPROT PDGFB
drug DRUGBANK Methylprednisolone
gene UNIPROT BRD2
disease MESH Mult
gene UNIPROT PDLIM5
gene UNIPROT EXOG
gene UNIPROT INTU
disease DOID neuromyelitis optica
gene UNIPROT ERBB2
gene UNIPROT NEU1
gene UNIPROT NEURL1
disease MESH NMO spectrum disorders
disease MESH secondary progressive multiple sclerosis
gene UNIPROT SYNM
gene UNIPROT FYN
gene UNIPROT COL9A3
gene UNIPROT COMP
gene UNIPROT COL9A1
gene UNIPROT COL9A2
gene UNIPROT SCN8A
gene UNIPROT MBNL1
gene UNIPROT ZBTB8OS
gene UNIPROT IRF1
gene UNIPROT RNMT
gene UNIPROT MET
drug DRUGBANK Methionine
gene UNIPROT SLTM
gene UNIPROT TRIM37
disease DOID RRMS
drug DRUGBANK Clotiazepam
disease DOID SPMS
disease DOID obesity
disease MESH obesity
gene UNIPROT FANCE
gene UNIPROT ELOVL6
disease DOID face
disease MESH underweight
gene UNIPROT GEN1
gene UNIPROT LARGE1
gene UNIPROT ATM
gene UNIPROT MAX
gene UNIPROT ZAP70
gene UNIPROT SULT2A1
gene UNIPROT AMACR
disease DOID ADEM
disease DOID encephalitis
disease MESH encephalitis
disease MESH transverse myelitis
gene UNIPROT EMD
gene UNIPROT DEPP1
gene UNIPROT NANS
gene UNIPROT TSPAN31
gene UNIPROT GOPC
gene UNIPROT FBLIM1
gene UNIPROT CD40LG
disease DOID encephalomyelitis
disease MESH encephalomyelitis
gene UNIPROT SLC35G1
gene UNIPROT FBXW11
gene UNIPROT TBX5
disease DOID myelitis
disease MESH myelitis
disease DOID neuritis
disease MESH neuritis
gene UNIPROT FBN1
disease MESH visual
gene UNIPROT MOG
gene UNIPROT SLC26A5
drug DRUGBANK Water
gene UNIPROT LAMC2
gene UNIPROT CSF2
disease MESH demyelination
disease DOID Optic neuritis
disease MESH Optic neuritis
disease MESH relapses
gene UNIPROT CYREN
disease MESH risk factors
pathway BSID Reproduction
disease MESH sclerosis
disease MESH development
disease MESH multiple
gene UNIPROT AQP4
disease MESH diagnosis
disease MESH multi
disease MESH lost to follow-up
gene UNIPROT CISH
disease DOID multiple sclerosis
disease MESH multiple sclerosis
disease DOID syndrome
disease MESH syndrome

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