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Healthy individuals who either had no relatives with multiple sclerosis or had a family history of it were studied and evaluated according the Okuda and Swanton criteria for radiologically isolated syndrome. These investigators found that the frequency of white matter signal abnormalities and radiologically isolated syndrome were higher in the healthy relatives of patients with multiple sclerosis compared with nonfamilial healthy control subjects. In healthy relatives of patients with MS, smoking and obesity also contributed to the presence of white matter lesions.