Abstract Details

Title Performance of the 2023 Adult Criteria for the Radiologically Isolated Syndrome in Children and Comparison to the 2009 Criteria

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-007

Objective To evaluate and compare the performance of the 2023 and the 2009 adult criteria for the radiologically isolated syndrome (RIS) as predictors of a first clinical neurological event in children with RIS.

Background

Revised diagnostic criteria were published for RIS in adults in 2023—criteria that differ from those originally proposed in 2009 and that should allow for earlier recognition. We do not know how the 2023 criteria perform in children with RIS, as compared with the 2009 criteria.

Design/Methods

We evaluated these criteria in 95 children (<18 years) with RIS enrolled in an international longitudinal study. All children met the 2010 and 2017 MRI criteria for dissemination in space for MS on their index scans (Ped-RIS). Eighteen children (19%) did not have results for spinal cord imaging and/or unique oligoclonal bands in spinal fluid. We therefore performed both a complete case analysis (n=77) and used 30 imputed datasets (n=95).

Results Overall, 67.5% of the 95 children with Ped-RIS met 2023 RIS criteria and 49.5% met 2009 criteria (79.2% and 61.0% amongst 77 children with complete data). The proportion of children who subsequently developed a first clinical neurological event were similar at 35.9% vs. 34.0% (36.1% vs. 34.0% amongst children with complete data) across the two groups during a median follow-up time of 3.1 years (range 0.1-18.5 years). In the imputed dataset, diagnostic indices (with 95% C.I.s) for the 2023 versus the 2009 criteria were: sensitivity 89.1% (75.7%-100.0%) vs. 61.5% (42.8%-80.2%), specificity 40.7% (29.0%-52.3%) vs. 55.1% (43.3%-66.8%), positive predictive value 36.1% (24.3%-48.0%) vs. 34.0% (20.5%-47.6%), and negative predictive value 90.9% (79.8%-100.0%) vs. 76.2% (67.7%-90.8%).

Conclusions The 2023 adult RIS criteria perform favorably overall in children with higher sensitivity and modestly reduced specificity.

Authors/Disclosures
Naila Makhani, MD (Yale University School of Medicine, Department of Pediatrics) PRESENTER	Dr. Makhani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Institute for Advanced Clinical Trials for Children. The institution of Dr. Makhani has received research support from NIH/NINDS. The institution of Dr. Makhani has received research support from Charles H Hood Foundation. The institution of Dr. Makhani has received research support from National Multiple Sclerosis Society. Dr. Makhani has received personal compensation in the range of $0-$499 for serving as a contributor to online content with WebMD. Dr. Makhani has received personal compensation in the range of $500-$4,999 for serving as a contributor to a CME video podcast and newsletter with eMultiple Sclerosis Review. Dr. Makhani has received personal compensation in the range of $5,000-$9,999 for serving as a consultant with I-ACT for children.
Christine Lebrun Frenay, MD, FAAN (CRCSEP Neurologie)	Dr. Lebrun Frenay has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Revue Neurologique. The institution of Dr. Lebrun Frenay has received research support from FRANCE SEP.
Aksel Siva, MD (Istanbul University Cerrahpasa School of Medicine)	Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen - TR. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ali Raif Pharmaceuticals, Turkiye. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanovel Pharmaceuticals, Turkiye. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abdi Ibrahim Ilac - TR. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono . The institution of Dr. Siva has received research support from Turkish MS Society. The institution of Dr. Siva has received research support from The Scientific and Technological Research Council Of Turkey - Health Sciences Research Grants.
Veronika Shabanova	No disclosure on file
Evangeline Wassmer, MD (Birmingham Children's Hospital)	Dr. Wassmer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Wassmer has received research support from Birmingham Children's Hospital Charity Research Foundation.
Jonathan Santoro, MD (Department of Neurology, Children's Hospital Los Angeles)	Dr. Santoro has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Santoro has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Cycle Pharma. Dr. Santoro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dianthus. Dr. Santoro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Down Syndrome Society.
Sona Narula, MD (CHOP)	Dr. Narula has received personal compensation in the range of $0-$499 for serving as a Consultant for Medscape .
James N. Brenton, MD, FAAN	Dr. Brenton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for I-ACT on a Novartis sponsored project. The institution of Dr. Brenton has received research support from NIH/NINDS. The institution of Dr. Brenton has received research support from Autoimmune Encephalitis Alliance. Dr. Brenton has received publishing royalties from a publication relating to health care. Dr. Brenton has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Department of Defense. Dr. Brenton has received personal compensation in the range of $0-$499 for serving as a Grant Reviewer with NIH. Dr. Brenton has received personal compensation in the range of $0-$499 for serving as a Grant Reviewer with FDA.
Soe S. Mar, MD, FAAN (Washington University School of Medicine)	The institution of Dr. Mar has received research support from NIH.
Francoise Durand Dubief (Hopital Pierre Wertheimer)	The institution of Francoise Durand Dubief has received research support from ARSEP.
Helene Zephir (Hospital Roger Salengro)	Helene Zephir has received personal compensation in the range of $0-$499 for serving as a Consultant for BIogen Idec. Helene Zephir has received personal compensation in the range of $0-$499 for serving as a Consultant for novartis. Helene Zephir has received personal compensation in the range of $0-$499 for serving as a Consultant for BMS. Helene Zephir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion.
Guillaume Mathey	Guillaume Mathey has nothing to disclose.
Juan Ignacio Rojas, MD (Hospital Italiano)	Dr. Rojas has nothing to disclose.
Jerome De Seze	Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma. Jerome De Seze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pharma.
Silvia Tenembaum, MD	Dr. Tenembaum has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech-Roche Inc. . Dr. Tenembaum has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech-Roche Inc. . Dr. Tenembaum has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals Inc. .
Robert I. Thompson-Stone, MD, FAAN (University of Rochester)	Dr. Thompson-Stone has received personal compensation in the range of $500-$4,999 for serving as a Krabbe Disease expert with Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC). Dr. Thompson-Stone has a non-compensated relationship as a Editorial Board Member with Neurology: ��ɫ�� Journal that is relevant to AAN interests or activities.
Olivier Casez, MD (CHU De Grenoble)	Dr. Casez has nothing to disclose.
Clarisse Carra-Dalliere	No disclosure on file
Rinze F Neuteboom	Rinze F Neuteboom has nothing to disclose.
Nusrat Ahsan, MD	Dr. Ahsan has nothing to disclose.
Hugo A. Arroyo, MD	Dr. Arroyo has nothing to disclose.
Philippe Cabre	Philippe Cabre has nothing to disclose.
Grace Gombolay, MD, FAAN (Emory University/Children'S Healthcare of Atlanta)	The institution of Dr. Gombolay has received research support from CDC. The institution of Dr. Gombolay has received research support from NIH.
Matilde Inglese, MD, PhD (University of Genoa)	Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SANOFI GENZYME. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Inglese has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for MERCK-SERONO. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MS Journal.
Celine Louapre (Hôpital Pitié Salpêtrière, APHP)	Celine Louapre has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Celine Louapre has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Celine Louapre has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Celine Louapre has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Celine Louapre has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Oculis.
Monica Margoni	Monica Margoni has received research support from MAGNIMS. Monica Margoni has received research support from Merck-Serono. Monica Margoni has received research support from Sanofi-Genzyme.
Filipe Palavra	No disclosure on file
Daniela Pohl	Daniela Pohl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Syneos.
Daniel Reich, MD, PhD (National Institutes of Health, Neuroimmunology Branch, NINDS)	Dr. Reich has received research support from NIH. The institution of Dr. Reich has received research support from Adelson Medical Research Foundation. The institution of Dr. Reich has received research support from Sanofi. The institution of Dr. Reich has received research support from Abata Therapeutics. The institution of Dr. Reich has received research support from National Multiple Sclerosis Society. The institution of Dr. Reich has received research support from Cure Alzheimer's Fund. Dr. Reich has received intellectual property interests from a discovery or technology relating to health care. Dr. Reich has received personal compensation in the range of $5,000-$9,999 for serving as a CME Faculty with Integrity. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with Letters and Sciences. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with Academic CME. Dr. Reich has a non-compensated relationship as a Advisor with Sanofi that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Board of Directors with ACTRIMS that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Abata Therapeutics that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with University of Basel RC2NB that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Multiple Sclerosis Society of Canada that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Tuscan Doctorate in Neuroscience that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Editorial Board with Multiple Sclerosis Journal that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator, Advisor with Hyperfine that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Imaginab that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Annexon that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator, Advisor with Philips that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Siemens that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Calico Life Sciences that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Cognito Therapeutics that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Sudo that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Allumis that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with BioCentury that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Regeneron that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Eli Lilly that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with SetPoint that is relevant to AAN interests or activities.
Aurelie Ruet (Hopital Pellegrin)	The institution of Aurelie Ruet has received research support from BIOGEN. The institution of Aurelie Ruet has received research support from ROCHE. The institution of Aurelie Ruet has received research support from SANOFI GENZYME. The institution of Aurelie Ruet has received research support from BMS. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Board member with Horizon therapeutic. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Board member with Alexion. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Speaker meeting with BIOGEN. Aurelie Ruet has received personal compensation in the range of $500-$4,999 for serving as a Speaker meeting with MERCK. Aurelie Ruet has received personal compensation in the range of $0-$499 for serving as a Speaker meeting with Sanofi Genzyme.
Eric Thouvenot, MD, PhD (CHU De Nimes - Hopital Caremeau)	Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Biogen. Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Merck. Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Teva. Dr. Thouvenot has received personal compensation in the range of $0-$499 for serving as a Consultant for Novartis. Dr. Thouvenot has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Thouvenot has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Thouvenot has received research support from Biogen. The institution of Dr. Thouvenot has received research support from Novartis. The institution of Dr. Thouvenot has received research support from Roche.
Niklas Timby	No disclosure on file
Mar Tintoré, MD, PhD	The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche . The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi Genzyme . The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela bio. The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Janssen. Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. The institution of Mar Tintoré, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Parexel and UCB Biopharma. Mar Tintoré, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal: Experimental, Translational and Clinical. The institution of Mar Tintoré, MD, PhD has received research support from Fundació La Marató de TV3. The institution of Mar Tintoré, MD, PhD has received research support from Instituto de Salud Carlos III. The institution of Mar Tintoré, MD, PhD has received research support from Instituto de Salud Carlos III. The institution of Mar Tintoré, MD, PhD has received research support from Instituto de Salud Carlos III.
Ugur Uygunoglu (Cerrahpasa)	Ugur Uygunoglu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Turkey . The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen Idec/Gen Pharma of Turkey. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck-Serono of Turkey. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanovel of Turkey. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Genveon of Turkey.
Wendy S. Vargas, MD (Sanofi)	Dr. Vargas has received personal compensation for serving as an employee of Sanofi.
Helene Verhelst	No disclosure on file
Ronny Wickström (Karolinska University Hospital)	No disclosure on file
Christina Azevedo, MD, FAAN (University of Southern California)	Dr. Azevedo has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi Genzyme. Dr. Azevedo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Zenas Biopharma. Dr. Azevedo has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Azevedo has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Dr. Azevedo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Azevedo has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Wood, Smith, Henning & Berman LLP. The institution of Dr. Azevedo has received research support from National Multiple Sclerosis Society. The institution of Dr. Azevedo has received research support from National Institutes of Health/National Institutes of Neurological Disorders and Stroke. The institution of Dr. Azevedo has received research support from National Multiple Sclerosis Society.
Orhun H. Kantarci, MD	Dr. Kantarci has nothing to disclose.
Eugene Shapiro (Yale Univ School of Medicine)	No disclosure on file
Darin T. Okuda, MD, FAAN (UT Southwestern Medical Center)	Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cortechs AI. Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Okuda has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Okuda has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Bioscience. Dr. Okuda has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. Dr. Okuda has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Zenas BioPharma. The institution of Dr. Okuda has received research support from Novartis. The institution of Dr. Okuda has received research support from Alexion. Dr. Okuda has received intellectual property interests from a discovery or technology relating to health care.
Daniel Pelletier, MD (Keck School of Medicine of USC)	Dr. Pelletier has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Pelletier has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi Genzyme. Dr. Pelletier has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Pelletier has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Polpharma Biologics.

��ɫ����

��ɫ����

��ɫ��

��ɫ��