About half of people with radiologically isolated syndrome (RIS) experience a first clinical event within 10 years of index MRI. Identifying independent predictors of the risk of symptom onset can guide the education and clinical management of people with RIS. Several studies have attempted to identify common predictors of conversion of RIS to clinical MS, the strongest to date being asymptomatic cervical spinal cord injury. Treatment of RIS is generally not recommended, but could early treatment in carefully selected patients improve long-term outcomes?

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Declaration of interests

The author did not specify his possible competing interests.

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