Overview and challenges of the 2024 McDonald diagnostic criteria for multiple sclerosis

Abstract

There have been no disease–specific markers for multiple sclerosis (MS), and diagnosis has traditionally relied on demonstrating dissemination in space (DIS) and in time (DIT) while adequately ruling out other diseases. The McDonald criteria were published in 2001, incorporating MRI into diagnosis. The 2024 revised McDonald criteria show several significant changes compared to previous revised criteria, including a reduced emphasis on DIT and increased importance of MRI evaluation. Further, patients with radiologically isolated syndrome (RIS) could be diagnosed MS when specific criteria are fulfilled. This paper outlines these changes and considers challenges for their implementation in Japan.