Multiple Sclerosis Journal最新文献

Communication deficits in multiple sclerosis: Interactions with cognitive dysfunction and their impact on employment status.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-20 DOI: 10.1177/13524585251328556

Christos Bakirtzis, Nefeli Dimitriou, Theodoros Moysiadis, Sarah El-Wahsh, Athina Andravizou, Elli Nteli, Marina-Kleopatra Boziki, Grigorios Nasios, Lambros Messinis, Nikolaos Grigoriadis

{"title":"Communication deficits in multiple sclerosis: Interactions with cognitive dysfunction and their impact on employment status.","authors":"Christos Bakirtzis, Nefeli Dimitriou, Theodoros Moysiadis, Sarah El-Wahsh, Athina Andravizou, Elli Nteli, Marina-Kleopatra Boziki, Grigorios Nasios, Lambros Messinis, Nikolaos Grigoriadis","doi":"10.1177/13524585251328556","DOIUrl":"https://doi.org/10.1177/13524585251328556","url":null,"abstract":"Background: People living with multiple sclerosis (PwMS) are at risk of experiencing communication difficulties that can limit their vocational outcomes.Objective: To investigate clinical and cognitive variables that may contribute to communication restrictions in PwMS, and to evaluate how these factors affect vocational status.Methods: In this cross-sectional study, 502 PwMS underwent clinical and cognitive assessment tasks and were administered self-reported measures assessing fatigue and mood. The communication and language assessment questionnaire for persons with multiple sclerosis (CLAMS) was also administered.Results: Performance in information processing speed (p < 0.001), the presence of dysarthria (p < 0.001) and levels of self-reported fatigue (p < 0.001) were independent predictors of communication difficulties. Higher levels of communication difficulties were associated with a higher risk of unemployment and allowance (area under the receiver operating characteristic curve 0.649, p < 0.001 and 0.749, p < 0.001, respectively).Conclusion: Cognitive deficits, high levels of fatigue and the presence of dysarthria may independently contribute to communication difficulties in PwMS regardless of disease type or disability levels. These factors are associated with poorer vocational outcomes, highlighting the need for targeted interventions to support effective communication and improve employment prospects for this population.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"13524585251328556"},"PeriodicalIF":4.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663911","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

Seizure history and cognitive dysfunction in people with multiple sclerosis.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-18 DOI: 10.1177/13524585251326841

David E Freedman, Jiwon Oh, Cecilia Meza, Anthony Feinstein

{"title":"Seizure history and cognitive dysfunction in people with multiple sclerosis.","authors":"David E Freedman, Jiwon Oh, Cecilia Meza, Anthony Feinstein","doi":"10.1177/13524585251326841","DOIUrl":"https://doi.org/10.1177/13524585251326841","url":null,"abstract":"Background: Seizures are associated with reduced cognition in the general population and worse outcomes in people with multiple sclerosis (pwMS). Yet, it remains unclear whether seizures are linked to cognitive dysfunction in pwMS.Objectives: To evaluate the connection between seizure history and poorer cognition in pwMS.Methods: A consecutive sample of 803 pwMS reported any prior seizures. Covariates included age, sex, Wechsler Test of Adult Reading scores, educational years, Expanded Disability Status Scale (EDSS) scores, disease duration, disease subtype, high-efficacy disease-modifying therapy use, Hospital Anxiety and Depression Scale scores for anxiety and depression and Modified Fatigue Impact Scale scores. Linear regression analyses, controlling for covariates, were undertaken to predict Minimal Assessment of Cognitive Function in MS scores from seizure history.Results: Mean age was 44.01 years (SD = 11.58), 76.84% were female, and median EDSS was 2.0 (interquartile range (IQR) = 1.5-3.5). Accounting for covariates, people with seizures (n = 43, 5.35%) performed worse than those without (n = 760) on Judgement of Line Orientation (β = -0.09, p < 0.01), California Verbal Learning Test-II learning (β = -0.08, p < 0.01) and memory (β = -0.10, p < 0.01), Brief Visuospatial Memory Test-Revised learning (β = -0.08, p = 0.01) and memory (β = -0.07, p = 0.05), Symbol Digit Modalities Test (β = -0.06, p = 0.04), Paced Auditory Serial Addition Test (β = -0.10, p < 0.01) and Delis-Kaplan Executive Function System (β = -0.07, p = 0.02).Conclusions: A seizure history independently predicts reduced cognition in pwMS.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"13524585251326841"},"PeriodicalIF":4.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657830","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

Toward equity in MS care: A roadmap for accessible treatment.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-17 DOI: 10.1177/13524585251326843

Jorge Correale

引用次数: 0

Smoking status and vascular risk factors as predictors of disability in AQP4-NMOSD and MOGAD.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-15 DOI: 10.1177/13524585251325069

Fiona Chan, David Berhanu, Sara Samadzadeh, Anna Francis, Nasrin Asgari, Friedemann Paul, M Isabel Leite, Ruth Geraldes, Jacqueline Palace

{"title":"Smoking status and vascular risk factors as predictors of disability in AQP4-NMOSD and MOGAD.","authors":"Fiona Chan, David Berhanu, Sara Samadzadeh, Anna Francis, Nasrin Asgari, Friedemann Paul, M Isabel Leite, Ruth Geraldes, Jacqueline Palace","doi":"10.1177/13524585251325069","DOIUrl":"https://doi.org/10.1177/13524585251325069","url":null,"abstract":"Background: Smoking and vascular risk factors (VRFs) are reported to have adverse effects in multiple sclerosis but data are limited in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). This study aimed to measure their impact on disability.Methods: Smoking status was defined as never, past or current smokers and VRF comprised of ⩾1: hypertension, dyslipidemia, high body mass index or diabetes. Logistic regression models were fitted to predict their influence on recovery from onset attack and first optic neuritis (ON) attack.Results: A total of 442 patients were included. Current MOGAD smokers had a higher risk of disability from onset attack and first ON attack than never smokers (odds ratio (OR) 2.9, 95% confidence interval (CI) 1.3-6.9; OR 3.3, 95% CI 1.4-7.8). VRF in MOGAD was not predictive of disability. Current AQP4-NMOSD smokers and VRFs had a higher risk of residual disability from onset attacks (OR 7.5, 95% CI 2.1-27.7; OR 1.9, 95% CI 1.0-3.4). VRF was associated with higher risk of visual disability (OR 2.6, 95% CI 1.08-6.46) while smoking status was not.Conclusions: Current smoking status detrimentally influenced onset attack recovery in AQP4-NMOSD and MOGAD patients, including visual recovery in MOGAD. Non-smoking VRFs influenced clinical and visual outcomes in AQP4-NMOSD.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"13524585251325069"},"PeriodicalIF":4.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634152","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

Copy number variation at the complement C4 locus is associated with risk for multiple sclerosis.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-15 DOI: 10.1177/13524585251324850

Jacqueline Williams, Wesley M Marin, Kristen J Wade, Rayo Suseno, Kerry Kizer, Stacy Caillier, Danillo G Augusto, Paul J Norman, Jill A Hollenbach

引用次数: 0

Short- and mid-term efficacy of sacral neuromodulation in the treatment of neurogenic overactive bladder in patients with multiple sclerosis.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-13 DOI: 10.1177/13524585251323178

Benjamin Carolus, Pierre-Luc Dequirez, Louise Olivier, Samy Hafez, Marie-Aimée Perrouin-Verbe, Benoit Beyronnet, Grégoire Capon, Xavier Biardeau

{"title":"Short- and mid-term efficacy of sacral neuromodulation in the treatment of neurogenic overactive bladder in patients with multiple sclerosis.","authors":"Benjamin Carolus, Pierre-Luc Dequirez, Louise Olivier, Samy Hafez, Marie-Aimée Perrouin-Verbe, Benoit Beyronnet, Grégoire Capon, Xavier Biardeau","doi":"10.1177/13524585251323178","DOIUrl":"https://doi.org/10.1177/13524585251323178","url":null,"abstract":"Background: Sacral neuromodulation (SNM) is commonly used in the treatment of overactive bladder, but few studies have evaluated its efficacy in patients with multiple sclerosis (MS).Objectives: To assess the efficacy of SNM in the treatment of neurogenic overactive bladder (nOAB) in patients with MS.Methods: All MS patients that underwent a two-stage SNM to treat nOAB between 2013 and 2023 in four university hospitals were considered eligible. The primary outcome was clinical efficacy, defined as the implantation of an implantable pulse generator (IPG). Secondary outcome included the Patient Global Impression of Improvement (PGI-I), the 3-day bladder diary parameters and the maintenance of efficacy within 5 years.Results: A total of 38 patients were included. The IPG was implanted in 33 patients (87%). The median daily (9.0 to 7.0; p < 0.001) and nocturnal (2.5 to 1.0; p < 0.01) number of micturition/clean self-intermittent catheterization (CISC), the presence of urinary urgency (97% vs 58%; p < 0.01) and urinary incontinence (84% vs 25%, p < 0.001) significantly decreased at the end of the test phase. Efficacy was maintained at 5 years in 46% of cases.Conclusions: In MS patients with nOAB, SNM exhibits clinical efficacy comparable to that observed in the non-neurological population.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"13524585251323178"},"PeriodicalIF":4.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625334","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

A breathtaking case of NMOSD: About pulmonary involvement in patients with AQP4-antibodies.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-13 DOI: 10.1177/13524585251320923

Romain Marignier

引用次数: 0

Vaccination in multiple sclerosis: Tackling challenges and paving the way for effective immunization.

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-12 DOI: 10.1177/13524585251318513

René Carvajal, Carmen Tur, Blanca Borras-Bermejo, Deanna Saylor, Xavier Montalban, Mar Tintoré, Susana Otero-Romero

{"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":"https://doi.org/10.1177/13524585251318513","url":null,"abstract":"Background: 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.Aims: This study aimed to identify challenges in achieving effective immunization for PwMS and explore strategies to optimize vaccination practices.Methods: Recent guidelines and studies on vaccination in PwMS were reviewed to pinpoint challenges, unmet needs, and opportunities for improvement.Results: 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.Conclusion: 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.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"13524585251318513"},"PeriodicalIF":4.8,"publicationDate":"2025-03-12","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}

引用次数: 0

The confavreux lecture: The radiologically isolated syndrome diagnosis, prognosis and perspectives. confavreux讲座：影像学孤立综合征的诊断、预后及展望。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-01 Epub Date: 2025-01-17 DOI: 10.1177/13524585241311217

Christine Lebrun-Frenay

{"title":"The confavreux lecture: The radiologically isolated syndrome diagnosis, prognosis and perspectives.","authors":"Christine Lebrun-Frenay","doi":"10.1177/13524585241311217","DOIUrl":"10.1177/13524585241311217","url":null,"abstract":"Radiologically isolated syndrome (RIS) is the earliest documented stage in the disease continuum of multiple sclerosis (MS). It is discovered incidentally in individuals who are asymptomatic but have typical lesions in the brain or spinal cord suggestive of autoimmune inflammatory demyelination. The revised 2023 RIS criteria aim to secure an accurate and timely diagnosis due to the presence of imaging mimics. These criteria require having at least one T2-weighted hyperintense lesion in one of the four suggestive MS locations along with two of the following three features: spinal cord lesion, cerebrospinal fluid (CSF)-restricted oligoclonal bands, or new T2 or gadolinium-enhancing lesion observed on a subsequent magnetic resonance imaging (MRI) study. Once the diagnosis is confirmed, established risk factors, including age, lesion location and CSF, significantly improve prognostic stratification, which is crucial for immunoactive interventions. Recent clinical trials have shown that oral disease-modifying treatments can delay or prevent the first clinical event in RIS patients. Consulting with an MS team for each RIS case is strongly recommended to enhance care and disease surveillance. The revised 2024 McDonald criteria will classify individuals with additional CSF and advanced MRI biomarkers as having preclinical MS, highlighting the importance of vigilance in this area.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"249-256"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008694","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

Upper cervical spinal cord atrophy in MS: Sex, menopause, and neurodegeneration. 多发性硬化症的上颈脊髓萎缩：性别、更年期和神经变性。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2025-03-01 Epub Date: 2025-01-18 DOI: 10.1177/13524585241311441

Burcu Zeydan, Jiye Son, Nur Neyal, Christopher G Schwarz, Elizabeth J Atkinson, Holly A Morrison, Nabeela Nathoo, Kejal Kantarci, Eoin P Flanagan, John D Port, Orhun H Kantarci

{"title":"Upper cervical spinal cord atrophy in MS: Sex, menopause, and neurodegeneration.","authors":"Burcu Zeydan, Jiye Son, Nur Neyal, Christopher G Schwarz, Elizabeth J Atkinson, Holly A Morrison, Nabeela Nathoo, Kejal Kantarci, Eoin P Flanagan, John D Port, Orhun H Kantarci","doi":"10.1177/13524585241311441","DOIUrl":"10.1177/13524585241311441","url":null,"abstract":"Background: Spinal cord (SC) atrophy is a key imaging biomarker of progressive multiple sclerosis (MS). Progressive MS is more common in men and postmenopausal women.Objective: Investigate the impact of sex and menopause on SC measurements in persons with MS (pwMS).Methods: In pwMS and age- and sex-matched controls, upper cervical SC area from brain MRI (UCCbrain) was obtained. Impact of sex and menopause on UCCbrain (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated.Results: UCCbrain was smaller in pwMS (n = 118, 51.4 ± 5.3 mm2) than controls (n = 118, 54.2 ± 4.4 mm2, p < 0.001) and inversely correlated with older age in pwMS (r = -0.24, p = 0.010) but not in controls (r = -0.025, p = 0.786). In 173 pwMS (413 brain MRIs), UCCbrain was smaller in men (49.5 ± 5.9 mm2) than women (51.6 ± 5.5 mm2, p = 0.001), postmenopausal women (49.4 ± 5.6 mm2) than premenopausal women (52.9 ± 4.1 mm2, p < 0.001), and progressive (47.5 ± 5.6 mm2) than relapsing MS (52.1 ± 5.2 mm2, p < 0.001). UCCbrain also correlated with disease duration (r = -0.39, p < 0.001), 9-hole peg test (r = -0.26, p = 0.005), and severe ambulatory disability (Expanded Disability Status Scale ⩾6) (r = -0.27, p < 0.001).Conclusion: UCCbrain, a biomarker of progressive MS, is inversely associated with age, disease duration, male sex, and menopause, highlighting the potential impact of sex and hormones on neurodegeneration in MS.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"278-289"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008714","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