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'''Radiologically isolated syndrom''' ('''RIS''') is a [[medical condition|clinical situation]] where a patient has [[White_matter#Clinical_significance|white matter lesions]] suggestive of [[multiple sclerosis]] (MS) as shown on an incidental [[magnetic resonance imaging|MRI]]. The lesions in patients show [[McDonald criteria|dissemination in space]] with an otherwise normal neurological examination and without historical accounts of typical MS symptoms.<ref>{{Cite journal|last=Labiano-Fontcuberta|first=Andrés|last2=Benito-León|first2=Julián|date=October 2016|title=Radiologically isolated syndrome: An update on a rare entity|url=https://www.ncbi.nlm.nih.gov/pubmed/27288053|journal=Multiple Sclerosis (Houndmills, Basingstoke, England)|volume=22|issue=12|pages=1514–1521|doi=10.1177/1352458516653666|issn=1477-0970|pmid=27288053}}</ref> This condition was first characterized in 2009.<ref>{{Cite journal|last=Okuda|first=D. T.|last2=Mowry|first2=E. M.|last3=Beheshtian|first3=A.|last4=Waubant|first4=E.|last5=Baranzini|first5=S. E.|last6=Goodin|first6=D. S.|last7=Hauser|first7=S. L.|last8=Pelletier|first8=D.|date=2009-03-03|title=Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/19073949|journal=Neurology|volume=72|issue=9|pages=800–805|doi=10.1212/01.wnl.0000335764.14513.1a|issn=1526-632X|pmid=19073949}}</ref> MRI findings that are consistent with multiple sclerosis have been observed in healthy people who underwent scanning and 50% go on to develop MS, sometimes with a [[PPMS|primary progressive]] course.<ref name="NEJM">{{Cite journal|last=Reich|first=Daniel S|last2=Lucchinetti|first2=Claudia F.|last3=Calabresi|first3=Peter A|date=January 2018|title=Multiple Sclerosis|url=http://www.nejm.org/doi/10.1056/NEJMra1401483|journal=The New England Journal of Medicine|volume=378|issue=2|pages=169–180|doi=10.1056/NEJMra1401483|issn=|pmid=}}</ref><ref>https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.24564</ref>
'''Radiologically isolated syndrom''' ('''RIS''') is a [[medical condition|clinical situation]] where a patient has [[White_matter#Clinical_significance|white matter lesions]] suggestive of [[multiple sclerosis]] (MS) as shown on an incidental [[magnetic resonance imaging|MRI]]. The lesions in patients show [[McDonald criteria|dissemination in space]] with an otherwise normal neurological examination and without historical accounts of typical MS symptoms.<ref>{{Cite journal|last=Labiano-Fontcuberta|first=Andrés|last2=Benito-León|first2=Julián|date=October 2016|title=Radiologically isolated syndrome: An update on a rare entity|url=https://www.ncbi.nlm.nih.gov/pubmed/27288053|journal=Multiple Sclerosis (Houndmills, Basingstoke, England)|volume=22|issue=12|pages=1514–1521|doi=10.1177/1352458516653666|issn=1477-0970|pmid=27288053}}</ref> This condition was first characterized in 2009.<ref>{{Cite journal|last=Okuda|first=D. T.|last2=Mowry|first2=E. M.|last3=Beheshtian|first3=A.|last4=Waubant|first4=E.|last5=Baranzini|first5=S. E.|last6=Goodin|first6=D. S.|last7=Hauser|first7=S. L.|last8=Pelletier|first8=D.|date=2009-03-03|title=Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/19073949|journal=Neurology|volume=72|issue=9|pages=800–805|doi=10.1212/01.wnl.0000335764.14513.1a|issn=1526-632X|pmid=19073949}}</ref> MRI findings that are consistent with multiple sclerosis have been observed in healthy people who underwent scanning and 50% go on to develop MS, sometimes with a [[PPMS|primary progressive]] course.<ref name="NEJM">{{Cite journal|last=Reich|first=Daniel S|last2=Lucchinetti|first2=Claudia F.|last3=Calabresi|first3=Peter A|date=January 2018|title=Multiple Sclerosis|url=http://www.nejm.org/doi/10.1056/NEJMra1401483|journal=The New England Journal of Medicine|volume=378|issue=2|pages=169–180|doi=10.1056/NEJMra1401483|issn=|pmid=}}</ref><ref>{{Cite journal|last=Kantarci|first=Orhun H.|last2=Lebrun|first2=Christine|last3=Siva|first3=Aksel|last4=Keegan|first4=Mark B.|last5=Azevedo|first5=Christina J.|last6=Inglese|first6=Matilde|last7=Tintoré|first7=Mar|last8=Newton|first8=Braeden D.|last9=Durand-Dubief|first9=Francoise|date=February 2016|title=Primary Progressive Multiple Sclerosis Evolving From Radiologically Isolated Syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/26599831|journal=Annals of Neurology|volume=79|issue=2|pages=288–294|doi=10.1002/ana.24564|issn=1531-8249|pmid=26599831}}</ref>


==Naming==
==Naming==
The acronym RIS was coined in 2009 by Okuda and colleagues. An alternative name by Siva and colleagues suggested '''radiologically uncovered asymptomatic possible inflammatory-demyelinating disease''' ('''RAPIDD''').<ref>http://journals.sagepub.com/doi/10.1177/1352458512451943</ref><ref>Siva A, Saip S, Altintas A, . Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease. Mult Scler 2009; 15: 918–927.</ref>
The acronym RIS was coined in 2009 by Okuda and colleagues. An alternative name by Siva and colleagues suggested '''radiologically uncovered asymptomatic possible inflammatory-demyelinating disease''' ('''RAPIDD''').<ref name=":0">{{Cite journal|last=Granberg|first=Tobias|last2=Martola|first2=Juha|last3=Kristoffersen-Wiberg|first3=Maria|last4=Aspelin|first4=Peter|last5=Fredrikson|first5=Sten|date=March 2013|title=Radiologically isolated syndrome--incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review|url=https://www.ncbi.nlm.nih.gov/pubmed/22760099|journal=Multiple Sclerosis (Houndmills, Basingstoke, England)|volume=19|issue=3|pages=271–280|doi=10.1177/1352458512451943|issn=1477-0970|pmid=22760099}}</ref><ref>Siva A, Saip S, Altintas A, . Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease. Mult Scler 2009; 15: 918–927.</ref>


==Discovery==
==Discovery==
The most common symptom that is due to the incidental discovery of RIS, is headache, followed by trauma, psychiatric disorders, and endocrinological disorders.<ref>http://journals.sagepub.com/doi/10.1177/1352458512451943
The most common symptom that is due to the incidental discovery of RIS, is headache, followed by trauma, psychiatric disorders, and endocrinological disorders.<ref name=":0" />

</ref>


==Diagnosis==
==Diagnosis==
The criteria for an RIS diagnosis<ref>{{Cite journal|last=Okuda|first=D. T.|last2=Mowry|first2=E. M.|last3=Beheshtian|first3=A.|last4=Waubant|first4=E.|last5=Baranzini|first5=S. E.|last6=Goodin|first6=D. S.|last7=Hauser|first7=S. L.|last8=Pelletier|first8=D.|date=2009-03-03|title=Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/19073949|journal=Neurology|volume=72|issue=9|pages=800–805|doi=10.1212/01.wnl.0000335764.14513.1a|issn=1526-632X|pmid=19073949}}</ref><ref>http://nn.neurology.org/content/4/6/e395</ref><ref>http://journals.sagepub.com/doi/10.1177/1352458512451943</ref> are as follows:
The criteria for an RIS diagnosis<ref>{{Cite journal|last=Okuda|first=D. T.|last2=Mowry|first2=E. M.|last3=Beheshtian|first3=A.|last4=Waubant|first4=E.|last5=Baranzini|first5=S. E.|last6=Goodin|first6=D. S.|last7=Hauser|first7=S. L.|last8=Pelletier|first8=D.|date=2009-03-03|title=Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/19073949|journal=Neurology|volume=72|issue=9|pages=800–805|doi=10.1212/01.wnl.0000335764.14513.1a|issn=1526-632X|pmid=19073949}}</ref><ref>{{Cite journal|last=Makhani|first=Naila|last2=Lebrun|first2=Christine|last3=Siva|first3=Aksel|last4=Brassat|first4=David|last5=Dallière|first5=Clarisse Carra|last6=Seze|first6=Jérôme de|last7=Du|first7=Wei|last8=Dubief|first8=Françoise Durand|last9=Kantarci|first9=Orhun|date=2017-11-01|title=Radiologically isolated syndrome in children: Clinical and radiologic outcomes|url=http://nn.neurology.org/content/4/6/e395|journal=Neurology - Neuroimmunology Neuroinflammation|language=en|volume=4|issue=6|pages=e395|doi=10.1212/NXI.0000000000000395|issn=2332-7812}}</ref><ref name=":0" /> are as follows:
#The presence of incidental MRI findings in the CNS white matter:
#The presence of incidental MRI findings in the CNS white matter:
##Ovoid and well-circumscribed homogenous foci with or without involvement of the [[corpus callosum]]
##Ovoid and well-circumscribed homogenous foci with or without involvement of the [[corpus callosum]]
##[[Hyperintensity|T2 hyperintensities]] larger than 3 mm in diameter, which fulfill at least 3 of the 4 [[Diagnostic_criteria_for_MS#Barkhof-Tintor%C3%A9_criteria|Barkhof MRI criteria]]<ref>https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1044&context=neurol_bull</ref> for DIS
##[[Hyperintensity|T2 hyperintensities]] larger than 3 mm in diameter, which fulfill at least 3 of the 4 [[Diagnostic_criteria_for_MS#Barkhof-Tintor%C3%A9_criteria|Barkhof MRI criteria]]<ref name=":1">https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1044&context=neurol_bull</ref> for DIS
##the CNS abnormalities are not consistent with a vascular condition
##the CNS abnormalities are not consistent with a vascular condition
#No historical accounts of clinical symptoms consistent with neurological dysfunction
#No historical accounts of clinical symptoms consistent with neurological dysfunction
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==Follow up==
==Follow up==
Currently, routine clinical follow-up and MRI neuroimaging surveillance is the standard by which patients are observed.<ref>{{Cite journal|last=Okuda|first=D. T.|last2=Mowry|first2=E. M.|last3=Beheshtian|first3=A.|last4=Waubant|first4=E.|last5=Baranzini|first5=S. E.|last6=Goodin|first6=D. S.|last7=Hauser|first7=S. L.|last8=Pelletier|first8=D.|date=2009-03-03|title=Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/19073949|journal=Neurology|volume=72|issue=9|pages=800–805|doi=10.1212/01.wnl.0000335764.14513.1a|issn=1526-632X|pmid=19073949}}</ref> While treatment of MS [[Management_of_multiple_sclerosis#Disease-modifying_treatments|disease modifying therapies]] have been given to some individuals with RIS, the majority opt for subsequent follow ups or appearance of clinical symptoms before commencing treatment,<ref>http://journals.sagepub.com/doi/10.1177/1352458512451943</ref> as treatment is considered controversial.<ref>http://www.msard-journal.com/article/S2211-0348(17)30199-2/fulltext</ref>
Currently, routine clinical follow-up and MRI neuroimaging surveillance is the standard by which patients are observed.<ref>{{Cite journal|last=Okuda|first=D. T.|last2=Mowry|first2=E. M.|last3=Beheshtian|first3=A.|last4=Waubant|first4=E.|last5=Baranzini|first5=S. E.|last6=Goodin|first6=D. S.|last7=Hauser|first7=S. L.|last8=Pelletier|first8=D.|date=2009-03-03|title=Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/19073949|journal=Neurology|volume=72|issue=9|pages=800–805|doi=10.1212/01.wnl.0000335764.14513.1a|issn=1526-632X|pmid=19073949}}</ref> While treatment of MS [[Management_of_multiple_sclerosis#Disease-modifying_treatments|disease modifying therapies]] have been given to some individuals with RIS, the majority opt for subsequent follow ups or appearance of clinical symptoms before commencing treatment,<ref name=":0" /> as treatment is considered controversial.<ref>{{Cite journal|last=Yamout|first=B.|last2=Khawajah|first2=M. Al|date=2017-10-01|title=Radiologically isolated syndrome and multiple sclerosis|url=http://www.msard-journal.com/article/S2211-0348(17)30199-2/fulltext|journal=Multiple Sclerosis and Related Disorders|language=English|volume=17|pages=234–237|doi=10.1016/j.msard.2017.08.016|issn=2211-0348}}</ref>


==Prognosis==
==Prognosis==
In a 5 year study, clinical events indicative of MS appeared in 34% of individuals. Of those who developed symptoms, 9.6% fullfilled criteria for PPMS.<ref>http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090509</ref>
In a 5 year study, clinical events indicative of MS appeared in 34% of individuals. Of those who developed symptoms, 9.6% fullfilled criteria for PPMS.<ref>{{Cite journal|last=Okuda|first=Darin T.|last2=Siva|first2=Aksel|last3=Kantarci|first3=Orhun|last4=Inglese|first4=Matilde|last5=Katz|first5=Ilana|last6=Tutuncu|first6=Melih|last7=Keegan|first7=B. Mark|last8=Donlon|first8=Stacy|last9=Hua|first9=Le H.|date=2014-03-05|title=Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090509|journal=PLOS ONE|language=en|volume=9|issue=3|pages=e90509|doi=10.1371/journal.pone.0090509|issn=1932-6203}}</ref>


==Epidemiology==
==Epidemiology==
Due to the incidental nature of RIS, exact figures on prevalence is unknown, though it has been suggested that RIS is the most common type of [[asymptomatic MS]],<ref>https://www.sciencedirect.com/science/article/pii/S0303846713003661?via%3Dihub</ref> though prevalence may be higher in relatives of patients with MS.<ref>http://www.ajnr.org/content/35/1/106</ref> One study at a university hospital located in a high region of MS disease incidence, put the disease prevalence to approximately 1 in 2000.<ref>http://bmjopen.bmj.com/content/3/11/e003531</ref> An earlier study in 1961 of 15,644 autopsies found 12 cases (0.08%) of unexpected MS findings without a previous history of MS symptoms.<ref>http://journals.sagepub.com/doi/10.1177/1352458512451943</ref><ref> Georgi W. Multiple sclerosis. Anatomopathological findings of multiple sclerosis in diseases not clinically diagnosed. Schweiz Med Wochenschr 1961; 91: 605–607. (German)</ref> The mean age of first indication of RIS from 451 patients is 37.2 years.<ref>http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090509</ref>
Due to the incidental nature of RIS, exact figures on prevalence is unknown, though it has been suggested that RIS is the most common type of [[asymptomatic MS]],<ref>{{Cite journal|date=2013-12-01|title=Asymptomatic MS|url=https://www.sciencedirect.com/science/article/pii/S0303846713003661|journal=Clinical Neurology and Neurosurgery|language=en|volume=115|pages=S1–S5|doi=10.1016/j.clineuro.2013.09.012|issn=0303-8467}}</ref> though prevalence may be higher in relatives of patients with MS.<ref>{{Cite journal|last=Gabelic|first=T.|last2=Ramasamy|first2=D. P.|last3=Weinstock-Guttman|first3=B.|last4=Hagemeier|first4=J.|last5=Kennedy|first5=C.|last6=Melia|first6=R.|last7=Hojnacki|first7=D.|last8=Ramanathan|first8=M.|last9=Zivadinov|first9=R.|date=2014-01-01|title=Prevalence of Radiologically Isolated Syndrome and White Matter Signal Abnormalities in Healthy Relatives of Patients with Multiple Sclerosis|url=http://www.ajnr.org/content/35/1/106|journal=American Journal of Neuroradiology|language=en|volume=35|issue=1|pages=106–112|doi=10.3174/ajnr.A3653|issn=0195-6108|pmid=23886745}}</ref> One study at a university hospital located in a high region of MS disease incidence, put the disease prevalence to approximately 1 in 2000.<ref>{{Cite journal|last=Granberg|first=Tobias|last2=Martola|first2=Juha|last3=Aspelin|first3=Peter|last4=Kristoffersen-Wiberg|first4=Maria|last5=Fredrikson|first5=Sten|date=2013-11-01|title=Radiologically isolated syndrome: an uncommon finding at a university clinic in a high-prevalence region for multiple sclerosis|url=http://bmjopen.bmj.com/content/3/11/e003531|journal=BMJ Open|language=en|volume=3|issue=11|pages=e003531|doi=10.1136/bmjopen-2013-003531|issn=2044-6055|pmid=24189079}}</ref> An earlier study in 1961 of 15,644 autopsies found 12 cases (0.08%) of unexpected MS findings without a previous history of MS symptoms.<ref name=":0" /><ref> Georgi W. Multiple sclerosis. Anatomopathological findings of multiple sclerosis in diseases not clinically diagnosed. Schweiz Med Wochenschr 1961; 91: 605–607. (German)</ref> The mean age of first indication of RIS from 451 patients is 37.2 years.<ref>{{Cite journal|last=Okuda|first=Darin T.|last2=Siva|first2=Aksel|last3=Kantarci|first3=Orhun|last4=Inglese|first4=Matilde|last5=Katz|first5=Ilana|last6=Tutuncu|first6=Melih|last7=Keegan|first7=B. Mark|last8=Donlon|first8=Stacy|last9=Hua|first9=Le H.|date=2014-03-05|title=Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090509|journal=PLOS ONE|language=en|volume=9|issue=3|pages=e90509|doi=10.1371/journal.pone.0090509|issn=1932-6203}}</ref>


==Research directions==
==Research directions==
Current studies have been noted in being short in study duration, and so longer prospective studies, tracking the development of potential disease progression over a longer period of time are warranted. This will ensure the current criteria in RIS is satisfactory and whether consideration should be given to treating individuals with RIS on current MS medication.<ref>http://journals.sagepub.com/doi/10.1177/1352458512451943</ref><ref>https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1044&context=neurol_bull</ref>
Current studies have been noted in being short in study duration, and so longer prospective studies, tracking the development of potential disease progression over a longer period of time are warranted. This will ensure the current criteria in RIS is satisfactory and whether consideration should be given to treating individuals with RIS on current MS medication.<ref name=":0" /><ref name=":1" />


==RIS in children==
==RIS in children==
Though rare, some children that have had unrelated MRI scans have been shown with signs of RIS. The most common reason for an initial MRI in these children was the occurrence of a headache. The first occurrence of a clinical event in nearly half of the children examined was 2 years, though in a majority of cases, 'radiologic evolution', i.e. the increase in lesions or size as detected in subsequent MRI, developed after one year. The presence of [[oligoclonal bands]] in the [[cerebrospinal fluid|CSF]] and [[spinal cord lesions]] were associated with an increased risk of a first clinical event. It was found that children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution.<ref>http://nn.neurology.org/content/4/6/e395</ref>
Though rare, some children that have had unrelated MRI scans have been shown with signs of RIS. The most common reason for an initial MRI in these children was the occurrence of a headache. The first occurrence of a clinical event in nearly half of the children examined was 2 years, though in a majority of cases, 'radiologic evolution', i.e. the increase in lesions or size as detected in subsequent MRI, developed after one year. The presence of [[oligoclonal bands]] in the [[cerebrospinal fluid|CSF]] and [[spinal cord lesions]] were associated with an increased risk of a first clinical event. It was found that children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution.<ref>{{Cite journal|last=Makhani|first=Naila|last2=Lebrun|first2=Christine|last3=Siva|first3=Aksel|last4=Brassat|first4=David|last5=Dallière|first5=Clarisse Carra|last6=Seze|first6=Jérôme de|last7=Du|first7=Wei|last8=Dubief|first8=Françoise Durand|last9=Kantarci|first9=Orhun|date=2017-11-01|title=Radiologically isolated syndrome in children: Clinical and radiologic outcomes|url=http://nn.neurology.org/content/4/6/e395|journal=Neurology - Neuroimmunology Neuroinflammation|language=en|volume=4|issue=6|pages=e395|doi=10.1212/NXI.0000000000000395|issn=2332-7812}}</ref>
==References==
==References==

Revision as of 04:48, 20 March 2018

Radiologically isolated syndrom (RIS) is a clinical situation where a patient has white matter lesions suggestive of multiple sclerosis (MS) as shown on an incidental MRI. The lesions in patients show dissemination in space with an otherwise normal neurological examination and without historical accounts of typical MS symptoms.[1] This condition was first characterized in 2009.[2] MRI findings that are consistent with multiple sclerosis have been observed in healthy people who underwent scanning and 50% go on to develop MS, sometimes with a primary progressive course.[3][4]

Naming

The acronym RIS was coined in 2009 by Okuda and colleagues. An alternative name by Siva and colleagues suggested radiologically uncovered asymptomatic possible inflammatory-demyelinating disease (RAPIDD).[5][6]

Discovery

The most common symptom that is due to the incidental discovery of RIS, is headache, followed by trauma, psychiatric disorders, and endocrinological disorders.[5]

Diagnosis

The criteria for an RIS diagnosis[7][8][5] are as follows:

  1. The presence of incidental MRI findings in the CNS white matter:
    1. Ovoid and well-circumscribed homogenous foci with or without involvement of the corpus callosum
    2. T2 hyperintensities larger than 3 mm in diameter, which fulfill at least 3 of the 4 Barkhof MRI criteria[9] for DIS
    3. the CNS abnormalities are not consistent with a vascular condition
  2. No historical accounts of clinical symptoms consistent with neurological dysfunction
  3. MRI anomalies do not account for apparent impairment in social, occupational, or generalized areas of functioning
  4. MRI anomalies are not due to substance abuse, such as recreational drug use, toxic exposure, or a prior known medical condition
  5. Exclusion of a differential diagnosis of leukoaraiosis, or extensive white matter pathology excluding the corpus callosum
  6. MRI anomalies of the CNS are not accoutned for by another disease

Follow up

Currently, routine clinical follow-up and MRI neuroimaging surveillance is the standard by which patients are observed.[10] While treatment of MS disease modifying therapies have been given to some individuals with RIS, the majority opt for subsequent follow ups or appearance of clinical symptoms before commencing treatment,[5] as treatment is considered controversial.[11]

Prognosis

In a 5 year study, clinical events indicative of MS appeared in 34% of individuals. Of those who developed symptoms, 9.6% fullfilled criteria for PPMS.[12]

Epidemiology

Due to the incidental nature of RIS, exact figures on prevalence is unknown, though it has been suggested that RIS is the most common type of asymptomatic MS,[13] though prevalence may be higher in relatives of patients with MS.[14] One study at a university hospital located in a high region of MS disease incidence, put the disease prevalence to approximately 1 in 2000.[15] An earlier study in 1961 of 15,644 autopsies found 12 cases (0.08%) of unexpected MS findings without a previous history of MS symptoms.[5][16] The mean age of first indication of RIS from 451 patients is 37.2 years.[17]

Research directions

Current studies have been noted in being short in study duration, and so longer prospective studies, tracking the development of potential disease progression over a longer period of time are warranted. This will ensure the current criteria in RIS is satisfactory and whether consideration should be given to treating individuals with RIS on current MS medication.[5][9]

RIS in children

Though rare, some children that have had unrelated MRI scans have been shown with signs of RIS. The most common reason for an initial MRI in these children was the occurrence of a headache. The first occurrence of a clinical event in nearly half of the children examined was 2 years, though in a majority of cases, 'radiologic evolution', i.e. the increase in lesions or size as detected in subsequent MRI, developed after one year. The presence of oligoclonal bands in the CSF and spinal cord lesions were associated with an increased risk of a first clinical event. It was found that children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution.[18]

References

  1. ^ Labiano-Fontcuberta, Andrés; Benito-León, Julián (October 2016). "Radiologically isolated syndrome: An update on a rare entity". Multiple Sclerosis (Houndmills, Basingstoke, England). 22 (12): 1514–1521. doi:10.1177/1352458516653666. ISSN 1477-0970. PMID 27288053.
  2. ^ Okuda, D. T.; Mowry, E. M.; Beheshtian, A.; Waubant, E.; Baranzini, S. E.; Goodin, D. S.; Hauser, S. L.; Pelletier, D. (2009-03-03). "Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome". Neurology. 72 (9): 800–805. doi:10.1212/01.wnl.0000335764.14513.1a. ISSN 1526-632X. PMID 19073949.
  3. ^ Reich, Daniel S; Lucchinetti, Claudia F.; Calabresi, Peter A (January 2018). "Multiple Sclerosis". The New England Journal of Medicine. 378 (2): 169–180. doi:10.1056/NEJMra1401483.
  4. ^ Kantarci, Orhun H.; Lebrun, Christine; Siva, Aksel; Keegan, Mark B.; Azevedo, Christina J.; Inglese, Matilde; Tintoré, Mar; Newton, Braeden D.; Durand-Dubief, Francoise (February 2016). "Primary Progressive Multiple Sclerosis Evolving From Radiologically Isolated Syndrome". Annals of Neurology. 79 (2): 288–294. doi:10.1002/ana.24564. ISSN 1531-8249. PMID 26599831.
  5. ^ a b c d e f Granberg, Tobias; Martola, Juha; Kristoffersen-Wiberg, Maria; Aspelin, Peter; Fredrikson, Sten (March 2013). "Radiologically isolated syndrome--incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review". Multiple Sclerosis (Houndmills, Basingstoke, England). 19 (3): 271–280. doi:10.1177/1352458512451943. ISSN 1477-0970. PMID 22760099.
  6. ^ Siva A, Saip S, Altintas A, . Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease. Mult Scler 2009; 15: 918–927.
  7. ^ Okuda, D. T.; Mowry, E. M.; Beheshtian, A.; Waubant, E.; Baranzini, S. E.; Goodin, D. S.; Hauser, S. L.; Pelletier, D. (2009-03-03). "Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome". Neurology. 72 (9): 800–805. doi:10.1212/01.wnl.0000335764.14513.1a. ISSN 1526-632X. PMID 19073949.
  8. ^ Makhani, Naila; Lebrun, Christine; Siva, Aksel; Brassat, David; Dallière, Clarisse Carra; Seze, Jérôme de; Du, Wei; Dubief, Françoise Durand; Kantarci, Orhun (2017-11-01). "Radiologically isolated syndrome in children: Clinical and radiologic outcomes". Neurology - Neuroimmunology Neuroinflammation. 4 (6): e395. doi:10.1212/NXI.0000000000000395. ISSN 2332-7812.
  9. ^ a b https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1044&context=neurol_bull
  10. ^ Okuda, D. T.; Mowry, E. M.; Beheshtian, A.; Waubant, E.; Baranzini, S. E.; Goodin, D. S.; Hauser, S. L.; Pelletier, D. (2009-03-03). "Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome". Neurology. 72 (9): 800–805. doi:10.1212/01.wnl.0000335764.14513.1a. ISSN 1526-632X. PMID 19073949.
  11. ^ Yamout, B.; Khawajah, M. Al (2017-10-01). "Radiologically isolated syndrome and multiple sclerosis". Multiple Sclerosis and Related Disorders. 17: 234–237. doi:10.1016/j.msard.2017.08.016. ISSN 2211-0348.
  12. ^ Okuda, Darin T.; Siva, Aksel; Kantarci, Orhun; Inglese, Matilde; Katz, Ilana; Tutuncu, Melih; Keegan, B. Mark; Donlon, Stacy; Hua, Le H. (2014-03-05). "Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event". PLOS ONE. 9 (3): e90509. doi:10.1371/journal.pone.0090509. ISSN 1932-6203.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  13. ^ "Asymptomatic MS". Clinical Neurology and Neurosurgery. 115: S1–S5. 2013-12-01. doi:10.1016/j.clineuro.2013.09.012. ISSN 0303-8467.
  14. ^ Gabelic, T.; Ramasamy, D. P.; Weinstock-Guttman, B.; Hagemeier, J.; Kennedy, C.; Melia, R.; Hojnacki, D.; Ramanathan, M.; Zivadinov, R. (2014-01-01). "Prevalence of Radiologically Isolated Syndrome and White Matter Signal Abnormalities in Healthy Relatives of Patients with Multiple Sclerosis". American Journal of Neuroradiology. 35 (1): 106–112. doi:10.3174/ajnr.A3653. ISSN 0195-6108. PMID 23886745.
  15. ^ Granberg, Tobias; Martola, Juha; Aspelin, Peter; Kristoffersen-Wiberg, Maria; Fredrikson, Sten (2013-11-01). "Radiologically isolated syndrome: an uncommon finding at a university clinic in a high-prevalence region for multiple sclerosis". BMJ Open. 3 (11): e003531. doi:10.1136/bmjopen-2013-003531. ISSN 2044-6055. PMID 24189079.
  16. ^ Georgi W. Multiple sclerosis. Anatomopathological findings of multiple sclerosis in diseases not clinically diagnosed. Schweiz Med Wochenschr 1961; 91: 605–607. (German)
  17. ^ Okuda, Darin T.; Siva, Aksel; Kantarci, Orhun; Inglese, Matilde; Katz, Ilana; Tutuncu, Melih; Keegan, B. Mark; Donlon, Stacy; Hua, Le H. (2014-03-05). "Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event". PLOS ONE. 9 (3): e90509. doi:10.1371/journal.pone.0090509. ISSN 1932-6203.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  18. ^ Makhani, Naila; Lebrun, Christine; Siva, Aksel; Brassat, David; Dallière, Clarisse Carra; Seze, Jérôme de; Du, Wei; Dubief, Françoise Durand; Kantarci, Orhun (2017-11-01). "Radiologically isolated syndrome in children: Clinical and radiologic outcomes". Neurology - Neuroimmunology Neuroinflammation. 4 (6): e395. doi:10.1212/NXI.0000000000000395. ISSN 2332-7812.


source: https://en.wikipedia.org/w/index.php?title=Radiologically_isolated_syndrome&diff=831355994&oldid=831353733&diffmode=source

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