Document Detail

Validation of diagnostic magnetic resonance imaging criteria for multiple sclerosis and response to interferon beta1a.
MedLine Citation:
PMID:  12783417     Owner:  NLM     Status:  MEDLINE    
In the recently proposed diagnostic criteria for multiple sclerosis (MS) by McDonald, the modified magnetic resonance imaging (MRI) Barkhof criteria have been incorporated. We examined the validity of this implementation in the Early Treatment of MS study, a randomized, double-blind, placebo-controlled study of 22 microg interferon beta1a given subcutaneously once weekly in 309 patients with a first episode consistent with demyelinating disease (and abnormal MRI). Conversion to clinically definite MS (CDMS) within 2 years of follow-up, as evidenced by a new clinical episode, occurred in 41% of patients (independent of treatment) with gadolinium enhancement or nine or more T2 lesions versus 11% of those without either finding (p = 0.017); similarly, proportions converting were 44% versus 31% for infratentorial lesions (p = 0.026), 40% versus 35% for juxtacortical lesions (p = 0.413), and 41% versus 17% for three or more periventricular lesions (p = 0.034). The rate of conversion to CDMS based on the number of modified Barkhof criteria was 22% for two or fewer positive criteria, increasing to 47% with four positive criteria. For a cutoff of three positive criteria, the hazard ratio for time to CDMS was 2.3 (95% confidence interval, 1.17-4.55; p = 0.016). Treatment effect seemed more evident as the number of positive criteria increased, and the number of patients needed to avoid one patient converting to CDMS decreased from 50 in patients with one or two positive criteria to 5.6 in patients with four positive criteria. However, the study was not powered to detect statistically significant treatment by variable interaction, and this remains an important issue for further study.
Frederik Barkhof; Mara Rocca; Gordon Francis; Jan-Hein T M Van Waesberghe; Bernard M J Uitdehaag; Otto R Hommes; Hans-Peter Hartung; Luca Durelli; Gilles Edan; Oscar Fernández; Pierette Seeldrayers; Per Sørensen; Simon Margrie; Marco Rovaris; Giancarlo Comi; Massimo Filippi;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Annals of neurology     Volume:  53     ISSN:  0364-5134     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-03     Completed Date:  2003-07-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  718-24     Citation Subset:  IM    
MS-MRI Centre and Department of Radiology, VU Medical Centre, Amsterdam, The Netherlands.
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MeSH Terms
Adjuvants, Immunologic / therapeutic use*
Brain / pathology*
Follow-Up Studies
Gadolinium / diagnostic use
Immunoglobulin G / cerebrospinal fluid
Interferon-beta / therapeutic use*
Magnetic Resonance Imaging*
Multiple Sclerosis / cerebrospinal fluid,  drug therapy*,  pathology*
Randomized Controlled Trials as Topic
Reproducibility of Results
Reg. No./Substance:
0/Adjuvants, Immunologic; 0/Immunoglobulin G; 145258-61-3/interferon beta 1a; 7440-54-2/Gadolinium; 77238-31-4/Interferon-beta

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