{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:47:58Z","timestamp":1789674478553,"version":"4.0.1"},"reference-count":15,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100003493","name":"Gemeinn\u00fctzige Hertie-Stiftung","doi-asserted-by":"publisher","award":["P1150063"],"award-info":[{"award-number":["P1150063"]}],"id":[{"id":"10.13039\/501100003493","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR-BRC-UCLH"},{"name":"Stichting voor MS Research","award":["14-358e"],"award-info":[{"award-number":["14-358e"]}]},{"DOI":"10.13039\/501100006401","name":"Fondation Charcot","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006401","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test the current progressive multifocal leukoencephalopathy (PML) diagnostic criteria by applying them to patients previously diagnosed with natalizumab\u00a0(NTZ)-associated\u00a0PML in a real-world clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients from the Dutch-Belgian NTZ-PML cohort (n=28) were reviewed at the time of first diagnostic work-up and during follow-up, using the PML diagnostic criteria as proposed in a consensus statement from the American Academy of Neurology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At first diagnostic work-up, 18 patients (64.3%) met the criteria for high diagnostic certainty for PML (\u2018definite PML\u2019 or \u2018probable PML\u2019). During follow-up, this increased to 20 patients (71.4%) as JC\u00a0virus\u00a0DNA was detected in cerebrospinal fluid\u00a0of two additional patients. Nonetheless, 28.6% of patients were still classified as \u2018possible PML\u2019 or \u2018not PML\u2019 (6\u00a0(21.5%) and 2\u00a0(7.1%)\u00a0patients, respectively) despite a very high suspicion for PML based on lesion evolution and signs of PML-immune reconstitution inflammatory syndrome on MRI, and development of compatible symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current case definition of PML has low sensitivity for diagnosis of NTZ-PML in a real-world clinical setting in which MRI is frequently used for PML screening. This may delay diagnosis and appropriate management of PML, and may complicate a valid estimation of PML incidence during NTZ therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2018-318261","type":"journal-article","created":{"date-parts":[[2018,8,12]],"date-time":"2018-08-12T12:15:26Z","timestamp":1534076126000},"page":"44-46","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Performance of PML diagnostic criteria in natalizumab-associated PML: data from the Dutch-Belgian cohort"],"prefix":"10.1136","volume":"90","author":[{"given":"Martijn T","family":"Wijburg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Warnke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Barkhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard M J","family":"Uitdehaag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joep","family":"Killestein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike P","family":"Wattjes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,12]]},"reference":[{"key":"2020050722322344000_90.1.44.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70040-5"},{"key":"2020050722322344000_90.1.44.2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.114"},{"key":"2020050722322344000_90.1.44.3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828c2fa1"},{"key":"2020050722322344000_90.1.44.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300511"},{"key":"2020050722322344000_90.1.44.5","doi-asserted-by":"crossref","unstructured":"Wijburg MT , Kleerekooper I , Lissenberg-Witte BI , et al . Association of progressive multifocal leukoencephalopathy lesion volume with JC virus polymerase chain reaction results in cerebrospinal fluid of natalizumab-treated patients with multiple sclerosis. JAMA Neurol 2018.doi:10.1001\/jamaneurol.2018.0094","DOI":"10.1001\/jamaneurol.2018.0094"},{"key":"2020050722322344000_90.1.44.6","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31823b9b27"},{"key":"2020050722322344000_90.1.44.7","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313772"},{"key":"2020050722322344000_90.1.44.8","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-308630"},{"key":"2020050722322344000_90.1.44.9","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002586"},{"key":"2020050722322344000_90.1.44.10","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015150673"},{"key":"2020050722322344000_90.1.44.11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.neurad.2015.08.001","article-title":"Use of quantitative susceptibility mapping (QSM) in progressive multifocal leukoencephalopathy","volume":"43","author":"Carra-Dalliere","year":"2016","journal-title":"J Neuroradiol"},{"key":"2020050722322344000_90.1.44.12","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23676"},{"key":"2020050722322344000_90.1.44.13","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2015-311411"},{"key":"2020050722322344000_90.1.44.14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-315298"},{"key":"2020050722322344000_90.1.44.15","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24153"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2018-318261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T14:12:13Z","timestamp":1601043133000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2018-318261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,12]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12,14]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/jnnp-2018-318261"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2018-318261","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,12]]}}}