Multiple Sclerosis Journal最新文献

{"title":"Reliability of paramagnetic rim lesion detection at 1.5T MRI in multiple sclerosis patients.","authors":"Maria Sofia Martire, Lucia Moiola, Pietro Maggi, Serena Borrelli, Valentina Novati, Vittorio Martinelli, Maria A Rocca, Paolo Vezzulli, Andrea Falini, Massimo Filippi, Martina Absinta","doi":"10.1177/13524585251314358","DOIUrl":"10.1177/13524585251314358","url":null,"abstract":"<p><strong>Background: </strong>Paramagnetic rim lesions (PRL) are valuable for diagnosing and prognosing multiple sclerosis (MS) and detectable at 7T and 3T MRI. For translation into clinical practice, it is essential assessing their visibility on 1.5T clinical scanners.</p><p><strong>Objective: </strong>To evaluate the reliability of detecting PRL using commercially available susceptibility-weighted imaging (SWI) at 1.5 versus 3T MRI.</p><p><strong>Methods: </strong>SWI images were obtained in 20 people with MS at 1.5T and 3T MRI, with an average scan interval of 1.1 years. Only stable, non-enhancing lesions visible on both scans were analyzed. PRL at 3T were identified by two expert raters using NAIMS PRL criteria and used as a reference. Four raters, blinded to 3T results, assessed PRL at 1.5T. Discrepancies were resolved by consensus.</p><p><strong>Results: </strong>PRL were identified in 16 of 20 patients. At 3T, 95 PRL were identified by consensus (mean 5 PRL per patient, range 0-30). Blinded to 3T scans, 82% of PRL were visible at 1.5T (78 of 95 PRL). Interrater reliability was \"almost perfect\" for both 1.5 and 3T scans. Raters accurately classified all patients as having ⩾1PRL or not at 1.5T.</p><p><strong>Conclusion: </strong>The majority of PRL are detectable at 1.5T without significantly reducing the specificity of PRL identification or increasing the detection of pseudo-PRL. This may facilitate their clinical use in MS diagnosis and prognosis.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"955-963"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075018","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":"Addressing patient-reported cognitive impairment in multiple sclerosis clinical practice: A challenging endeavor.","authors":"Gabrielle Macaron, Nour Farah, Simon Charbonneau, Sarah A Morrow, Amel Zertal, Dave Saint-Amour, Pierre Duquette, Isabelle Rouleau","doi":"10.1177/13524585251334488","DOIUrl":"10.1177/13524585251334488","url":null,"abstract":"<p><p>Cognitive impairment (CI) is a common and disabling symptom in people with multiple sclerosis (PwMS), significantly affecting employment outcomes and quality of life. Despite its prevalence, routine assessment of CI is often hindered by limited access to comprehensive neuropsychological evaluations and challenges in interpreting subjective concerns. The relationship between objective and subjective measures of cognition is complex and often discordant. This review provides an overview focused on patient-reported CI, emphasizing on the association with objective measures of CI, the role of confounding factors, and the limitations of current screening approaches. Regardless of the underlying processes driving these concerns, patient-reported CI has a significant impact on day-to-day quality of life of PwMS and needs to be efficiently evaluated and addressed as several reversible causes can be managed efficiently when detected.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"896-904"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001984","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":"Personalized treatment decision algorithms for the clinical application of serum neurofilament light chain in multiple sclerosis: A modified Delphi Study.","authors":"Özgür Yaldizli, Pascal Benkert, Lutz Achtnichts, Amit Bar-Or, Viviane Bohner-Lang, Claire Bridel, Manuel Comabella, Oliver Findling, Giulio Disanto, Sebastian Finkener, Claudio Gobbi, Cristina Granziera, Marina Herwerth, Robert Hoepner, Dana Horakova, Nicole Kamber, Michael Khalil, Philipp Kunz, Patrice Lalive, Ralf Linker, Johannes Lorscheider, Stefanie Müller, Johanna Oechtering, Victoria Pettypool, Fredrik Piehl, Caroline Pot, Patrick Roth, Marie Théaudin, Mar Tintore, Carmen Tur, Denis Uffer, Marjolaine Uginet, Jochen Vehoff, Heinz Wiendl, Tjalf Ziemssen, Chiara Zecca, Anke Salmen, David Leppert, Tobias Derfuss, Ludwig Kappos, Lars G Hemkens, Perrine Janiaud, Jens Kuhle","doi":"10.1177/13524585251335466","DOIUrl":"10.1177/13524585251335466","url":null,"abstract":"<p><strong>Background: </strong>Serum neurofilament light (sNfL) chain levels, a sensitive measure of disease activity in multiple sclerosis (MS), are increasingly considered for individual therapy optimization yet without consensus on their use for clinical application.</p><p><strong>Objective: </strong>We here propose treatment decision algorithms incorporating sNfL levels to adapt disease-modifying therapies (DMTs).</p><p><strong>Methods: </strong>We conducted a modified Delphi study to reach consensus on algorithms using sNfL within typical clinical scenarios. sNfL levels were defined as \"high\" (>90th percentile) vs \"normal\" (<80th percentile), based on normative values of control persons. In three rounds, 10 international and 18 Swiss MS experts, and 3 patient consultants rated their agreement on treatment algorithms. Consensus thresholds were defined as moderate (50%-79%), broad (80%-94%), strong (≥95%), and full (100%).</p><p><strong>Results: </strong>The Delphi provided 9 escalation algorithms (e.g. initiating treatment based on high sNfL), 11 horizontal switch (e.g. switching natalizumab to another high-efficacy DMT based on high sNfL), and 3 de-escalation (e.g. stopping DMT or extending intervals in B-cell depleting therapies).</p><p><strong>Conclusion: </strong>The consensus reached on typical clinical scenarios provides the basis for using sNfL to inform treatment decisions in a randomized pragmatic trial, an important step to gather robust evidence for using sNfL to inform personalized treatment decisions in clinical practice.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"932-943"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028026","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":"Response to letter to the editor: 'Investigating the complementary value of OCT to MRI in cognitive impairment in relapsing-remitting multiple sclerosis'.","authors":"Ronja Christensen, Amy Jolly, Charmaine Yam, Marios C Yiannakas, Ahmed T Toosy, Marco Pitteri, Anna He, Riccardo Nistri, Suraya Mohamud, Eirini Samdanidou, Alan J Thompson, Olga Ciccarelli","doi":"10.1177/13524585251329787","DOIUrl":"10.1177/13524585251329787","url":null,"abstract":"","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1016-1018"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064162","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":"Emphasizing complementary in \"Investigating the complementary value of OCT to MRI in cognitive impairment in relapsing-remitting multiple sclerosis\".","authors":"Gabriel Bsteh, Harald Hegen, Philipp Albrecht, Joachim Havla, Christian Cordano, E Ann Yeh, Shiv Saidha","doi":"10.1177/13524585251329800","DOIUrl":"10.1177/13524585251329800","url":null,"abstract":"","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1014-1016"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036067","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":"The characteristics and influencing factors of paramagnetic rim lesions in Chinese MS patients: A 7T MRI study.","authors":"Xinyao Liu, Yue Wang, Ning Wei, Wanlin Zhu, Yue Suo, Yuyuan Xu, Aoming Jin, Qin Xu, Nan Qi, Qianmei Jiang, Zhaobin Wang, Lei Su, Ai Guo, Jiali Sun, Yunyun Duan, Zhe Zhang, Jing Jing, De-Cai Tian","doi":"10.1177/13524585251328902","DOIUrl":"10.1177/13524585251328902","url":null,"abstract":"<p><strong>Background: </strong>Paramagnetic rim lesions (PRLs) in multiple sclerosis (MS) are a significant factor for disability progression and prognosis, but their characteristics in the Chinese population are unclear.</p><p><strong>Objective: </strong>To explore PRLs in Chinese MS patients using 7T magnetic resonance imaging (MRI), including their number, proportion, distribution, and associated factors.</p><p><strong>Methods: </strong>Patients from the 7T MRI subgroup of the China National Registry of Neuro-Inflammatory Diseases (CNRID) were prospectively included. PRLs were assessed on susceptibility-weighted imaging (SWI)-phase images. Patients were grouped by PRL count (0, 1-3, 4-10, >10). Associations between clinical characteristics and PRL count were analyzed using multivariable linear regression, while correlations with disease duration were assessed using Pearson partial correlation and regression.</p><p><strong>Results: </strong>Among 110 participants, 96 (87.3%) had at least one PRL. In PRL groups, proportions were 12.7%, 20.0%, 29.1%, and 38.2%. PRL count positively correlated with Expanded Disability Status Scale (EDSS), total lesion count, and volume and negatively with Symbol Digit Modality Test (SDMT; <i>p</i> < 0.05). Longer disease duration was associated with a lower PRL proportion after adjusting for age and sex (β = -0.006, <i>p</i> = 0.032).</p><p><strong>Conclusion: </strong>A high proportion of Chinese MS patients in our 7T MRI cohort had PRLs, with many exhibiting multiple PRLs (⩾4). PRL count was influenced by EDSS, SDMT, total lesion count, and volume, while PRL proportion negatively correlated with disease duration.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"964-974"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993623","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":"Home-sampling of B cells using quantitative dried blood spots to enable tailored therapeutic re-dosing of anti-CD20 therapies.","authors":"Emma C Tallantyre, Emily Jacob, Laura Davies, Samantha Loveless, Emily Carne, Kath Bramhall, Janika Schulze, Stuart J Moat, Stephen Jolles","doi":"10.1177/13524585251330962","DOIUrl":"10.1177/13524585251330962","url":null,"abstract":"<p><p>Anti-CD20 monoclonal antibodies are commonly used to manage neuroinflammatory diseases. The rate of B-cell re-emergence after dosing of ocrelizumab or rituximab varies considerably between individuals, but most people remain completely B-cell depleted at 6 months. Tailoring the dosing according to B-cell re-emergence may improve the safety profile of anti-CD20s but poses logistical challenges such as the need for regular attendances for whole-blood sampling. Here we combined a quantitative dried blood spot sampling technique with a DNA methylation test, to provide a reliable means of remotely monitoring B-cell counts, with 100% sensitivity and specificity for reaching >10 × 10⁶ cells/L.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1007-1010"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753552","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":"Change in serum neurofilament light chain and glial fibrillary acidic protein levels with high-efficacy and low-efficacy early therapy in multiple sclerosis.","authors":"Evan Madill, Vanessa Moreira Ferreira, Brian Healy, Jonathan Zurawski, Mariann Polgar-Turcsanyi, Howard L Weiner, Tanuja Chitnis","doi":"10.1177/13524585251335521","DOIUrl":"10.1177/13524585251335521","url":null,"abstract":"<p><strong>Introduction: </strong>Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are associated with multiple sclerosis (MS) outcomes. We compare how high-efficacy early therapy (HEET) and lower-efficacy early therapy (LEET) affect serum NfL and GFAP at the initiation of disease-modifying therapy (DMT) and in the years afterwards.</p><p><strong>Methods: </strong>Adults diagnosed with MS within 5 years of symptom onset at our centre were eligible. Records from DMT-naïve patients with serum NfL and GFAP drawn in the year before treatment start and follow-up samples 6-36 months after treatment initiation were included in the 'pre-initiation' cohort. Those with baselines after DMT initiation and follow-up samples within 5 years were included in the 'post-initiation' cohort.</p><p><strong>Results: </strong>There were 155 pre-initiation patients (HEET: 85, LEET: 70) and 213 post-initiation (HEET: 55, LEET: 158). NfL levels were reduced following DMT initiation but did not differ significantly between HEET and LEET in either cohort. GFAP was not substantially impacted by either HEET or LEET.</p><p><strong>Conclusion: </strong>The difference in NfL reduction with HEET and LEET may be smaller than anticipated, perhaps reflecting that disease activity risk is considered in real-world DMT selection. There is minimal impact of HEET or LEET on GFAP, at least over several years.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"944-954"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028334","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":"Evaluation of arterial spin labeling in the diagnosis and monitoring of myelin oligodendrocyte glycoprotein-associated cerebral cortical encephalitis.","authors":"Tomoya Shibahara, Kei Yamanaka, Mikiaki Matsuoka, Masaki Tachibana, Junya Kuroda, Hiroshi Nakane","doi":"10.1177/13524585241291444","DOIUrl":"10.1177/13524585241291444","url":null,"abstract":"<p><p>Myelin oligodendrocyte glycoprotein (MOG)-associated disorders are inflammatory demyelinating diseases of the CNS. Cerebral cortical encephalitis (CCE) is characterized by cortical fluid-attenuated inversion recovery hyperintensity with seizures and headaches. We report two cases of MOG antibody-associated CCE (MOG-CCE) evaluated using serial MRI sequences, including arterial spin labeling (ASL), pre- and posttreatment. In both patients, ASL demonstrated hyperperfusion correlating with disease activity, which normalized following steroid therapy. Our cases highlight the usefulness of ASL in early detection, monitoring, and assessment of treatment response in MOG-CCE.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1011-1013"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546383","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":"Vaccination in multiple sclerosis: Tackling challenges and paving the way for effective immunization.","authors":"René Carvajal, Carmen Tur, Blanca Borras-Bermejo, Deanna Saylor, Xavier Montalban, Mar Tintoré, Susana Otero-Romero","doi":"10.1177/13524585251318513","DOIUrl":"10.1177/13524585251318513","url":null,"abstract":"<p><strong>Background: </strong>Vaccination in patients with multiple sclerosis (PwMS) presents unique challenges. Disease-modifying therapies (DMTs) can increase infectious risks, though these are largely preventable through immunizations. However, DMTs can also reduce vaccine efficacy.</p><p><strong>Aims: </strong>This study aimed to identify challenges in achieving effective immunization for PwMS and explore strategies to optimize vaccination practices.</p><p><strong>Methods: </strong>Recent guidelines and studies on vaccination in PwMS were reviewed to pinpoint challenges, unmet needs, and opportunities for improvement.</p><p><strong>Results: </strong>Early immunization before DMT initiation is vital for optimal responses, coordinating vaccinations with DMTs' presents challenges. Strategies to enhance vaccine efficacy, such as bridging therapies or more immunogenic formulations, may benefit highly active patients requiring immediate DMT initiation. Although live-attenuated vaccines pose challenges for those on immunosuppressive therapies, emerging evidence suggests safe administration in select cases. Overcoming vaccine hesitancy demands targeted education, personalized counseling, and improved access to services, especially in low- and middle-income countries. Inclusivity is crucial, particularly for groups, such as pediatric, pregnant, and elderly PwMS.</p><p><strong>Conclusion: </strong>A multifaceted approach is essential to addressing vaccination challenges in PwMS. Collaborative efforts involving multiple stakeholders are crucial for overcoming these obstacles and generating robust evidence. We propose an integrated strategy to ensure effective immunization while maintaining timely DMT administration.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"754-763"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605703","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}