Source (journal article): NEURON, Vol. 30, #3 (2025), pp. 18–22 (Dutch).
In this article, Christine Lebrun-Frenay, member of the McDonald and ECTRIMS committees and co-founder of the RIS Consortium, reviews the rationale behind the 2024 revision and discusses its practical implications, particularly in asymptomatic patients transitioning from Radiologically Isolated Syndrome (RIS) to Multiple Sclerosis (MS).
This publication reflects ParadigMS’ ongoing commitment to translating evolving diagnostic frameworks into clinically relevant guidance for neurologists.
Key takeaways
- The 2024 McDonald criteria seek a better balance between early diagnosis and avoiding overdiagnosis in Multiple Sclerosis (MS).
- Radiologically Isolated Syndrome (RIS) can carry a high risk of conversion to MS, particularly when CSF abnormalities, spinal cord lesions, and dissemination in time are present (up to 87% at 10 years).
- Even in the absence of high-risk factors, patients with RIS require regular follow-up.
- Early treatment in RIS (dimethyl fumarate, teriflunomide) significantly reduces the risk of a first clinical event.
- The core diagnostic principles remain unchanged:
- dissemination in space, dissemination in time, and exclusion of alternative diagnoses.
- The 2024 revision integrates additional MRI markers and cerebrospinal fluid biomarkers to increase diagnostic confidence.
- Clinical judgment remains central. The updated criteria support earlier identification while maintaining diagnostic rigor.
The article
“De vertaling van de 2024-criteria bij asymptomatische patiënten in de klinische praktijk: van het RIS naar MS”
The article is published in Dutch.
- pp. 18–19: The 2024 McDonald criteria aim to improve the balance between early MS diagnosis and avoiding misdiagnosis.
- pp. 18–20: In Radiologically Isolated Syndrome (RIS), conversion risk is highest when CSF is positive + spinal cord lesions + dissemination in time (DIT) are present (reported up to 87% at 10 years).
- pp. 18–20: Even without high-risk factors, RIS still warrants structured monitoring (low risk ≠ no follow-up).
- pp. 18–20: Early treatment in RIS (e.g., dimethyl fumarate or teriflunomide) can markedly reduce the risk of a first clinical demyelinating event in trials.
- pp. 19–22: Core principles remain unchanged: dissemination in space + dissemination in time + exclusion of better alternatives, supported by clinical judgement and updated paraclinical tools.
You’ll need to subscribe to our platform or log-in to see the presentation.
The biography of the expert
Christine Lebrun-Frenay
MD PhD, FAAN, is Professor of Neurology and Oncologist.
She is head of the inflammatory neurological disorders clinical research unit and MS center at the University of Nice Cote d’Azur.
She is a member of the French Neurological Society and French MS Society (SFSEP), in which she was president and of the European and American Academies of Neurology.
In 2008, she described the first cohort of a subclinical form of MS. Subsequently, she co-founded with American, European, and Turkish colleagues the RIS Consortium, which expanded worldwide to collect a unique, extensive patient cohort. Her research interest includes therapeutical and MRI studies in MS with a specific implication in the description of Radiologically Isolated Syndrome (RIS).
She is the co-editor of recommendations in MS for the French MS Society (vaccines, infections, and DMTs). She is participating in numerous clinical trials and research studies with international publications in neuroinflammatory diseases. Member of several editorial boards of scientific journals and scientific boards, she is also involved in medical evaluations for MS patients’ associations.
She was nominated in 2018 for the executive committee of the ECTRIMS, the French Association for MS Research (ARSEP), received in 2020, the Excellence Price of the Cote d’Azur University, The French Neurological Society, and 2023 member of the McDonald Committee.
Media
Details
We value your opinion.
