Journal of Neurology最新文献

{"title":"The association between neurofilament light chain and cognitive function: a UK Biobank cohort study.","authors":"Yunmeng Niu, Yunyun Chen, Yan Li, Yayue Du, Shenjun Li, Ting Gao, Xinyi Xu","doi":"10.1007/s00415-026-13832-y","DOIUrl":"https://doi.org/10.1007/s00415-026-13832-y","url":null,"abstract":"<p><strong>Introduction: </strong>Blood neurofilament light chain reflects axonal injury, but its association with cognitive subdomains remains inconsistent across non-dementia populations.</p><p><strong>Methods: </strong>Data were drawn from two waves of the UK Biobank. Participants completed tests in reaction time, fluid intelligence, prospective memory, and incorrect matches. Generalized Linear Models (GLM) and Restricted Cubic Spline (RCS) were used to examine associations between NfL levels and cognitive function, and subgroup analyses were conducted to explore these associations within specific population subgroups.</p><p><strong>Results: </strong>One thousand one hundred seventy-nine participants with plasma NfL measurements were evaluated at baseline. The cross-sectional results show that high NfL levels were associated with poor prospective memory in females, while no significant associations were observed in males. In participants with low education, NfL levels exhibited a non-linear relationship with fluid intelligence. The longitudinal results show that the annual change rate of reaction time increased with the annual change rate of NfL levels among participants < 60 and in females. Additionally, non-linear associations were observed between the annual change rate of NfL levels and the annual change rate of fluid intelligence in participants < 60 and in the low-education group.</p><p><strong>Discussion: </strong>This study examined the relationships between NfL levels and cognitive functions in non-dementia individuals from the UK Biobank. Overall, NfL showed linear and non-linear associations with cognitive performance, reflecting complex and variable links between neural integrity and cognition. These findings highlight that the relationships between NfL and cognition are complex and vary across populations, underscoring the need for further research to clarify the underlying mechanisms.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-linked Emery-Dreifuss muscular dystrophy: a multicenter, Italian, cohort study.","authors":"A Elkoush, R Giossi, G Gadaleta, A Maccabeo, F Pinna, A Palladino, M Giannotta, D Leone, G Colacicco, B Risi, S Gibertini, L Verriello, C Panicucci, C Bruno, M Pane, S Messina, C Rodolico, A Pini, G Vattemi, M Filosto, A Padovani, V A Sansone, M C Carella, C Forleo, P Tonin, C Fiorillo, L Politano, N Carboni, T Mongini, L Maggi","doi":"10.1007/s00415-026-13834-w","DOIUrl":"https://doi.org/10.1007/s00415-026-13834-w","url":null,"abstract":"<p><strong>Background and objectives: </strong>X-linked Emery-Dreifuss muscular dystrophy (EDMD1) is a rare early-onset myopathy, affecting 1/400.000 individuals, characterized by humeroperoneal weakness, contractures and cardiac involvement. EDMD1 natural history has been poorly investigated, with most of the studies including only a few patients. The aim of the study was to investigate the clinical and molecular features in a large Italian cohort of EDMD1.</p><p><strong>Methods: </strong>We retrospectively collected data of 38 genetically defined EDMD1 males (16 members of 6 families, and 22 sporadic cases) and 10 female carriers, from 14 referral neuromuscular centers in Italy. Patients were included only if showing detectable muscle weakness or contractures at the neurological examination.</p><p><strong>Results: </strong>Mean age at onset of patients was 12.0 ± 3.4 years (range 2-61). Among them 32 (84.2%) presented with muscle weakness or contractures and 6 (15.8%) with cardiac symptoms. Twenty-nine (76.3%) patients had heart involvement, with a mean age at onset of 24.2 ± 13.1 years. Age at disease onset was significantly different (p = 0.0011) between patients with cardiac onset and those with muscular onset. Moreover, patients with muscular onset had worse (p = 0.0163) motor performance at last follow-up (LFU), according to Gardner-Medwin-Walton Scale (GMWS). Loss of walking ability was observed in 3/38 (7.9%) patients, after a disease duration of 35, 49 and 35 years, respectively. Most of the remaining patients showed a mild disease severity, scoring 1-3 at the GMWS at LFU. Ten EMD mutations were novel and unreported in the literature.</p><p><strong>Conclusions: </strong>Our data provide further insight in the field of EDMD1 and suggest that the disease natural history is dominated by heart involvement, while skeletal muscle weakness slowly progresses over the years.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Impact of device pass count and reperfusion levels in anterior circulation stroke: differential effects based on large-scale data from clinical practice.","authors":"Luca Meucci, Lukas Meyer, Gabriel Broocks, Matthias Bechstein, Christian Thaler, Christian Heitkamp, Laurens Winkelmeier, Vincent Geest, Alexander Heitkamp, Maximilian Jungnitz, Gregor Peter, Felix Schlicht, Jawed Nawabi, Caspar Brekenfeld, Máté E Maros, Maximilian Schell, Uta Hanning, Götz Thomalla, Jens Fiehler, Susanne Gellißen, Fabian Flottmann, Helge C Kniep","doi":"10.1007/s00415-026-13792-3","DOIUrl":"https://doi.org/10.1007/s00415-026-13792-3","url":null,"abstract":"","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demyelinating disorders in women: epidemiology, immunology, and clinical implications across MS, NMOSD, and MOGAD.","authors":"Gabriel Ind, Zain Hashmi, Shivansh Ahuja, Tamara Fayad, Zaneh Kahook, Rumaiza Ahmad, Syeda Maryam Batool, Keziah Mariam Jiji, Hafsah Hudli, Shamera Hossain, Ali Lafi, Abdallah AbuJlambo","doi":"10.1007/s00415-026-13831-z","DOIUrl":"https://doi.org/10.1007/s00415-026-13831-z","url":null,"abstract":"<p><p>Multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein-associated disease (MOGAD) are the major types of demyelinating disorders of the central nervous system (CNS). Demyelinating disorders impact women disproportionately and frequently present during reproductive years. These conditions can cause significant neurological disability and psychosocial challenges, especially for women. Because they often present during reproductive years, clinicians frequently manage contraception, pregnancy, and the postpartum period alongside disease control. Sex-specific evidence, therefore, becomes especially important for treatment decisions. Despite this, sex-specific differences in epidemiology, immunopathology, clinical features, and therapeutic response remain inconsistently addressed in both clinical practice and research. In this review, we synthesize current evidence on the factors underlying the female predominance observed in MS, NMOSD, and MOGAD, and discuss the clinical consequences of these findings. We investigate the influence of sex hormones, X-chromosome-mediated immune regulation, and immunological changes associated with pregnancy and the postpartum period, as well as disease-specific mechanisms. We also examine how these factors affect diagnosis, prognosis, therapeutic decision-making, pregnancy management, and quality of life. Finally, we highlight important gaps in knowledge and underscore the necessity for a sex-informed approach to the diagnosis, management, and research of autoimmune demyelinating diseases.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient profiling in relapsing multiple sclerosis: insights from a real-world observational study into the unmet medical needs of patients on disease-modifying therapy.","authors":"I K Penner, T Maier, T Wiemer, J Leemhuis, E Weber, H Schreiber, T Ziemssen","doi":"10.1007/s00415-026-13806-0","DOIUrl":"https://doi.org/10.1007/s00415-026-13806-0","url":null,"abstract":"<p><strong>Background: </strong>Patient-centred care is essential for effectively managing relapsing multiple sclerosis (RMS). The PROFILE-RMS study aimed to characterise unmet medical needs using clinically meaningful patient profiles.</p><p><strong>Methods: </strong>This 12 month observational study collected real-world data across Germany. Adults with RMS receiving disease-modifying therapy (DMT) were classified into predefined profiles: ongoing disease activity (Profile 1), significant adverse drug reactions (ADRs; Profile 2), or low treatment satisfaction (Profile 3). Outcomes included treatment response, disease activity, patient-reported outcomes (PROs), and safety.</p><p><strong>Results: </strong>In total, 488 patients were analysed. In Profile 1 (n = 246), 41.6% had insufficient response to therapy, with severe fatigue identified as an indicator (hazard ratio [HR]: 2.08; 95% confidence interval [CI]: 1.12-3.88), but only 14.2% changed treatment (mainly for disease activity); 4.1% experienced a serious adverse event (SAE). In Profile 2 (n = 179), 31.5% had insufficient response, but only 18.4% changed treatment (mainly for disease activity); 1.6% experienced an SAE. In Profile 3 (n = 63), 33.3% had insufficient response, with male sex identified as an indicator (HR: 3.09; 95% CI: 1.40-6.82), but only 17.5% changed treatment (mainly for low satisfaction); 1.6% experienced an SAE. Across profiles, most patients received low-moderate efficacy DMTs, the percentage of patients without DMTs increased, and PROs were impaired.</p><p><strong>Conclusions: </strong>Patient profiling highlights gaps in real-world RMS management, where DMTs are often discontinued without substitution and escalation to high-efficacy regimens often delayed, reinforcing the need for patient-centred care. Fatigue may indicate non‑response (Profile 1), disease activity outweighs ADR burden (Profile 2), and symptom load drives dissatisfaction (Profile 3).</p><p><strong>Trial registration: </strong>Protocol number ML39348.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early bilingualism as a protective factor against acute post-stroke aphasia.","authors":"Marcello Naccarato, Federica Palacino, Edoardo Ricci, Ilario Scali, Magda Quagliotto, Michele Malesani, Gianpiero Farina, Emanuele Vincis, Paola Potente, Martina Maset, Paola Caruso, Giovanni Furlanis, Paolo Manganotti","doi":"10.1007/s00415-026-13820-2","DOIUrl":"https://doi.org/10.1007/s00415-026-13820-2","url":null,"abstract":"<p><strong>Background and aims: </strong>Aphasia is among the most debilitating post-stroke deficits. Previous studies have suggested that bilingualism, the ability to use more than one language, may confer advantages in language recovery compared with monolingualism in patients with chronic stroke. Our aim was to determine whether early pre-scholar simultaneous bilingualism acts as a protective factor by examining language recovery within the first seven days after acute ischaemic stroke.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical and neuroimaging data from Italian monolingual and early bilingual (Slovenian- and Croatian-Italian) patients with anterior-circulation ischaemic stroke and aphasia who were consecutively admitted between January 2018 and April 2020. The two cohorts were compared, and a multivariate logistic regression model was used to identify variables associated with language improvement at 7 days, defined as a ≥ 1-point reduction or complete recovery.</p><p><strong>Results: </strong>The two groups did not differ in demographic or clinical characteristics, type of acute treatment, or extent of the ischaemic lesion. Early bilingual patients exhibited significantly greater improvement in NIHSS language scores at day seven. In multivariate analysis, early bilingualism (p = 0.005) emerged as independent predictor of early language recovery, with consistent effect sizes across sensitivity analyses.</p><p><strong>Conclusions: </strong>Early bilingualism (eBL) is an independent and robust predictor of aphasia recovery within the first seven days after stroke.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raw, centile and individualised minimal clinically important differences for the MMN-Rasch-built Overall Disability Scale^© in the monitoring of multifocal motor neuropathy.","authors":"Yusuf A Rajabally, Ahmad Al-Areed, Roshan Iqbal, Muhammed A Noushad, Young G Min, Chinar Osman","doi":"10.1007/s00415-026-13771-8","DOIUrl":"https://doi.org/10.1007/s00415-026-13771-8","url":null,"abstract":"<p><strong>Background: </strong>Optimal clinical application of the minimal clinically important difference (MCID) for the MMN-Rasch-built Overall Disability Scale^© (MMN-RODS) scale is unknown.</p><p><strong>Methods: </strong>We retrospectively studied subjects with MMN from 2 UK neuropathy centres. Raw and centile MMN-RODS scores were collected, at initial, two intermediate, and latest assessment, and distribution-based MCIDs determined at studied time-points. The sensitivities of raw, centile and individualised MCIDs, were compared.</p><p><strong>Results: </strong>We included 32 consecutive subjects with MMN on individualised immunoglobulin dosing regimens. First intermediate, second intermediate, and latest assessments were performed at a median of 17.0, 54.1 and 74.6 months from onset, respectively. Progressive amelioration of mean raw MMN-RODS score occurred between initial and latest assessment. The distribution-based raw MMN-RODS MCID was of 3, 4 and 5, and the distribution-based centile MMN-RODS MCID was of 6, 7 and 7, at first intermediate, second intermediate and latest assessment, respectively. At first intermediate assessment, raw and individualised MCIDs were equally sensitive, and both more sensitive than centile MCID (McNemar's Test: p < 0.001, p < 0.001). Raw MCID, centile MCID and individualised MCID, all had equivalent sensitivity at the second intermediate and latest assessment. Neither initial MMN-RODS score, nor amplitude of treatment-induced changes in early disease stages, independently predicted total improvement amplitude or final outcome.</p><p><strong>Conclusions: </strong>MMN-RODS MCID cut-offs may require adaption to assessment timing. In earlier stages, raw/individualised MCID may be more sensitive than centile MCID, whereas all three methods may subsequently be equivalent. Initial disability and early treatment response do not predict achievable total improvement amplitude nor final outcome.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Disease in Myasthenia Gravis: A Targeted Literature Review.","authors":"Mamatha Pasnoor, Lesley-Ann Miller-Wilson, Yuriy Edwards, Kati Copley-Merriman, Jessica Costello, Allison Foss, Srikanth Muppidi","doi":"10.1007/s00415-026-13662-y","DOIUrl":"https://doi.org/10.1007/s00415-026-13662-y","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is a rare autoimmune neurologic disorder with a heterogenous disease presentation. The objective of this targeted literature review was to characterize the burden of disease and unmet treatment needs in patients with MG.</p><p><strong>Methods: </strong>Scientific articles published in English between May 4, 2013, and November 24, 2025, were identified in the PubMed, Medline, Embase, and Cochrane Library databases using a pre-defined Boolean search strategy. Titles and abstracts were screened for information on clinical presentation, pathology, and diagnostic considerations for MG; burden of disease, including epidemiologic, clinical, humanistic, and economic burden; and treatments, including treatment guidelines.</p><p><strong>Results: </strong>The analysis included 318 records. Population-based estimates of MG incidence published from 2007 onwards ranged from 0.3 to 6.1 per 100,000 person-years, and prevalence estimates ranged from 2.2 to 58.6 per 100,000 persons. The clinical and humanistic burden of MG remains high, with patients reporting inadequate symptom control, fatigue, poor quality of life, and dissatisfaction with their current treatment. Greater disease severity was associated with reduced quality of life and poorer mental health. Medical costs varied by region, and key drivers of direct medical costs include hospitalization and treatment of exacerbation or myasthenic crisis.</p><p><strong>Conclusion: </strong>The burden of MG remains high, despite the availability of novel treatments. Studies are needed to better characterize the current burden of MG in the context of newer treatment options and to explore how the disease burden may be reduced for patients.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes and experiences with COMT inhibitors in the management of motor fluctuations in Parkinson's disease: a UK-based nested cross-sectional study.","authors":"Alastair J Noyce, Lara Akindele, Emma-Louise Shelton, Olina Efthymiadou, Maria Teresa Periñan, Raquel Maio, Glynn Harrison-Jones, Mario Ippolito","doi":"10.1007/s00415-026-13752-x","DOIUrl":"https://doi.org/10.1007/s00415-026-13752-x","url":null,"abstract":"<p><strong>Background: </strong>Motor fluctuations are a common complication in Parkinson's disease (PD), often managed with catechol-O-methyltransferase (COMT) inhibitors. We aimed to explore patient perspectives on their COMT inhibitor treatment and to evaluate and compare patient-reported outcomes and experiences with the COMT inhibitors opicapone and entacapone.</p><p><strong>Methods: </strong>This UK-based cross-sectional study utilised anonymised, real-world data from the AccessPD registry. A convenience sample of 102 registry participants who had received either opicapone or entacapone. completed validated patient-reported outcome measures (PDQ-39 and, EQ-5D-5L) and an online survey assessing treatment experiences, preferences, and communication with healthcare providers.</p><p><strong>Results: </strong>Survey responses highlighted that increased ON time and reduced OFF time were the most valued treatment attributes for COMT inhibitors, while hallucinations and dyskinesia were the least acceptable side effects. Only 25% of respondents recalled being informed about alternative treatment options prior to starting COMT inhibitor therapy. Communication from clinicians about the role of these drugs was inconsistent, with 27.5% of participants only rating it as 'fair/poor' and 58% reporting no follow-up after initiation. Patients' overall quality of life was generally reported as mild to moderately affected in both treatment groups.</p><p><strong>Conclusions: </strong>Survey findings underscore the heterogeneity of patient preferences and the need for improved clinician-patient communication and personalised care. Both COMT inhibitors should be considered in shared decision-making to optimise motor fluctuation management and quality of life in PD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of monoclonal antibodies in the treatment of relapsing remitting multiple sclerosis: a systematic review.","authors":"Ana Avedillo-Salas, Laura Baeza Martínez, Ana Fanlo-Villacampa, Jorge Vicente-Romero","doi":"10.1007/s00415-026-13824-y","DOIUrl":"https://doi.org/10.1007/s00415-026-13824-y","url":null,"abstract":"<p><strong>Introduction: </strong>In relapsing-remitting multiple sclerosis (RRMS), conventional immunomodulatory and immunosuppressive therapies are widely used. However, in many cases, optimal control of inflammatory activity and disease progression is not achieved, which has led to the use of biological drugs such as monoclonal antibodies that act specifically on key components of the immune system. The aim was to evaluate the efficacy and safety of monoclonal antibodies compared to other drugs or placebo in adult patients with RRMS.</p><p><strong>Methods: </strong>A systematic review was performed based on randomized, double-blind, phase III controlled clinical trials published between 2012 and 2025 in the PubMed, Cochrane Library, and Web of Science databases, assessing efficacy and safety in adult patients with RRMS. The review was carried out following the PICO methodology and PRISMA guidelines.</p><p><strong>Results: </strong>A total of 11 studies were included, evaluating 5 monoclonal antibodies: alemtuzumab, daclizumab, ocrelizumab, ofatumumab, and ublituximab. These therapies showed superior efficacy compared to conventional treatments in reducing the annual relapse rate, MRI inflammatory activity and MRI activity, particularly in patients with highly active disease. However, effects on disability progression were heterogeneous across trials and not consistently significant. In addition, decreases in biomarkers of axonal damage were observed. Nevertheless, relevant adverse effects were identified, including infections, autoimmune reactions, hepatic and cutaneous toxicity, whose incidence varies depending on the drug, requiring close clinical monitoring.</p><p><strong>Conclusions: </strong>Monoclonal antibodies are an effective option in RRMS, with clinical and radiological benefits superior to those of conventional treatments. Their use requires individualized assessment and close follow-up due to the risk of adverse effects, especially in high-risk patients.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"273 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}