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Review
. 2024 May;30(6):630-636.
doi: 10.1177/13524585241245306. Epub 2024 Apr 15.

Radiologically isolated syndrome in the spectrum of multiple sclerosis

Darin T Okuda  1   2 , Christine Lebrun-Frénay  3
Affiliations
Review

Radiologically isolated syndrome in the spectrum of multiple sclerosis

Darin T Okuda et al. Mult Scler. 2024 May.

Abstract

The radiologically isolated syndrome (RIS) currently represents the earliest detectable preclinical phase of multiple sclerosis (MS). Remarkable advancements have been recently made, including the identification of risk factors for disease evolution, revisions to the existing 2009 RIS criteria, and our understanding of the impact of early disease-modifying therapy use in the prevention/delay of symptomatic MS from two randomized clinical trials. Here, we discuss RIS in the context of the spectrum of MS, implications in the clinical management of individuals, and provide insights into future opportunities and challenges given the anticipated inclusion of asymptomatic MS in the formal definition of MS.

Keywords: Radiologically isolated syndrome; disease-modifying therapy; multiple sclerosis.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. D.T.O. received personal compensation for consulting and advisory services from Biogen, Eisai, EMD Serono, Genentech, Genzyme/Sanofi, Moderna, RVL Pharmaceuticals, Inc., and Zenas Biopharma in addition to research support from Biogen, EMD Serono/Merck, and Novartis. Dr. D.T.O. has issued national/international patents and pending patents related to developed technologies. Dr. D.T.O. received royalties for intellectual property licensed by The Board of Regents of The University of Texas System. Dr. D.T.O. is the Founder of Revert Health Inc. and holds equity interest of Blackwerx. Dr. C.L.-F. reports no disclosures.

Figures

Figure 1.
Figure 1.
Envisioned series of events from environmental exposures, including the Epstein Barr virus (top), activation of B and T (blue) immune cells (scanning electron micrographs of human lymphocytes from the National Institute of Allergy and Infectious Diseases), development of the first MRI lesion visible on MRI, and possible evolution to radiologically isolated syndrome and multiple sclerosis.
See this image and copyright information in PMC

References

    1. Okuda DT, Mowry EM, Beheshtian A, et al.. Incidental MRI anomalies suggestive of multiple sclerosis: The radiologically isolated syndrome. Neurology 2009; 72: 800–805. - PubMed
    1. Lebrun C, Bensa C, Debouverie M, et al.. Unexpected multiple sclerosis: Follow-up of 30 patients with magnetic resonance imaging and clinical conversion profile. J Neurol Neurosurg Psychiatry 2008; 79(2): 195–198. - PubMed
    1. Siva A, Saip S, Altintas A, et al.. Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease. Mult Scler 2009; 15(8): 918–927. - PubMed
    1. Okuda DT, Siva A, Kantarci O, et al.. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS ONE 2014; 9(3): e90509. - PMC - PubMed
    1. Lebrun-Frenay C, Kantarci O, Siva A, et al.. Radiologically isolated syndrome: 10-year risk estimate of a clinical event. Ann Neurol 2020; 88(2): 407–417. - PubMed

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