Is radiologically isolated syndrome (RIS) the earliest sign of multiple sclerosis (MS)? This article discusses RIS as the earliest detectable preclinical phase of MS, highlighting recent advancements in understanding risk factors, diagnostic criteria revisions, and the impact of early disease-modifying therapy. The review examines RIS within the spectrum of MS, discussing its implications for clinical management and future opportunities given the anticipated inclusion of asymptomatic MS in the formal definition of MS. It addresses critical questions about the natural history of MS and the potential for early intervention. This work provides valuable insights for neurologists and researchers, contributing to the ongoing efforts to improve the diagnosis, management, and prevention of MS. The discussion of asymptomatic MS further emphasizes the evolving understanding of this complex neurological disorder.
Published in Multiple Sclerosis Journal, this article directly fits the journal’s scope by providing a comprehensive overview of radiologically isolated syndrome (RIS) and its relationship to MS. It addresses critical issues in the diagnosis and management of MS, contributing to the journal's objective of advancing knowledge in this field.