Understanding Radiologically Isolated Syndrome as Either Presymptomatic MS or an Independent Condition: Mikael Cohen, MD

WATCH TIME: 4 minutes

"The reason for the first brain MRI does not influence the risk of conversion to [multiple sclerosis] and does not have a real impact on the follow-up of the patients."

Prior research shows that radiologically isolated syndrome (RIS) is clinically defined by the incidental finding of MRI lesions suggestive of multiple sclerosis (MS) among patients who had an MRI scan for an unrelated reason and who had a normal neurological examination. In some recent studies, findings suggested that subtle abnormalities could be identified in patients with MS who had an Expanded Disability Status Scale of 0 using more challenging tasks than the traditional examination; however, little evidence was available on the RIS patient population.

In a recent study presented at the recently concluded 2024 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, September 18-20, in Copenhagen, Denmark, findings demonstrated the usefulness of digital tools in revealing subtle neurological abnormalities in patients with RIS compared with healthy controls. Presented by lead author Mikael Cohen, MD, and colleagues, these results provided evidence of how fast and efficiently accessible tools can unveil abnormalities in patients with a normal traditional examination, suggesting that digital neurological assessment could also be used in other neurological conditions.¹

Cohen, a neurologist of the MS Center at the University Hospital Center of Nice in France, also participated as a speaker in a hot topic session titled “Prodromal MS and radiologically isolated syndromes,” which debated the question whether RIS is presymptomatic MS. At the Congress, Cohen sat down with NeurologyLive^® in an interview to dive deeper into a discussion on how the current research differentiates between RIS and early MS in clinical practice. He also talked about the diagnostic challenges that arise in identifying subtle neurological abnormalities in patients with RIS. Furthermore, he spoke about how recent clinical trials influence treatment approaches for RIS and its potential conversion to MS.

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REFERENCES
1. Cohen M, et al. Exploring the radiologically isolated syndrome through digital biomarkers: what’s the real definition of a normal neurological examination? normal neurological examination?. Presented at: 2024 ECTRIMS; September 18-20; Copenhagen, Denmark. Abstract P288.