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NCT04495556Completed

Central Vein Sign: a Diagnostic Biomarker in Multiple Sclerosis

Source: ClinicalTrials.gov · Last updated 16 Oct 2026

Brief summary (registry, in English)

The need for improved diagnostic methods in Multiple Sclerosis (MS) is widely recognized. Although Magnetic Resonance Imaging (MRI) is a longstanding tool for detecting MS lesions, diagnostic inaccuracies persist. Up to 20% of people diagnosed with MS (1 in 5) are later found not to have the disease. This is highly consequential, as more than two-thirds of misdiagnosed patients are unnecessarily exposed to risks from disease-modifying therapies, which in rare cases can be life-threatening. Moreover, the current standard in MS diagnosis - the McDonald criteria, which combine clinical symptoms and MRI findings - were developed from studies in people with typical clinical presentations of MS. This reduces the specificity of these criteria, rendering them uninformative for the nearly half of MS patients who present to neurologists with atypical or nonclassical symptoms. Timeliness of MS diagnosis is also key, as diagnostic delay is common in cases of relapsing-remitting MS and can carry severe and lifelong consequences. The CentrAl Vein Sign in MS (CAVS-MS) study has been designed to assess whether Central Vein Sign (CVS) criteria can help address some of these unmet diagnostic needs. It will specifically explore the role of presentation type by enrolling a mixed population of patients with typical clinical presentations (n = 200) and those with atypical presentations, including suggestive MRI findings in the absence of neurologic symptoms (n = 200) across North America.

Status (registry)
Completed
Study type
Observational
Enrollment
420 (actual)
First submitted
23 Jul 2020
Start date
11 Jun 2020
Primary completion date
30 Jun 2026
Lead sponsor
The Cleveland Clinic
NCT number
NCT04495556

What you commit to

  • Study type: Observational
  • Participants enrolled: 420
  • From 11 Jun 2020 to the primary completion date, 30 Jun 2026
  • 11 sites in 2 countries
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Contraindication to MRI studies; metal or metal implants incompatible with MRI
  • Treatment with systemic corticosteroids in the 4 weeks preceding enrollment.

Other illness

  • Contraindication to use of gadolinium containing contrast agents (allergy or renal failure)

Other

  • Inability to tolerate MRI due to claustrophobia or known excessive movement (e.g. tremor)

Who the study is looking for

  • Age 18 to 65 inclusive
  • Referral to a study academic site for a clinical suspicion of MS
  • Onset with typical symptom onset including: acute unilateral optic neuritis, double vision due to an internuclear ophthalmoplegia or sixth nerve palsy, facial sensory loss or trigeminal neuralgia in a young adult (\<40 years of age), cerebellar ataxia and nystagmus, partial myelopathy, sensory symptoms in a CNS pattern, Lhermitte's symptom, asymmetric limb weakness, urge incontinence or erectile dysfunction, or other neurological presentation considered to be typical by the site investigator.
  • Able to provide written informed consent to participate in the study
  • For participants referred for clinical suspicion of multiple sclerosis who had workup prior to referral or who are taking disease-modifying therapies for MS, digital availability of diagnostic cranial MRI with gadolinium within 3 months of initial symptoms
  • Onset of typical neurological symptoms within 10 years of screening.
  • Age 18 to 65 inclusive
  • Referral to a study academic site for a suspicion of MS
  • Onset with atypical onset including: bilateral optic neuritis or unilateral optic neuritis with a poor visual recovery, complete gaze palsy or fluctuating ophthalmoparesis, intractable nausea, vomiting, or hiccups, complete transverse myelopathy with bilateral motor and sensory involvement, encephalopathy, subacute cognitive decline, headache or meningismus, isolated fatigue or asthenia, constitutional symptoms, other clinical presentations considered atypical by the site investigator (examples include: vague or patchy sensory symptoms, pain, short lasting bilateral blurred vision, etc.), or absence of clinical symptoms with MRI features suggestive of MS
  • Able to provide written informed consent to participate in the study
  • For participants referred for clinical suspicion of multiple sclerosis who had workup prior to referral or who are taking disease-modifying therapies for MS, digital availability of diagnostic cranial MRI with gadolinium within 3 months of initial symptoms
  • Onset of atypical neurological symptoms within 10 years of screening.

Age in the registry: 18 years to 65 years · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (11)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
St. Michael's Hospital of Unity Health Toronto
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TorontoCanadaUnknown status
University of Colorado
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AuroraUnited StatesUnknown status
The University of Texas at Austin
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AustinUnited StatesUnknown status
Johns Hopkins University
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BaltimoreUnited StatesUnknown status
University of Vermont
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BurlingtonUnited StatesUnknown status
Cleveland Clinic Foundation
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ClevelandUnited StatesUnknown status
Cedars-Sinai Medical Center
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Los AngelesUnited StatesUnknown status
University of Southern California
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Los AngelesUnited StatesUnknown status
Yale University
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New HavenUnited StatesUnknown status
University of Pennsylvania
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PhiladelphiaUnited StatesUnknown status
Washington University in St. Louis
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St LouisUnited StatesUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.