Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Alan J. Thompson; Brenda L. Banwell; Frederik Barkhof; William M. Carroll; Timothy Coetzee; Giancarlo Comi; Jorge Correale; Franz Fazekas; Massimo Filippi; Mark S. Freedman; Kazuo Fujihara; Steven L. Galetta; Hans Peter Hartung; Ludwig Kappos; Fred D. Lublin; Ruth Ann Marrie; Aaron E. Miller; David H. Miller; Xavier Montalban; Ellen M. Mowry; Per Soelberg Sorensen; Mar Tintoré; Anthony L. Traboulsee; Maria Trojano; Bernard M.J. Uitdehaag; Sandra Vukusic; Emmanuelle Waubant; Brian G. Weinshenker; Stephen C. Reingold; Jeffrey A. Cohen

doi:10.1016/S1474-4422(17)30470-2

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

Alan J. Thompson, Brenda L. Banwell, Frederik Barkhof, William M. Carroll, Timothy Coetzee, Giancarlo Comi, Jorge Correale, Franz Fazekas, Massimo Filippi, Mark S. Freedman, Kazuo Fujihara, Steven L. Galetta, Hans Peter Hartung, Ludwig Kappos, Fred D. Lublin, Ruth Ann Marrie, Aaron E. Miller, David H. Miller, Xavier Montalban, Ellen M. MowryPer Soelberg Sorensen, Mar Tintoré, Anthony L. Traboulsee, Maria Trojano, Bernard M.J. Uitdehaag, Sandra Vukusic, Emmanuelle Waubant, Brian G. Weinshenker, Stephen C. Reingold, Jeffrey A. Cohen

School of Medicine

Research output: Contribution to journal › Review article › peer-review

1528 Scopus citations

Abstract

The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

Original language	English (US)
Pages (from-to)	162-173
Number of pages	12
Journal	The Lancet Neurology
Volume	17
Issue number	2
DOIs	https://doi.org/10.1016/S1474-4422(17)30470-2
State	Published - Feb 2018

ASJC Scopus subject areas

Clinical Neurology

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10.1016/S1474-4422(17)30470-2

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Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., Correale, J., Fazekas, F., Filippi, M., Freedman, M. S., Fujihara, K., Galetta, S. L., Hartung, H. P., Kappos, L., Lublin, F. D., Marrie, R. A., Miller, A. E., Miller, D. H., Montalban, X., ... Cohen, J. A. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology, 17(2), 162-173. https://doi.org/10.1016/S1474-4422(17)30470-2

Thompson, AJ, Banwell, BL, Barkhof, F, Carroll, WM, Coetzee, T, Comi, G, Correale, J, Fazekas, F, Filippi, M, Freedman, MS, Fujihara, K, Galetta, SL, Hartung, HP, Kappos, L, Lublin, FD, Marrie, RA, Miller, AE, Miller, DH, Montalban, X, Mowry, EM, Sorensen, PS, Tintoré, M, Traboulsee, AL, Trojano, M, Uitdehaag, BMJ, Vukusic, S, Waubant, E, Weinshenker, BG, Reingold, SC & Cohen, JA 2018, 'Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria', The Lancet Neurology, vol. 17, no. 2, pp. 162-173. https://doi.org/10.1016/S1474-4422(17)30470-2

@article{12be92e821814e7cbe3af89901852b13,

title = "Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria",

abstract = "The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.",

author = "Thompson, {Alan J.} and Banwell, {Brenda L.} and Frederik Barkhof and Carroll, {William M.} and Timothy Coetzee and Giancarlo Comi and Jorge Correale and Franz Fazekas and Massimo Filippi and Freedman, {Mark S.} and Kazuo Fujihara and Galetta, {Steven L.} and Hartung, {Hans Peter} and Ludwig Kappos and Lublin, {Fred D.} and Marrie, {Ruth Ann} and Miller, {Aaron E.} and Miller, {David H.} and Xavier Montalban and Mowry, {Ellen M.} and Sorensen, {Per Soelberg} and Mar Tintor{\'e} and Traboulsee, {Anthony L.} and Maria Trojano and Uitdehaag, {Bernard M.J.} and Sandra Vukusic and Emmanuelle Waubant and Weinshenker, {Brian G.} and Reingold, {Stephen C.} and Cohen, {Jeffrey A.}",

note = "Funding Information: AJT reports personal consultancy fees from MedDay, Novartis, Eisai, Biogen Idec, and Teva; is an Editorial Board member of The Lancet Neurology; is Editor in Chief of Multiple Sclerosis Journal and receives honoraria from SAGE Publications; chairs the Scientific Advisory Committee of, and receives financial support for travel to international meetings from, the International Progressive MS Alliance; is a member of, and receives financial support for travel to international meetings from, the Research Programs Advisory Committee of the US National Multiple Sclerosis Society; was Chair of the Multiple Sclerosis International Federation (MSIF) International Medical and Scientific Board between 2005 and 2015; has received financial support for travel to international meetings from MSIF; and has been a member of the MSIF International Medical and Scientific Board (since 2015). He has received honoraria and support for travel for lecturing from EXCEMED, and has received support from the University College London Hospitals National Institute for Health Research Biomedical Research Centre. BLB received grants from the Multiple Sclerosis Scientific Research Foundation during the conduct of this study. FB reports consultancy fees from Apitope, Bayer-Schering Pharma, Biogen Idec, GeNeuro, IXICO, Janssen Research, Merck-Serono, Novartis, Roche, Sanofi Genzyme, and Teva; speakers' fees from Biogen Idec and IXICO; and grants or pending grants from AMYPAD (IMI), Dutch MS Society, ECTRIMS-MAGNIMS, EuroPOND (Horizon 2020), University College London Hospitals National Institute for Health Research Biomedical Research Centre, PICTURE (IMDI-NWO), and the UK Multiple Sclerosis Society. WMC reports travel support from Biogen, Genzyme, and Teva; lecture fees from Merck and Roche; and has served as the Asia Pacific Editor for Multiple Sclerosis Journal. TC declares no competing interests. GC reports personal fees from Almirall, Biogen, Celgene, EXCEMED, Forward Pharma, Genzyme, Merck, Novartis, Roche, Sanofi, and Teva. JC reports personal fees from Merck Argentina, Merck LATAM, Genzyme LATAM, Genzyme Global, Novartis LATAM, Roche LATAM, and TEVA LATAM; grants and personal fees from Genzyme Argentina and Novartis Argentina; and grants from Biogen Idec. FF reports personal fees from Actelion, Biogen Idec, MedDay, Merck, Novartis, Parexel, Sanofi Genzyme, and Teva Ratiopharm. MF reports personal fees from Biogen Idec, Merck-Serono, Novartis, and Teva Pharmaceutical Industries; and grants from Alzheimer's Drug Discovery Foundation, ARiSLA (Fondazione Italiana di Ricerca per la SLA), Biogen Idec, Cure PSP, Fondazione Italiana Sclerosi Multipla, the Jacques and Gloria Gossweiler Foundation (Switzerland), Italian Ministry of Health, Novartis, and Teva Pharmaceutical Industries. MSF reports grants from Sanofi Genzyme and honoraria from Actelion, Biogen Idec, Chugai, EMD, Genzyme, Merck Serono, Novartis, Roche, Sanofi, and Teva Canada Innovation. KF has received grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and the Ministry of Health, Welfare and Labor of Japan during the conduct of the study; grants and personal fees from Asahi Kasei Medical, Astellas, Bayer Schering, Biogen, Chugai, Mitsubishi Tanabe, Nihon Pharmaceutical, Takeda, and Teijin; personal fees from Alexion, Daiichi Sankyo, Medimmune, Merck Serono, and Novartis; and grants from Chemo-Sero-Therapeutic Research Institute, Genzyme, Ono, and Teva. SLG reports personal fees from Biogen. HPH reports personal fees from Bayer HealthCare, Biogen, Geneuro, MedDay, Medimmune, Novartis, Octapharma, Receptos Celgene, Roche, Sanofi Genzyme, and Teva. LK reports grants from Actelion, Alkermes, Allergan, Almirall, Bayer HealthCare, Biogen Idec, CSL Behring, df-mp, The European Union, EXCEMED, GeNeuro SA, Genzyme, Merck, Mitsubishi, Novartis, Pfizer, Receptos, Roche, Roche Research Foundations, Sanofi-Aventis, Santhera, Teva, UCB, Vianex, the Swiss Multiple Sclerosis Society, and the Swiss National Research Foundation. FDL reports personal fees from AbbVie, Acorda, Actelion, Akros, Atara Biotherapeutics, Bayer HealthCare, EMD Serono, Forward Pharma, Innate Immunotherapeutics, MedDay, Medimmune, Osmotica, Questcor/Mallinckrodt, Receptos, Roche/Genentech, TG Therapeutics, and Xenoport; grants and personal fees from Biogen Idec, Celgene, Sanofi Genzyme, and Teva Neuroscience; and grants from Transparency Life Sciences. RAM reports research funding from the Canadian Institutes of Health Research, Crohn's and Colitis Canada, Canadian Multiple Sclerosis Scientific Foundation, Multiple Sclerosis Society of Canada, National Multiple Sclerosis Society, Research Manitoba, and Rx&D Health Research Foundation; and support paid to her institution by Sanofi-Aventis. AEM reports research support from Biogen Idec, Genzyme/Sanofi, Mallinckrodt (Questcor), MedDay, Novartis, and Roche/Genentech; personal fees from Acorda Therapeutics, Adamas, Alkermes, Biogen Idec, Celgene, EMD Serono (Merck Serono), Genzyme/Sanofi, Mallinckrodt (Questcor), Mapi-Pharma, Novartis, Roche/Genentech, and Teva; and has served on the Speakers Bureaus for Biogen (unbranded disease awareness programmes only) and Roche/Genentech (unbranded disease awareness programmes only). DHM reports grants from Apitope and Biogen Idec; personal fees from Bayer Schering, GlaxoSmithKline, and Mitsubishi Pharma Europe; and grants and personal fees from Novartis. XM reports personal fees from Actelion, Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Receptos, Roche, Sanofi, and Teva. EMM reports grants from Biogen and Genzyme, and free medication for a clinical trial from Teva and royalties for editorial duties from Up-to-Date. PSS reports personal fees from Celgene, Forward Pharma, GlaxoSmithKline, and MedDay; grants and personal fees from Biogen, Merck, Sanofi-Aventis/Genzyme, and Teva; and grants from Roche. MTi reports personal fees from Almirall, Bayer HealthCare, Merck Serono, Novartis, Roche, and Teva Neuroscience; grants and personal fees from Biogen Idec and Sanofi Genzyme. ALT reports grants and personal fees from Biogen Idec, Chugai, F Hoffmann-La Roche, and Sanofi Genzyme; grants from the Canadian Institutes of Health Research and Multiple Sclerosis Society Canada; and personal fees from Novartis, Teva Innovation, and the Consortium of Multiple Sclerosis Centers. MTr reports personal fees from Almirall, Biogen Idec, Merck, Novartis, Roche, Sanofi Genzyme, and Teva; and grants from Biogen Idec, Merck, and Novartis; BMJU reports personal fees from Biogen Idec, Genzyme, Merck Serono, Roche, and Teva. SV reports grants and personal fees from Biogen, Merck-Serono, Novartis, Roche, Sanofi Genzyme, and Teva; personal fees from Geneuro; and grants from MedDay. EW has received honoraria as Co-Chief Editor of Multiple Sclerosis and Related Disorders and as Section Editor for Annals of Clinical and Translational Neurology. BGW reports personal fees from Alexion, Biogen Idec, Caladrius Biosciences, MedImmune, and Novartis; and has a patent for NMO-IgG for diagnosis of neuromyelitis optica with royalties paid to RSR, the University of Oxford, Hospices Civil de Lyon, and MVZ Labor PD Dr Volkmann und Kollegen GbR. SCR has received personal fees or travel support from the National Multiple Sclerosis Society, the Observatoire Fran{\c c}ais pour la Scl{\'e}rose en Plaques, and the European Committee for Treatment and Research in Multiple Sclerosis during the conduct of the study; personal fees and other support from F Hoffmann-La Roche, Ionis Pharmaceuticals, MedDay Pharmaceuticals SA, MedImmune, Merck Serono, Novartis; personal fees from Opexa Therapeutics, Teva Pharmaceuticals Industries, and TG Therapeutics; and personal fees and non-financial support from Scientific and Clinical Review Associates LLC. JAC reports personal fees from Adamas and Celgene, and has served as Co-Editor of Multiple Sclerosis Journal. Publisher Copyright: {\textcopyright} 2018 Elsevier Ltd",

year = "2018",

month = feb,

doi = "10.1016/S1474-4422(17)30470-2",

language = "English (US)",

volume = "17",

pages = "162--173",

journal = "The Lancet Neurology",

issn = "1474-4422",

publisher = "Lancet Publishing Group",

number = "2",

}

TY - JOUR

T1 - Diagnosis of multiple sclerosis

T2 - 2017 revisions of the McDonald criteria

AU - Thompson, Alan J.

AU - Banwell, Brenda L.

AU - Barkhof, Frederik

AU - Carroll, William M.

AU - Coetzee, Timothy

AU - Comi, Giancarlo

AU - Correale, Jorge

AU - Fazekas, Franz

AU - Filippi, Massimo

AU - Freedman, Mark S.

AU - Fujihara, Kazuo

AU - Galetta, Steven L.

AU - Hartung, Hans Peter

AU - Kappos, Ludwig

AU - Lublin, Fred D.

AU - Marrie, Ruth Ann

AU - Miller, Aaron E.

AU - Miller, David H.

AU - Montalban, Xavier

AU - Mowry, Ellen M.

AU - Sorensen, Per Soelberg

AU - Tintoré, Mar

AU - Traboulsee, Anthony L.

AU - Trojano, Maria

AU - Uitdehaag, Bernard M.J.

AU - Vukusic, Sandra

AU - Waubant, Emmanuelle

AU - Weinshenker, Brian G.

AU - Reingold, Stephen C.

AU - Cohen, Jeffrey A.

N1 - Funding Information: AJT reports personal consultancy fees from MedDay, Novartis, Eisai, Biogen Idec, and Teva; is an Editorial Board member of The Lancet Neurology; is Editor in Chief of Multiple Sclerosis Journal and receives honoraria from SAGE Publications; chairs the Scientific Advisory Committee of, and receives financial support for travel to international meetings from, the International Progressive MS Alliance; is a member of, and receives financial support for travel to international meetings from, the Research Programs Advisory Committee of the US National Multiple Sclerosis Society; was Chair of the Multiple Sclerosis International Federation (MSIF) International Medical and Scientific Board between 2005 and 2015; has received financial support for travel to international meetings from MSIF; and has been a member of the MSIF International Medical and Scientific Board (since 2015). He has received honoraria and support for travel for lecturing from EXCEMED, and has received support from the University College London Hospitals National Institute for Health Research Biomedical Research Centre. BLB received grants from the Multiple Sclerosis Scientific Research Foundation during the conduct of this study. FB reports consultancy fees from Apitope, Bayer-Schering Pharma, Biogen Idec, GeNeuro, IXICO, Janssen Research, Merck-Serono, Novartis, Roche, Sanofi Genzyme, and Teva; speakers' fees from Biogen Idec and IXICO; and grants or pending grants from AMYPAD (IMI), Dutch MS Society, ECTRIMS-MAGNIMS, EuroPOND (Horizon 2020), University College London Hospitals National Institute for Health Research Biomedical Research Centre, PICTURE (IMDI-NWO), and the UK Multiple Sclerosis Society. WMC reports travel support from Biogen, Genzyme, and Teva; lecture fees from Merck and Roche; and has served as the Asia Pacific Editor for Multiple Sclerosis Journal. TC declares no competing interests. GC reports personal fees from Almirall, Biogen, Celgene, EXCEMED, Forward Pharma, Genzyme, Merck, Novartis, Roche, Sanofi, and Teva. JC reports personal fees from Merck Argentina, Merck LATAM, Genzyme LATAM, Genzyme Global, Novartis LATAM, Roche LATAM, and TEVA LATAM; grants and personal fees from Genzyme Argentina and Novartis Argentina; and grants from Biogen Idec. FF reports personal fees from Actelion, Biogen Idec, MedDay, Merck, Novartis, Parexel, Sanofi Genzyme, and Teva Ratiopharm. MF reports personal fees from Biogen Idec, Merck-Serono, Novartis, and Teva Pharmaceutical Industries; and grants from Alzheimer's Drug Discovery Foundation, ARiSLA (Fondazione Italiana di Ricerca per la SLA), Biogen Idec, Cure PSP, Fondazione Italiana Sclerosi Multipla, the Jacques and Gloria Gossweiler Foundation (Switzerland), Italian Ministry of Health, Novartis, and Teva Pharmaceutical Industries. MSF reports grants from Sanofi Genzyme and honoraria from Actelion, Biogen Idec, Chugai, EMD, Genzyme, Merck Serono, Novartis, Roche, Sanofi, and Teva Canada Innovation. KF has received grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and the Ministry of Health, Welfare and Labor of Japan during the conduct of the study; grants and personal fees from Asahi Kasei Medical, Astellas, Bayer Schering, Biogen, Chugai, Mitsubishi Tanabe, Nihon Pharmaceutical, Takeda, and Teijin; personal fees from Alexion, Daiichi Sankyo, Medimmune, Merck Serono, and Novartis; and grants from Chemo-Sero-Therapeutic Research Institute, Genzyme, Ono, and Teva. SLG reports personal fees from Biogen. HPH reports personal fees from Bayer HealthCare, Biogen, Geneuro, MedDay, Medimmune, Novartis, Octapharma, Receptos Celgene, Roche, Sanofi Genzyme, and Teva. LK reports grants from Actelion, Alkermes, Allergan, Almirall, Bayer HealthCare, Biogen Idec, CSL Behring, df-mp, The European Union, EXCEMED, GeNeuro SA, Genzyme, Merck, Mitsubishi, Novartis, Pfizer, Receptos, Roche, Roche Research Foundations, Sanofi-Aventis, Santhera, Teva, UCB, Vianex, the Swiss Multiple Sclerosis Society, and the Swiss National Research Foundation. FDL reports personal fees from AbbVie, Acorda, Actelion, Akros, Atara Biotherapeutics, Bayer HealthCare, EMD Serono, Forward Pharma, Innate Immunotherapeutics, MedDay, Medimmune, Osmotica, Questcor/Mallinckrodt, Receptos, Roche/Genentech, TG Therapeutics, and Xenoport; grants and personal fees from Biogen Idec, Celgene, Sanofi Genzyme, and Teva Neuroscience; and grants from Transparency Life Sciences. RAM reports research funding from the Canadian Institutes of Health Research, Crohn's and Colitis Canada, Canadian Multiple Sclerosis Scientific Foundation, Multiple Sclerosis Society of Canada, National Multiple Sclerosis Society, Research Manitoba, and Rx&D Health Research Foundation; and support paid to her institution by Sanofi-Aventis. AEM reports research support from Biogen Idec, Genzyme/Sanofi, Mallinckrodt (Questcor), MedDay, Novartis, and Roche/Genentech; personal fees from Acorda Therapeutics, Adamas, Alkermes, Biogen Idec, Celgene, EMD Serono (Merck Serono), Genzyme/Sanofi, Mallinckrodt (Questcor), Mapi-Pharma, Novartis, Roche/Genentech, and Teva; and has served on the Speakers Bureaus for Biogen (unbranded disease awareness programmes only) and Roche/Genentech (unbranded disease awareness programmes only). DHM reports grants from Apitope and Biogen Idec; personal fees from Bayer Schering, GlaxoSmithKline, and Mitsubishi Pharma Europe; and grants and personal fees from Novartis. XM reports personal fees from Actelion, Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Receptos, Roche, Sanofi, and Teva. EMM reports grants from Biogen and Genzyme, and free medication for a clinical trial from Teva and royalties for editorial duties from Up-to-Date. PSS reports personal fees from Celgene, Forward Pharma, GlaxoSmithKline, and MedDay; grants and personal fees from Biogen, Merck, Sanofi-Aventis/Genzyme, and Teva; and grants from Roche. MTi reports personal fees from Almirall, Bayer HealthCare, Merck Serono, Novartis, Roche, and Teva Neuroscience; grants and personal fees from Biogen Idec and Sanofi Genzyme. ALT reports grants and personal fees from Biogen Idec, Chugai, F Hoffmann-La Roche, and Sanofi Genzyme; grants from the Canadian Institutes of Health Research and Multiple Sclerosis Society Canada; and personal fees from Novartis, Teva Innovation, and the Consortium of Multiple Sclerosis Centers. MTr reports personal fees from Almirall, Biogen Idec, Merck, Novartis, Roche, Sanofi Genzyme, and Teva; and grants from Biogen Idec, Merck, and Novartis; BMJU reports personal fees from Biogen Idec, Genzyme, Merck Serono, Roche, and Teva. SV reports grants and personal fees from Biogen, Merck-Serono, Novartis, Roche, Sanofi Genzyme, and Teva; personal fees from Geneuro; and grants from MedDay. EW has received honoraria as Co-Chief Editor of Multiple Sclerosis and Related Disorders and as Section Editor for Annals of Clinical and Translational Neurology. BGW reports personal fees from Alexion, Biogen Idec, Caladrius Biosciences, MedImmune, and Novartis; and has a patent for NMO-IgG for diagnosis of neuromyelitis optica with royalties paid to RSR, the University of Oxford, Hospices Civil de Lyon, and MVZ Labor PD Dr Volkmann und Kollegen GbR. SCR has received personal fees or travel support from the National Multiple Sclerosis Society, the Observatoire Français pour la Sclérose en Plaques, and the European Committee for Treatment and Research in Multiple Sclerosis during the conduct of the study; personal fees and other support from F Hoffmann-La Roche, Ionis Pharmaceuticals, MedDay Pharmaceuticals SA, MedImmune, Merck Serono, Novartis; personal fees from Opexa Therapeutics, Teva Pharmaceuticals Industries, and TG Therapeutics; and personal fees and non-financial support from Scientific and Clinical Review Associates LLC. JAC reports personal fees from Adamas and Celgene, and has served as Co-Editor of Multiple Sclerosis Journal. Publisher Copyright: © 2018 Elsevier Ltd

PY - 2018/2

Y1 - 2018/2

N2 - The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

AB - The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

UR - http://www.scopus.com/inward/record.url?scp=85038826113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038826113&partnerID=8YFLogxK

U2 - 10.1016/S1474-4422(17)30470-2

DO - 10.1016/S1474-4422(17)30470-2

M3 - Review article

C2 - 29275977

AN - SCOPUS:85038826113

SN - 1474-4422

VL - 17

SP - 162

EP - 173

JO - The Lancet Neurology

JF - The Lancet Neurology

IS - 2

ER -

Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria

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