%0 Journal Article
%T Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event
%A Darin T. Okuda
%A Aksel Siva
%A Orhun Kantarci
%A Matilde Inglese
%A Ilana Katz
%A Melih Tutuncu
%A B. Mark Keegan
%A Stacy Donlon
%A Le H. Hua
%A Angela Vidal-Jordana
%A Xavier Montalban
%A Alex Rovira
%A Mar Tintor谷
%A Maria Pia Amato
%A Bruno Brochet
%A J谷rˋme de Seze
%A David Brassat
%A Patrick Vermersch
%A Nicola De Stefano
%A Maria Pia Sormani
%A Daniel Pelletier
%A Christine Lebrun
%A on behalf of the Radiologically Isolated Syndrome Consortium (RISC) and Club Francophone de la Scl谷rose en Plaques (CFSEP)
%J PLOS ONE
%D 2014
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0090509
%X Objective To report the 5-year risk and to identify risk factors for the development of a seminal acute or progressive clinical event in a multi-national cohort of asymptomatic subjects meeting 2009 RIS Criteria. Methods Retrospectively identified RIS subjects from 22 databases within 5 countries were evaluated. Time to the first clinical event related to demyelination (acute or 12-month progression of neurological deficits) was compared across different groups by univariate and multivariate analyses utilizing a Cox regression model. Results Data were available in 451 RIS subjects (F: 354 (78.5%)). The mean age at from the time of the first brain MRI revealing anomalies suggestive of MS was 37.2 years (y) (median: 37.1 y, range: 11每74 y) with mean clinical follow-up time of 4.4 y (median: 2.8 y, range: 0.01每21.1 y). Clinical events were identified in 34% (standard error = 3%) of individuals within a 5-year period from the first brain MRI study. Of those who developed symptoms, 9.6% fulfilled criteria for primary progressive MS. In the multivariate model, age [hazard ratio (HR): 0.98 (95% CI: 0.96每0.99); p = 0.03], sex (male) [HR: 1.93 (1.24每2.99); p = 0.004], and lesions within the cervical or thoracic spinal cord [HR: 3.08 (2.06每4.62); p = <0.001] were identified as significant predictors for the development of a first clinical event. Interpretation These data provide supportive evidence that a meaningful number of RIS subjects evolve to a first clinical symptom. An age <37 y, male sex, and spinal cord involvement appear to be the most important independent predictors of symptom onset.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0090509