An article published in the November issue of Annals of Neurology examined 30-year outcomes for people who experience clinically isolated syndrome (CIS), often a warning sign for eventual development of multiple sclerosis (MS). The analysis, from a cohort of 132 people who enrolled in a UK study in the 1980s, identified several factors associated with increased or decreased likelihood of clinical MS onset by 30 years post-CIS. The presence of baseline infra-tentorial lesions and deep white matter lesions at one year post-CIS was the strongest early predictor of developing secondary progressive MS within the 30-year window. The initial number—and subsequent accumulation—of brain lesions also correlated with likelihood of developing MS-related disability within 20 years.
“One of the most challenging questions that any neurologist faces from a young person with CIS is, ‘What will happen to me in the long-term?’ This unique study from the Queen Square group supplies new and potentially helpful prognostic information,” notes ANA President Justin McArthur, MBBS, MPH, John W. Griffin Professor of Neurology at Johns Hopkins Medicine.
“Data are being accumulated from imaging, optical, and soluble biomarkers in several large multi-center cohorts that will hopefully provide even more precise answers to critical questions of prognostication, lifestyle and pregnancy recommendations, and the selection of the timing and level of potency of disease-modifying therapies. Precision medicine for MS may not yet be at the level of cancer therapy, but we are getting much closer.”