Multiple Sclerosis Journal最新文献

{"title":"Diagnostic accuracy of inter-eye difference of ganglion cell layer alone in identifying optic neuritis in multiple sclerosis.","authors":"Nik Krajnc, Fabian Föttinger, Markus Ponleitner, Barbara Kornek, Fritz Leutmezer, Stefan Macher, Paulus Rommer, Christiane Schmied, Karin Zebenholzer, Gudrun Zulehner, Tobias Zrzavy, Thomas Berger, Berthold Pemp, Gabriel Bsteh","doi":"10.1177/13524585251332895","DOIUrl":"10.1177/13524585251332895","url":null,"abstract":"<p><strong>Introduction: </strong>The 2024 McDonald criteria for diagnosing multiple sclerosis (MS) include optic nerve involvement as a fifth region for establishing dissemination in space. Optic neuritis (ON) can be detected through optical coherence tomography (OCT) using an inter-eye absolute or percentage difference (IEAD, IEPD) in ganglion cell-inner plexiform layer (GCIPL) thickness.</p><p><strong>Objective: </strong>To compare the diagnostic accuracy of GCIPL IEAD/IEPD with GCL and IPL IEAD/IEPD alone for identifying a history of ON.</p><p><strong>Methods: </strong>This cross-sectional retrospective study included people with MS (pwMS) who underwent an OCT scan. Diagnostic accuracy was assessed using ROC analysis.</p><p><strong>Results: </strong>A total of 241 pwMS (mean age 34.7 years [SD 9.7], 70.1% female) were included. Sixty-eight (28.2%) patients had a documented history of unilateral ON. GCL IEAD (AUC 0.79, cut-off ⩾ 0.06 mm³ or ⩾2µm, 58.9% sensitivity, 85.1% specificity) and IEPD (AUC 0.80, cut-off ⩾ 3%, 48.7% sensitivity, 89.8% specificity) demonstrated excellent diagnostic accuracy for unilateral ON, showing non-inferiority to the established GCIPL IEAD/IEPD.</p><p><strong>Conclusion: </strong>GCL IEAD and IEPD provide strong diagnostic accuracy for identifying unilateral ON and can be effectively used as an alternative to GCIPL IEAD/IEPD to facilitate implementation in clinical routine.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1051-1060"},"PeriodicalIF":5.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036106","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":"Health care use preceding pediatric multiple sclerosis: A population-based study from Ontario, Canada.","authors":"Ruth Ann Marrie, Colleen J Maxwell, Karl Everett, Feng Zhu, Ping Li, Kyla A McKay, Yinshan Zhao, Helen Tremlett","doi":"10.1177/13524585251338745","DOIUrl":"10.1177/13524585251338745","url":null,"abstract":"<p><strong>Background: </strong>Investigations of a prodrome in multiple sclerosis (MS) usually have included adults.</p><p><strong>Objective: </strong>To compare rates and reasons for health care use in youth with and without MS, considering time relative to the MS index date and to birth.</p><p><strong>Methods: </strong>This retrospective cohort study used population-based administrative data (1991-2020) from Ontario, Canada. We matched youth (<18 years) with MS up to 5:1 to youth without MS by sex, birth year, region, and duration of observation (full cohorts). Subcohorts had data from birth to MS index date (first demyelinating disease claim). We compared health services use, adjusting for age, sex, area-level income, region, and year.</p><p><strong>Results: </strong>We included 451 individuals with pediatric-onset MS and 1422 without MS. As of 6 years pre-index, the full MS cohort had higher physician services use (year 6: rate ratio (RR) = 1.45; 95% confidence interval (95% CI) = 1.25-1.67) and hospitalizations (RR = 2.79; 95% CI = 1.31-5.94). Findings were similar in subcohorts. The MS subcohort had elevated physician visit rates in early life that rose as the MS index date approached.</p><p><strong>Discussion: </strong>Youth with pediatric-onset MS exhibit increased health care use from birth. Early life may be a risk period for MS. A prodromal phase may emerge 6 years before the onset of typical MS symptoms.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1078-1087"},"PeriodicalIF":5.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128183","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":"Treatment discontinuation in MOGAD: A reassuring step forward.","authors":"Yael Hacohen, Romain Marignier","doi":"10.1177/13524585251336891","DOIUrl":"10.1177/13524585251336891","url":null,"abstract":"","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1021-1022"},"PeriodicalIF":5.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981611","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":"Physical activity demonstrates protective associations with structural visual metrics in children with multiple sclerosis through time.","authors":"Samantha Stephens, Nahid Iseyas, E Ann Yeh","doi":"10.1177/13524585251335510","DOIUrl":"10.1177/13524585251335510","url":null,"abstract":"<p><strong>Background: </strong>Previous work has demonstrated that higher levels of physical activity (PA) are associated with better retinal fiber integrity in children with multiple sclerosis (MS).</p><p><strong>Objective: </strong>To determine whether high PA levels are associated with retinal fiber integrity through time in children with demyelinating disease.</p><p><strong>Methods: </strong>Children with MS or monophasic acquired demyelinating syndromes (mono-ADS) were included. PA level was assessed by questionnaire, and a spectral-domain optical coherence tomography (OCT) scanner determined retinal nerve and ganglion cell inner plexiform fiber layer thickness (RNFL and GCIPL, respectively). Linear mixed models were used to analyze longitudinal associations.</p><p><strong>Results: </strong>Children with MS (<i>n</i> = 28, 20F, mean age 14.6 (standard deviation (SD) ±2.4)) and mono-ADS (<i>n</i> = 24, 11F, mean age 9.5 (SD ±4.5)) took part. In children with MS, RNFL and GCIPL thickness was shown to decline by 1.0 mm (<i>p</i> < 0.05) over time. More active children with MS had thicker GCIPL through time compared to those who were inactive (2.5 mm, <i>p</i> < 0.01). Furthermore, taking part in any strenuous PA was associated with greater RNFL and GCIPL thickness (1.5-2.1 mm, <i>p</i> < 0.05). These differences were not found in children with mono-ADS.</p><p><strong>Conclusion: </strong>Moderate to vigorous PA is associated with better retinal integrity over time in pediatric MS. Future interventions should evaluate whether changes to PA level coincide with changes to retinal integrity in children with MS.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1070-1077"},"PeriodicalIF":5.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018747","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":"Considerations for family planning in adolescent and young adults with multiple sclerosis.","authors":"Kristen M Krysko","doi":"10.1177/13524585241303481","DOIUrl":"10.1177/13524585241303481","url":null,"abstract":"","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1137-1138"},"PeriodicalIF":5.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792089","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":"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":"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":"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":"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}