Multiple sclerosis is a debilitating disease in which the body’s immune system attacks the fatty substance surrounding the nerve fibers in the brain and spinal cord. The resulting damage interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. In the February 2010 issue of Neurology, investigators are suggesting new diagnostic criteria for multiple sclerosis.

The proposed multiple sclerosis criteria are less strict and are designed to promote early diagnosis of the disease. The investigative group, led by researchers from Spain, suggests that current recommendations for diagnosing multiple sclerosis are complex and may not be obvious, even for neurologists. Recommendations for new multiple sclerosis  diagnostic criteria include confirmation of the diagnosis based on a single brain MRI showing at least 1 or more brain lesion indicating multiple sclerosis disease activity. The proposed recommendations also offer guidance on when follow-up brain imaging should be performed.

These new diagnostic recommendations are controversial, as more than 30 percent of people with high-risk brain MRI changes suggestive of multiple sclerosis do not have significant symptoms. These less stringent criteria could increase the risk of treating people with diseases other than multiple sclerosis. Another consideration is the expense and inconvenience associated with current multiple sclerosis treatments. So, before these new diagnostic criteria are adopted, they should be tested in prospective trials.

Source:

Neurology. 2010;74:427-434.