title: Risk factors for convertion to clinically defined multiple sclerosis after clinically isolated syndrome in a racially mixed Brazilian cohort.
abstract: Clinically isolated syndrome may reflect the first symptom of Multiple Sclerosis. Though more prevalent in Caucasians, MS can also affect Afrodescendts. Modifying disease drugs can delay convertion to clinically defined multiple sclerosis, therefore, identify patients at a higher risk of convertion is important. However data of risk factors in racially mixed population are scarce.
  
  
  OBJECTIVE
  To analyze predictor factors to the conversion from CIS to CDMS in a mixed race Brazilian cohort.
  
  
  METHODS
  It is a prognostic observational retrospective study, in 122 patients from MS referential center at Hospital da Lagoa, Rio de Janeiro-Brazil. Demographic and clinical features, as well as MRI and cerebrospinal fluid data were analyzed.
  
  
  RESULTS
  After five years follow-up 87.3% converted to CDMS. Regarding to median time of conversion, there was no difference between gender, race, age at onset, mono or polysymptomatic presentation. Cerebellar CIS significantly reduced time to second event; likewise sphincter impairment. Considering DMD, patients without treatment converted earlier.
  
  
  CONCLUSIONS
  Ancestry did not influence conversion risk. Cerebellar and shpincter impairment as well as MRI criteria both Barkhof/Tintoré and Swanton were important predictors. In future studies it should be also analysed the risk factors of progression in mixed race populations.
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro-UNIRIO/Hospital Universitário Gaffree Guinle, Brazil. Electronic address: anacriswing@globo.com.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Wing
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro-UNIRIO/Hospital Universitário Gaffree Guinle, Brazil.
authors.forename: Claudia Cristina Ferreira
authors.initials: CC
authors.lastname: Vasconcelos
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro-UNIRIO/Hospital Universitário Gaffree Guinle, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Calvet
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro-UNIRIO/Hospital Universitário Gaffree Guinle, Brazil; Hospital Federal da Lagoa, Brazil.
authors.forename: Regina Maria
authors.initials: RM
authors.lastname: Papais-Alvarenga
authors.affiliation: Instituto Nacional do Cancer-INCA, Brazil.
authors.forename: Luiz Claudio Santos
authors.initials: LC
authors.lastname: Thuler
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003711:Demyelinating Diseases / Q000453:epidemiology* / Q000208:ethnology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000208:ethnology; D012307:Risk Factors; D055815:Young Adult
keywords: Afrodescendt; Clinicaly isolated syndrome; Convertion; Multiple sclerosis; Risk factors