Researchers from Spain have proposed new criteria to replacing existing measures used to diagnosis multiple sclerosis. If adopted, the new criteria could lead to an MS diagnosis on the basis of a single MRI. The investigators’ recommendations, which have received mixed reviews from the medical community, are published in the February issue of Neurology.
Less strict than the current criteria, the proposed criteria are designed to promote earlier diagnosis of MS in clinically isolated syndromes. The goal is to “simplify the existing MS diagnostic criteria, while maintaining a high specificity that is essential to minimize false positive diagnoses,” according to researchers led by Xavier Montalban, MD, from the Hospital Universitari Vall d'Hebron, in Barcelona, Spain.
Because the current recommendations are complex, even neurologists may be overlooking cases of MS, the investigators say. However, some MS experts approach the idea of earlier diagnostics with caution.
“There are both risks and benefits to an earlier diagnosis of MS,” says MSF Senior Medical Advisor Ben Thrower, M.D. “Risks include the potential for more inaccurate diagnoses. An earlier diagnosis may also lead to more patients starting therapy with expensive and inconvenient medications. Some would argue that a certain percentage of people with MS will follow a benign course and may not need early treatment.”
For others, an earlier diagnosis could be beneficial. Says Dr. Thrower: “The benefits of establishing the diagnosis of MS sooner include peace of mind for patients and families when dealing with unexplained symptoms. Also, studies have shown fewer relapses and new MRI lesions in those who started there MS therapy sooner. These newly proposed guidelines will need to be studied further and compared to the existing McDonald criteria."