 The diagnosis of multiple sclerosis MS was revised according to the 2010 revision of the McDonald criteria, and patients were classified according to the course of the disease into relapsing remitting multiple sclerosis RRMS, secondary progressive multiple sclerosis SPMS and primary-progressive multiple sclerosis PPMS. Patients with first demyelinating event, before 2010, were re-assessed by on-site coordinators to label them clinically isolated syndrome CIS, whenever applicable, according to McDonalds 2010, and neuromyelitis optica NMO cases diagnosis was verified according to the 2015 diagnostic criteria. Those with typical brain Magnetic Resonant Imaging MRI MS like lesions without related clinical manifestations were diagnosed as radiologically isolated syndrome RIS. 