Judicious multiple sclerosis (MS) diagnosis and early start of disease modifying therapy significantly improves long-term disability outcomes in persons with MS (pwMS). Retrospective analysis based on 25-year New York State MS Consortium (NYSMSC) data determined the effect of changes in the respective diagnostic criteria in shortening the time between symptom onset to MS diagnosis. Based on 9378 current and historical MS cases, there was a significant decrease in time to diagnosis in pwMS from 1982–2001 to >2017 periods (average 4.2 vs. 1.1 years, p < 0.001). Additional improvements and better implementation of the MS diagnostic criteria can further decrease the diagnosis lag.
ThompsonAJBaranziniSEGeurtsJ, et al. Multiple sclerosis. Lancet2018; 391: 1622–1636.
2.
MarrieRAAllegrettaMBarcellosLF, et al. From the prodromal stage of multiple sclerosis to disease prevention. Nat Rev Neurol2022; 18: 559–572.
3.
HartungHPGrafJAktasO, et al. Diagnosis of multiple sclerosis: Revisions of the McDonald criteria 2017—Continuity and change. Curr Opin Neurol2019; 32(3): 327–337.
4.
Wandall-HolmMFBuronMDKoppTI, et al. Time to first treatment and risk of disability pension in relapsing-remitting multiple sclerosis. J Neurol Neurosurg Psychiatry2022; 93(8): 858–864.
5.
JakimovskiDKavakKSVaughnCB, et al. Discontinuation of disease modifying therapies is associated with disability progression regardless of prior stable disease and age. Mult Scler Relat Disord2022; 57: 103406.
6.
ThompsonAJBanwellBLBarkhofF, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol2018; 17: 162–173.
7.
BlaschkeSJEllenbergerDFlacheneckerP, et al. Time to diagnosis in multiple sclerosis: Epidemiological data from the German Multiple Sclerosis Registry. Mult Scler2022; 28(6): 865–871.
8.
VaughnCBJakimovskiDKavakKS, et al. Epidemiology and treatment of multiple sclerosis in elderly populations. Nat Rev Neurol2019; 15(6): 329–342.
9.
KaufmannMKuhleJPuhanMA, et al. Factors associated with time from first-symptoms to diagnosis and treatment initiation of Multiple Sclerosis in Switzerland. Mult Scler J Exp Transl Clin2018; 4(4): 1–10.
10.
TintoreMCobo-CalvoACarbonellP, et al. Effect of changes in MS diagnostic criteria over 25 years on time to treatment and prognosis in patients with clinically isolated syndrome. Neurology2021; 97: e1641–e1652.
11.
FilippiMPreziosaPMeaniA, et al. Performance of the 2017 and 2010 revised McDonald criteria in predicting MS diagnosis after a clinically isolated syndrome: A MAGNIMS study. Neurology2022; 98: e1–e14.
12.
SolomonAJNaismithRTCrossAH. Misdiagnosis of multiple sclerosis: Impact of the 2017 McDonald criteria on clinical practice. Neurology2019; 92: 26–33.
