Problems start long before diagnosis

D'Anna L, Lorenzut S, Perelli A, Zanchettin B, Valente M, Gigli G.The contribution of assessing cognitive impairment in radiologically-isolated syndrome (RIS): a single case report follow-up study. Mult Scler. 2014 Feb. [Epub ahead of print]

Radiologically-isolated syndrome (RIS) is a recently-defined entity, described as the incidental discovery of lesions suggestive of multiple sclerosis(MS) on brain magnetic resonance imaging (MRI) scans demonstrating dissemination in space (DIS) without symptom expression and with a normal neurological examination.  We describe a case of a RIS patient in whom investigating cognitive functions. 
Recent studies demonstrate that RIS patients present similar features of cognitive impairment as MS patients.




Prof G is a supporter in the "aggressive & early/early & effective" approach because he believes that "Time in Brain" Radiologically isolated syndrome occurs when some one gets a scan but has not yet shown clinical symptoms suggestive of MS and even at that state there is evidence of cognitive problems and supports the view that at presentation there is some loss of cognitive ability. Whilst you can protect it with brain training it is further evidence that MS does damage early and is not a benign condition.

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