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Multiparametric MRI-based biomarkers in the non-fluent and semantic variants of primary progressive aphasia. 基于多参数mri的生物标志物在原发性进行性失语症的非流利和语义变体。
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-07-02 DOI: 10.1007/s00415-025-13215-9
Marco Michelutti, Hans-Jürgen Huppertz, Heiko Volkmann, Sarah Anderl-Straub, Daniele Urso, Benedetta Tafuri, Salvatore Nigro, Paolo Manganotti, Leonie Werner, Jolina Lombardi, Markus Otto, Giancarlo Logroscino, Hans-Peter Müller, Jan Kassubek
{"title":"Multiparametric MRI-based biomarkers in the non-fluent and semantic variants of primary progressive aphasia.","authors":"Marco Michelutti, Hans-Jürgen Huppertz, Heiko Volkmann, Sarah Anderl-Straub, Daniele Urso, Benedetta Tafuri, Salvatore Nigro, Paolo Manganotti, Leonie Werner, Jolina Lombardi, Markus Otto, Giancarlo Logroscino, Hans-Peter Müller, Jan Kassubek","doi":"10.1007/s00415-025-13215-9","DOIUrl":"10.1007/s00415-025-13215-9","url":null,"abstract":"<p><strong>Background: </strong>The non-fluent (nfPPA) and semantic (svPPA) variants of primary progressive aphasia exhibit distinct clinical features. We investigated whether diffusion tensor imaging (DTI) and atlas-based volumetry (ABV) could reveal divergent patterns of longitudinal changes in brain white matter microstructure and gray matter volumes.</p><p><strong>Methods: </strong>MRI datasets from 29 nfPPA, 27 svPPA, and 39 controls were analyzed. White matter fractional anisotropy (FA) differences were assessed using unbiased Whole Brain-based Spatial Statistics (WBSS) and Tract-Wise Fractional Anisotropy Statistics (TFAS). Gray matter volumetric differences were calculated by Atlas-Based Volumetry (ABV). A subset of 10 nfPPA and 6 svPPA patients underwent longitudinal MRI at 12 months. FA maps were correlated with disease severity (FTLD-CDR sum of boxes). A random forest classifier validated tracts of interest (TOI) and structures of interest (SOIs) selection as a proof-of-concept.</p><p><strong>Results: </strong>At baseline, nfPPA showed frontal, callosal, and temporal white matter degeneration, while the left inferior longitudinal fasciculus (ILF) was predominantly involved in svPPA. Longitudinally, nfPPA exhibited frontal, callosal, and posterior temporal progression, while svPPA showed localized antero-posterior ILF progression. ABV aligned with the DTI analyses, demonstrating volumetric reductions in the frontal lobe for nfPPA and in temporal lobe and subcortical limbic structures in svPPA. Sub-clusters of white matter damage progression correlated with worsening FTLD-CDR scores. Random forest analysis identified the most discriminative TOIs and SOIs.</p><p><strong>Conclusions: </strong>Distinct degeneration patterns emerged across nfPPA and svPPA, supporting early differential diagnosis and correlating with disease worsening. These findings support the utility of combined DTI and ABV in tracking disease progression.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 8","pages":"490"},"PeriodicalIF":4.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540581","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}
引用次数: 0
Insight into NeuroCOVID: neurofilament light chain (NfL) as a biomarker in post-COVID-19 patients with olfactory dysfunctions. 神经新冠肺炎:神经丝轻链(NfL)作为新冠肺炎后嗅觉功能障碍患者的生物标志物
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-07-01 DOI: 10.1007/s00415-025-13222-w
Fiorenza Pennacchia, Federica Zoccali, Carla Petrella, Giuseppina Talarico, Eqrem Rusi, Maria Antonella Zingaropoli, Wael Abu Ruqa, Giuseppe Bruno, Rosamaria Capuano, Alexandro Catini, Corrado Di Natale, Antonio Minni, Christian Barbato
{"title":"Insight into NeuroCOVID: neurofilament light chain (NfL) as a biomarker in post-COVID-19 patients with olfactory dysfunctions.","authors":"Fiorenza Pennacchia, Federica Zoccali, Carla Petrella, Giuseppina Talarico, Eqrem Rusi, Maria Antonella Zingaropoli, Wael Abu Ruqa, Giuseppe Bruno, Rosamaria Capuano, Alexandro Catini, Corrado Di Natale, Antonio Minni, Christian Barbato","doi":"10.1007/s00415-025-13222-w","DOIUrl":"10.1007/s00415-025-13222-w","url":null,"abstract":"<p><p>The term NeuroCOVID was coined to describe the neurological consequences observed in COVID-19 patients. Numerous patients infected with SARS-CoV-2 reported olfactory dysfunction as the first symptom preceding clinical manifestations, such as cough and fever, or even the only symptom, suggesting the sudden loss of smell or hyposmia as an important predictive factor for COVID-19 infection. Several patients developed long-term olfactory impairment, but to date there is not available a biochemical diagnosis of anosmia. The aim of this pilot study is to investigate the association between neurofilament light-chain (NfL) serum levels and the olfactory dysfunctions in post-COVID-19 patients. This study recruited patients who developed COVID-19 between January 2020 and August 2021. They were evaluated between October 2022 and March 2023 by Sniffin' Sticks tests to investigate deficits of odor identification, discrimination, and threshold and serum NfL biomarker measurement to assess a neuronal damage. Out of 27 patients, 11 were affected by post-viral permanent olfactory dysfunction (named Od-post-COVID-19) and 16 healed from the infection without residual Od problem, as a control group. We observed an increased levels of NfL 16.02 ± 1.91 pg/mL in Od-post-COVID-19, suggesting that NfL to be recognized as a biomarker of post-viral olfactory dysfunction, supporting the diagnostic process of NeuroCOVID, joined with other well-known neurological biomarkers and/or innovative investigative approaches.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"484"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540579","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}
引用次数: 0
Genetic variation of low-to-medium-affinity Fc-gamma receptors in Guillain-Barré syndrome. 格林-巴-罗综合征中低亲和力fc - γ受体的遗传变异
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-07-01 DOI: 10.1007/s00415-025-13216-8
Sander J van Tilburg, Selin Koçer, Judy Geissler, Wouter van Rijs, Anne P Tio-Gillen, Michael W T Tanck, Willem-Jan R Fokkink, Pieter A van Doorn, Bart C Jacobs, Sietse Q Nagelkerke, Ruth Huizinga
{"title":"Genetic variation of low-to-medium-affinity Fc-gamma receptors in Guillain-Barré syndrome.","authors":"Sander J van Tilburg, Selin Koçer, Judy Geissler, Wouter van Rijs, Anne P Tio-Gillen, Michael W T Tanck, Willem-Jan R Fokkink, Pieter A van Doorn, Bart C Jacobs, Sietse Q Nagelkerke, Ruth Huizinga","doi":"10.1007/s00415-025-13216-8","DOIUrl":"10.1007/s00415-025-13216-8","url":null,"abstract":"<p><strong>Introduction: </strong>Fc-gamma receptors (FcγRs) are important for the effector functions of immunoglobulin G (IgG) and are therefore expected to play a role in the pathophysiology of Guillain-Barré syndrome (GBS). The FCGR2/3 locus, which encodes low-to-medium-affinity FcγRs, contains extensive genetic variation. We hypothesized that genetic variation in the FCGR2/3 locus influences GBS susceptibility, muscle weakness, outcomes, and the pharmacokinetics of intravenous immunoglobulin (IVIg).</p><p><strong>Methods: </strong>Copy number variation and single nucleotide polymorphisms in the FCGR2/3 locus were studied using multiplex ligation-dependent probe amplification (MLPA). The study cohort consisted of 467 GBS patients and 919 healthy controls of European descent. Severe weakness was defined as an MRC sum score < 40 at nadir. The increase in serum IgG one or two weeks after start of IVIg treatment was determined.</p><p><strong>Results: </strong>No significant associations were found between genetic variation in the FCGR2/3 locus and susceptibility to GBS. However, in patients with an antecedent Campylobacter jejuni infection, a higher frequency of three or more FCGR3A copies was observed compared to healthy controls (p = 0.023). FCGR3A copy numbers were also associated with more severe disease (OR = 2.02; 95% CI = 1.00-4.12), even after correcting for age and positive C. jejuni serology. No association was found between FCGR2/3 variants and the ability to walk unaided in time-to-event analyses. In addition, the pharmacokinetics of IVIg were not affected by genetic variation in the FCGR2/3 locus.</p><p><strong>Conclusion: </strong>Overall, FCGR2/3 polymorphisms are not associated with susceptibility to GBS or response to IVIg treatment. However, associations may exist in specific subgroups, as demonstrated in patients with a preceding C. jejuni infection who more frequently carry a duplication in FCGR3A.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"487"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540578","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}
引用次数: 0
Clonidine for the management of crises in stiff-person syndrome. 可乐定对僵硬人综合征危象的处理。
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-07-01 DOI: 10.1007/s00415-025-13226-6
Salvatore Maria Lima, Nicasio Rini, Andrea Calì, Filippo Brighina, Vincenzo Di Stefano
{"title":"Clonidine for the management of crises in stiff-person syndrome.","authors":"Salvatore Maria Lima, Nicasio Rini, Andrea Calì, Filippo Brighina, Vincenzo Di Stefano","doi":"10.1007/s00415-025-13226-6","DOIUrl":"10.1007/s00415-025-13226-6","url":null,"abstract":"<p><p>Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder characterized by high titers of antibodies against glutamic acid decarboxylase (GAD) and impaired GABAergic inhibitory neurotransmission. If not promptly treated, SPS progresses to disability with high risk of respiratory insufficiency; therefore, it is essential to apply the best therapeutic regimens since the beginning, both in the chronic and in the emergency setting during exacerbations. To date, there are no defined guidelines for the treatment of this rare disease. In this study, we report the case of a woman affected by refractory SPS who benefited from clonidine with immediate resolution of stiffness and SPS crisis.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"485"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540576","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}
引用次数: 0
Comparative efficacy and safety of irreversible (rasagiline) and reversible (safinamide) monoamine oxidase inhibitors as add-on therapy for Parkinson's disease. 不可逆(雷沙吉兰)和可逆(沙芬酰胺)单胺氧化酶抑制剂作为帕金森病附加治疗的比较疗效和安全性
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-07-01 DOI: 10.1007/s00415-025-13230-w
Marwah Bintay Khalid, Faizan Shahzad, Momina Riaz Siddiqui, Muhammad Zain Ul Abedin, Saad Hulou, Besher Shami, Syed Ijlal Ahmed
{"title":"Comparative efficacy and safety of irreversible (rasagiline) and reversible (safinamide) monoamine oxidase inhibitors as add-on therapy for Parkinson's disease.","authors":"Marwah Bintay Khalid, Faizan Shahzad, Momina Riaz Siddiqui, Muhammad Zain Ul Abedin, Saad Hulou, Besher Shami, Syed Ijlal Ahmed","doi":"10.1007/s00415-025-13230-w","DOIUrl":"10.1007/s00415-025-13230-w","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a progressive, neurodegenerative condition caused by progressive loss of dopaminergic neurons of the substantia nigra. Safinamide and rasagiline are both novel medications that are indicated for PD. Safinamide (reversible) and rasagiline (Irreversible) are selective monoamine oxidase B inhibitors which work by decreasing the degradation of dopamine in the brain.</p><p><strong>Objective: </strong>This network meta-analysis aimed to examine the efficacy and safety of both drugs as add-on therapy in patients with Parkinson's disease.</p><p><strong>Methodology: </strong>A systematic literature search of PubMed, Embase, and Cochrane databases was conducted in September 2024. Primary outcomes were Changes in the Unified Parkinson's Disease Rating Scale (UPDRS-III) and adverse effects. Standardized mean difference (SMD) and odds ratio (OR) were calculated with 95% confidence intervals. Surface Under Cumulative Ranking Curve (SUCRA) was used to compare individual interventions. The Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the risk of bias in studies.</p><p><strong>Results: </strong>The search query resulted in 557 studies. After screening, 15 studies were included in the final analysis, totaling 5676 participants. Safinamide (100 mg) was associated with the highest change in UPDRS-III scores (SMD = 0.3007, 95% CI = [0.1710-0.4304], z-score = 4.54, p value =  < 0.0001, I2 = 55.8%, SUCRA = 71.17%), with rasagiline (1 mg) being a close contender with a SUCRA of 70.64%. Safinamide (50 mg) had the lowest odds of serious adverse events (SAEs) with OR = 0.4394 (95% CI = [0.2231-0.8652], z-score = - 2.38, p value = 0.0174, I2 = 0%, SUCRA = 99.34%). Safinamide (100 mg) had the second-lowest odds of SAEs (OR = 0.9575, 95% CI = [0.6520-1.4061], z-score = - 0.22, p value = 0.8246, I2 = 0%, SUCRA = 66.96%). Almost all the studies had a low risk of bias.</p><p><strong>Conclusion: </strong>Safinamide (100 mg) has good efficacy outcomes, whereas safinamide (50 mg) has favorable safety outcomes as compared to rasagiline for add-on therapy for PD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"486"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540577","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}
引用次数: 0
Equity in neuromuscular research: a 20-year analysis of race, ethnicity, sex, and age representation. 神经肌肉研究的公平性:对种族、民族、性别和年龄代表性的20年分析。
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-06-30 DOI: 10.1007/s00415-025-13208-8
Lorenzo Fontanelli, Gabriele Vadi, Gabriele Bellini, Andrea Cossu, Gabriele Siciliano
{"title":"Equity in neuromuscular research: a 20-year analysis of race, ethnicity, sex, and age representation.","authors":"Lorenzo Fontanelli, Gabriele Vadi, Gabriele Bellini, Andrea Cossu, Gabriele Siciliano","doi":"10.1007/s00415-025-13208-8","DOIUrl":"10.1007/s00415-025-13208-8","url":null,"abstract":"<p><strong>Objectives: </strong>We conducted a systematic analysis of studies on neuromuscular diseases registered on ClinicalTrials.gov over the last 20 years to assess disparities in study populations.</p><p><strong>Methods: </strong>Data from interventional and observational neuromuscular disease studies initiated between January 1, 2004, and December 31, 2024, were retrieved from ClinicalTrials.gov and PubMed/MEDLINE. Collected variables included participant race, ethnicity, sex, eligible age range, mean and median ages, as well as study funding source, start year, and phase. These variables were analyzed to evaluate disparities in race, ethnicity, and age across studies and over time.</p><p><strong>Results: </strong>A total of 2166 studies were screened, with 462 meeting inclusion criteria, encompassing data from 37,131 participants. Most participants were male (61.4%), White (83.5%), and non-Hispanic/Latino (87.6%). While the proportion of studies reporting race and ethnicity increased over time (p < 0.001 and p = 0.001, respectively), the racial and ethnic composition of participants remained unchanged (p = 1). Studies on X-linked recessive disorders (i.e., Duchenne muscular dystrophy (DMD), Becker muscular dystrophy, and spinal and bulbar muscular atrophy (SMA)) predominantly excluded female participants. Regarding age accessibility, 37.9% of studies allowed children. Similarly, trial accessibility for older adults was limited. Even in studies with broader age eligibility, mean and median participant ages clustered around midlife, with underrepresentation at both age extremes. Notably, about half of DMD and SMA studies excluded participants over 16 and 18 years, respectively.</p><p><strong>Conclusion: </strong>Significant disparities persist in race, ethnicity, and age representation in neuromuscular disease clinical research, highlighting the need for more inclusive study designs.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"483"},"PeriodicalIF":4.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528422","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}
引用次数: 0
Added value of spinal cord MRI in detecting active disease in non-relapsing progressive multiple sclerosis patients. 脊髓MRI对非复发进行性多发性硬化症患者活动性病变的检测价值。
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-06-28 DOI: 10.1007/s00415-025-13217-7
Marco Vercellino, S Marasciulo, C Bosa, A Rolando, P Garelli, M L Vassallo, V Gallina, G Morana, P Cavalla
{"title":"Added value of spinal cord MRI in detecting active disease in non-relapsing progressive multiple sclerosis patients.","authors":"Marco Vercellino, S Marasciulo, C Bosa, A Rolando, P Garelli, M L Vassallo, V Gallina, G Morana, P Cavalla","doi":"10.1007/s00415-025-13217-7","DOIUrl":"10.1007/s00415-025-13217-7","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord MRI is not routinely recommended in the monitoring of MS. In patients with progressive MS (pMS), presence of disease activity is an important predictor of treatment response to currently approved treatments. The aim of this study was to investigate the added usefulness of spinal cord MRI in the identification of active disease in patients with non-relapsing pMS.</p><p><strong>Methods: </strong>MRI records were reviewed in a cohort of pMS patients. All patients with at least 2 years of follow-up with the same MRI scanner were included in the study. Patients with clinical relapses during follow-up were excluded from the study. Asymptomatic combined unique active lesions (CUA) were defined as any new T2/STIR lesion or any T1 Gd + lesion, in absence of a clinical relapse.</p><p><strong>Results: </strong>185 non-relapsing pMS patients were included in the study (41 primary progressive, 144 secondary progressive; median EDSS 6.0), out of a cohort of 422 pMS patients. Mean length of MRI follow-up was 4.0 years (range 2-8). 28/185 (15.1%) patients showed new asymptomatic CUA brain lesions during follow-up, 14/185 (7.6%) patients showed new asymptomatic CUA spinal cord lesions, 4/185 (3.4%) patients showed new asymptomatic CUA lesions both in the brain and in the spinal cord. Overall, the addition of spinal cord MRI allowed to detect disease activity in + 43.75% more patients than brain MRI only.</p><p><strong>Conclusion: </strong>The addition of spinal cord MRI allows to detect active disease in a significantly higher proportion of non-relapsing pMS patients. This is important in stratifying expected response to treatment and to inform treatment choices.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"482"},"PeriodicalIF":4.8,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528421","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}
引用次数: 0
Long-term effectiveness and safety of ocrelizumab: a single-centre real-world study. ocrelizumab的长期有效性和安全性:一项单中心现实世界研究
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-06-28 DOI: 10.1007/s00415-025-13224-8
Tiziana Zaccone, Lucia Moiola, Simone Guerrieri, Agostino Nozzolillo, Chiara Zanetta, Irene Gattuso, Angela Genchi, Federica Esposito, Maria G Scarale, Paola M V Rancoita, Maria A Rocca, Massimo Filippi
{"title":"Long-term effectiveness and safety of ocrelizumab: a single-centre real-world study.","authors":"Tiziana Zaccone, Lucia Moiola, Simone Guerrieri, Agostino Nozzolillo, Chiara Zanetta, Irene Gattuso, Angela Genchi, Federica Esposito, Maria G Scarale, Paola M V Rancoita, Maria A Rocca, Massimo Filippi","doi":"10.1007/s00415-025-13224-8","DOIUrl":"10.1007/s00415-025-13224-8","url":null,"abstract":"<p><strong>Background: </strong>This retrospective single-centre study evaluated the effectiveness and safety of ocrelizumab (OCR) in relapse-onset multiple sclerosis (RMS) and primary progressive MS (PPMS) and identified predictors of treatment response.</p><p><strong>Methods: </strong>We included 260 RMS and 73 PPMS patients treated with ocrelizumab for ≥ 1 year at our MS Centre until May 2024.</p><p><strong>Results: </strong>Median follow-up was 3.90 years for RMS and 4.23 years for PPMS. Within 2 years from treatment initiation, annualized relapse rate (ARR) decreased from 0.412 to 0.014 and was maintained low throughout follow-up in RMS, with no relapses in PPMS. MRI activity significantly declined and was maintained in both groups (p < 0.0001). After 3 years, confirmed disability progression (CDP)-free survival was high in relapsing-remitting MS (> 97%) and lower in secondary progressive MS (48.9%) and PPMS (57.2%). Predictors of ocrelizumab inefficacy included higher baseline Expanded Disability Status Scale (EDSS), older age and longer disease duration in RMS; male sex, older age and prior lower-efficacy treatments in PPMS. Adverse events were in line with previous clinical studies, with hypogammaglobulinemia and recurrent infections being the most frequent.</p><p><strong>Conclusions: </strong>In this study we confirm ocrelizumab sustained efficacy in controlling inflammatory disease activity, with greater impact in RMS, with a favourable safety profile. Early treatment initiation is crucial to prevent irreversible disability accumulation.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"481"},"PeriodicalIF":4.8,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528423","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}
引用次数: 0
Mitochondrial pathology in inflammatory myopathies: a marker of worse clinical outcome. 炎症性肌病的线粒体病理:临床结果较差的标志。
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-06-26 DOI: 10.1007/s00415-025-13192-z
Antonio Lauletta, Luca Bosco, Gioia Merlonghi, Yuri Matteo Falzone, Marta Cheli, Roberta Piera Bencivenga, Dario Zoppi, Marco Ceccanti, Felix Kleefeld, Sarah Léonard-Louis, Werner Stenzel, Olivier Benveniste, Lorenzo Maggi, Stefano Carlo Previtali, Matteo Garibaldi
{"title":"Mitochondrial pathology in inflammatory myopathies: a marker of worse clinical outcome.","authors":"Antonio Lauletta, Luca Bosco, Gioia Merlonghi, Yuri Matteo Falzone, Marta Cheli, Roberta Piera Bencivenga, Dario Zoppi, Marco Ceccanti, Felix Kleefeld, Sarah Léonard-Louis, Werner Stenzel, Olivier Benveniste, Lorenzo Maggi, Stefano Carlo Previtali, Matteo Garibaldi","doi":"10.1007/s00415-025-13192-z","DOIUrl":"10.1007/s00415-025-13192-z","url":null,"abstract":"<p><strong>Objectives: </strong>Mitochondrial dysfunction is well documented in inclusion body myositis (IBM), but its role in non-IBM myositis remains unclear. This study aimed to investigate the prevalence and clinical significance of mitochondrial pathology in non-IBM myositis and to assess its potential role as a marker for disease progression towards IBM, treatment response, and clinical outcomes.</p><p><strong>Methods: </strong>Muscle biopsies from 850 patients with inflammatory myopathy (IM) across 6 neuromuscular centers in Italy, France, and Germany were retrospectively analyzed. Inclusion required meeting diagnostic criteria for definite adult IM, mitochondrial pathology (age-exceeding numbers of COX-negative fibers), and exclusion of definite IBM according to Hilton-Jones 2013 criteria. The percentage of COX-negative fibers was quantified, correlated with clinical outcomes, and compared with myositis control cases without relevant signs of mitochondrial alterations.</p><p><strong>Results: </strong>Twenty-five patients with non-IBM myositis and mitochondrial abnormalities were identified. These patients, predominantly women (68%), had a mean onset age of 58.8 years. Polymyositis with mitochondrial pathology (PM-Mito) and nonspecific myositis (NSM) were the most prevalent subtypes (72%). The mean percentage of COX-negative fibers was 3% (0.25-8.5%) in these patients. The presence of mitochondrial pathology was associated with treatment refractoriness and worse clinical outcome evaluated based on residual muscle weakness and the level of independence (p < 0.005). A higher percentage of COX-negative fibers also correlated with poorer clinical outcomes (p = 0.031). Four patients, initially diagnosed with PM-Mito and NSM, progressed to definite IBM.</p><p><strong>Conclusions: </strong>Mitochondrial dysfunction represents a key element informing about disease severity and poor clinical outcomes in non-IBM myositis. It may predict progression to IBM, especially in PM-Mito and NSM, and guide treatment strategies.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"480"},"PeriodicalIF":4.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497340","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}
引用次数: 0
William Halse Rivers Rivers (1864-1922). 威廉·哈尔斯·里弗斯(1864-1922)。
IF 4.8 2区 医学
Journal of Neurology Pub Date : 2025-06-25 DOI: 10.1007/s00415-025-13212-y
Andrew J Larner
{"title":"William Halse Rivers Rivers (1864-1922).","authors":"Andrew J Larner","doi":"10.1007/s00415-025-13212-y","DOIUrl":"10.1007/s00415-025-13212-y","url":null,"abstract":"","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"479"},"PeriodicalIF":4.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484747","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}
引用次数: 0
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