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Predicting multiple sclerosis at optic neuritis onset

Neuroepidemiology Unit, Division of Neurology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden, Division of Medical Statistics, Chongqing University of Medical Sciences, Chongqing, Peoples Republic of China, Ya-Ping.Jin{at}neurotec.ki.se

J de Pedro-Cuesta

Neuroepidemiology Unit, Division of Neurology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden, Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain

Y H Huang

Neuroepidemiology Unit, Division of Neurology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden

M Söderström

Neuroepidemiology Unit, Division of Neurology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden, Division of Ophthalmology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden

Using multivariate analyses, individual risk of clinically definite multiple sclerosis (C DMS) after monosymptomatic optic neuritis (MO N) was quantified in a prospective study with clinical MO N onset during 1990 -95 in Stockholm, Sweden. During a mean follow-up time of 3.8 years, the presence of MS-like brain magnetic resonance imaging (MRI) lesions and oligoclonal immunoglobulin (Ig) G bands in cerebrospinal fluid (CSF) were strong prognostic markers of C DMS, with relative hazard ratios of 4.68 {95% confidence interval (CI) 2.21 -9.91} and 5.39 (95% C I 1.56 -18.61), respectively. Age and season of clinical onset were also significant predictors, with relative hazard ratios of 1.76 (95% C I 1.02 -3.04) and 2.21 (95% C I 1.13 -3.98), respectively. Based on the above two strong predicto rs, individual probability of C DMS development after MO N was calculated in a three-quarter sample drawn from a cohort, with completion of follow-up at three years. The highest probability, 0.66 (95% C I 0.48 -0.80), was obtained for individuals presenting with three or more brain MRI lesions and oligoclonal bands in the C SF, and the lowest, 0.09 (95% C I 0.02 -0.32), for those not presenting with these traits. Medium values, 0.29 (95% C I 0.13 -0.53) and 0.32 (95% C I 0.07 -0.73), were obtained for individuals discordant for the presence of brain MRI lesions and oligoclonal bands in the C SF. These predictions were validated in an external one-quarter sample.

Key Words: individuality • multiple sclerosis • multivariate analysis • optic neuritis • probability

Multiple Sclerosis, Vol. 9, No. 2, 135-141 (2003)
DOI: 10.1191/1352458503ms895oa


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