Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran; Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Science, Isfahan, Iran.
Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Neurol Neurosurg. 2024 Oct;245:108509. doi: 10.1016/j.clineuro.2024.108509. Epub 2024 Aug 14.
Since data is limited on radiologically isolated syndrome (RIS) subjects in certain regions like the Middle East, we aimed to further explore the replicability and generalizability of previously suggested predictors among a cohort of Iranian RIS subjects and report the long-term clinically definite MS (CDMS) conversion rate in this cohort.
We conducted a prospective 10-year cohort on our RIS participants, during which we collected the MRI, paraclinical, and demographic data of the subjects, and identified those who converted to CDMS.
Out of 35 participants, 10 (28.5 %) developed CDMS during an average of 5.58 ± 3.08 years (range: 4 months to 10.33 years). OCB positivity was the only definitive predictor for conversion to CDMS in this cohort (P-value = 0.006), but other previously reported risk factors such as spinal cord lesions or age lacked statistical significance (P-values > 0.05). We also reported the median survival time as 114 months, the proportion surviving after 14 months as 96.9 % ± 3.1 %, and the overall conversion rate as 0.05 cases per year.
Our results highlight OCB as an important predictive factor of clinical conversion in RIS. The prominence of OCB suggests a need for routine CSF analysis in RIS subjects and could guide clinicians in deciding which RIS subjects benefit from DMTs.
由于中东等某些地区的放射学孤立综合征(RIS)患者的数据有限,我们旨在进一步探讨伊朗 RIS 患者队列中先前提出的预测因子的可复制性和普遍性,并报告该队列中的长期临床确诊多发性硬化症(CDMS)转化率。
我们对我们的 RIS 参与者进行了一项前瞻性的 10 年队列研究,在此期间收集了受试者的 MRI、临床前和人口统计学数据,并确定了那些转化为 CDMS 的患者。
在 35 名参与者中,有 10 名(28.5%)在平均 5.58±3.08 年(范围:4 个月至 10.33 年)期间发展为 CDMS。本队列中,OCB 阳性是向 CDMS 转化的唯一明确预测因子(P 值=0.006),但其他先前报道的风险因素,如脊髓病变或年龄,缺乏统计学意义(P 值>0.05)。我们还报告了中位生存时间为 114 个月,14 个月后存活率为 96.9%±3.1%,总体转化率为 0.05 例/年。
我们的结果强调了 OCB 作为 RIS 临床转化的重要预测因子。OCB 的突出表现表明 RIS 患者需要常规进行 CSF 分析,并可以指导临床医生决定哪些 RIS 患者受益于 DMT。