CVS Just as Sensitive as LP for Dx of MS in Patients With Clinically Isolated Syndrome

Background: Multiple sclerosis (MS) is difficult to diagnose, and delay in diagnosis can lead to increased morbidity due to lack of treatment. Unpaired oligoclonal bands (OCBs) within the cerebrospinal fluid on lumbar puncture (LP) has been used to support the diagnosis in patients with clinically isolated syndrome using the 2017 McDonald criteria. Currently, proposed upgraded McDonald criteria include using the central vein sign (CVS) to support the diagnosis. Objective: To determine whether the CVS could replace LP in the diagnosis of MS in patients with clinically isolated syndrome, and to determine if the rule of 6 (finding of 6 lesions with a central vein) is just as good as the threshold of 40% of lesions having a central vein, as has been suggested by other studies. Design: Prospective multicenter study in which raters were blinded to data. Participants: 113 patients were enrolled in the study, with 14 dropping out before completion of study activities. Methods: All participan more...