Performance of the revised 2017 McDonald criteria

Abstract

A rapid and reliable diagnosis of multiple sclerosis (MS) is crucial to initiate adapted disease-modifying treatment. The 2017 McDonald criteria were revised with the aim of further improving the diagnostic performance. In this article the published studies comparing the use of the 2017 and 2010 McDonald criteria were reviewed and analyzed in terms of diagnostic performance. A total of 20studies and 1review article with atotal of 3006 evaluated patients were identified by means of aliterature search in the PubMed database (search term: McDonald criteria 2010 and McDonald criteria 2017). Using the 2017 McDonald criteria, adiagnosis of MS was made in more patients (2277/3006patients, 76%) and in an earlier stage (3-10months) compared with the 2010 revision (1562/3006patients, 52%). Of the additional MS diagnoses, 193/715 were due to the adjustment of the imaging criteria of temporal dissemination and 536/715 were due to the introduction of oligoclonal bands as adiagnostic criterion. The revised McDonald criteria of 2017 have achieved their goal and enable the diagnosis of MS in ahigher proportion of patients at the first clinical event.