Esra Taşkıran , Bilgin Öztürk , Serkan Demir , Naim Ata , Mustafa Mahir Ülgü , Şuayip Birinci , Aslı Tuncer , Murat Kürtüncü
{"title":"Prevalence and incidence of neuromyelitis optica spectrum disorder in Türkiye: A nationwide epidemiologic study","authors":"Esra Taşkıran , Bilgin Öztürk , Serkan Demir , Naim Ata , Mustafa Mahir Ülgü , Şuayip Birinci , Aslı Tuncer , Murat Kürtüncü","doi":"10.1016/j.msard.2025.106383","DOIUrl":"10.1016/j.msard.2025.106383","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological studies of neuromyelitis optica spectrum disorder (NMOSD) show variability due to differences in methodologies, diagnostic criteria, and geographic factors.</div></div><div><h3>Objective</h3><div>This study aimed to determine NMOSD's epidemiological profile in Türkiye using official health records covering over 95 % of the population.</div></div><div><h3>Methods</h3><div>Data were collected using ICD-10 codes (G36.0) from the Health Record Reporting System (HRRS). Patients with at least three G36.0 codes or one G36.0 code combined with a prescription for rituximab, eculizumab, or tocilizumab were included. Nationwide prevalence of NMOSD in 2022 and incidence (2018–2022) were calculated using census data.</div></div><div><h3>Results</h3><div>We identified 1,623 patients meeting inclusion criteria. The prevalence was 1.9 per 100,000, and the incidence in 2022 was 2.1 per 1,000,000. A decreasing prevalence gradient from east to west was observed. The mean (±SD) patient age was 44.2 ± 15.7 years. Among 193 aquaporin-4 antibody positive patients, the female-to-male ratio was 8.2. Additionally, 83 % received at least one disease-modifying treatment.</div></div><div><h3>Conclusion</h3><div>NMOSD epidemiological features in Türkiye align with European data but remain lower than figures reported in African and Asian populations. Further research is needed to enhance the understanding of NMOSD in this population.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"97 ","pages":"Article 106383"},"PeriodicalIF":2.9,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Moškon , Lara Šinkovec , Katja Tomažin , Rok Amon , Vojko Strojnik , Darjan Spudić
{"title":"Effects of submotor-threshold tibial nerve stimulation on plantarflexion torque in healthy adults and people with multiple sclerosis","authors":"Sara Moškon , Lara Šinkovec , Katja Tomažin , Rok Amon , Vojko Strojnik , Darjan Spudić","doi":"10.1016/j.msard.2025.106381","DOIUrl":"10.1016/j.msard.2025.106381","url":null,"abstract":"<div><h3>Background</h3><div>Submotor-threshold electrical stimulation (subES) can enhance motoneuron excitability, presenting a potential strategy for improving exercise efficiency in people with multiple sclerosis (PwMS).</div></div><div><h3>Objective</h3><div>This study aimed to investigate the effects of superimposed subES of the tibial nerve during voluntary isometric contraction on ankle plantarflexor torque production.</div></div><div><h3>Methods</h3><div>A total of 48 participants, comprising both PwMS and healthy participants, performed plantarflexion at three voluntary isometric contraction (MVIC) levels: 20, 60, and 100 %. During the plantarflexion, the tibial nerve was stimulated with one-second trains of subES at frequency of 80 Hz.</div></div><div><h3>Results</h3><div>Plantarflexor torque decreased over one-second time intervals (from before to during and from during to after a train of subES) in both groups at 60 and 100 % MVIC (<em>p</em> < 0.01). While subES did not affect EMG signal amplitude (<em>p</em> > 0.05), it did lead to a statistically significant increase in median EMG frequency (<em>p</em> < 0.05). No differences in the effects of subES were observed between the two groups regarding torque, median EMG frequency, or EMG amplitude of the soleus muscle (<em>p</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>The findings indicate that the subES of the tibial nerve, as presented in this study, has limited potential for acutely enhancing ankle plantarflexor torque in PwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"97 ","pages":"Article 106381"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guido Giunti , Tiia Yrttiaho , Sharon Guardado-Medina , Anna Sachinopoulou , Vasiliki Mylonopoulou , Jani Fält , Benjamin Paloniemi , Mervi Ryytty , Johanna Krüger , Minna Isomursu
{"title":"Feasibility and usability evaluation of a gamified fatigue management mobile application for persons with multiple sclerosis in everyday life","authors":"Guido Giunti , Tiia Yrttiaho , Sharon Guardado-Medina , Anna Sachinopoulou , Vasiliki Mylonopoulou , Jani Fält , Benjamin Paloniemi , Mervi Ryytty , Johanna Krüger , Minna Isomursu","doi":"10.1016/j.msard.2025.106379","DOIUrl":"10.1016/j.msard.2025.106379","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is the most debilitating and prevalent symptom of multiple sclerosis (MS), affecting up to 80 % of patients and significantly impairing quality of life (QoL). Managing MS fatigue is challenging due to its multifactorial nature, encompassing physical, cognitive, and psychosocial components. Mobile health (mHealth) tools offer promising approaches for self-management, but most lack personalization and rigorous validation. <em>More Stamina</em>, a gamified mHealth application, was developed to support MS patients by tracking energy expenditure and facilitating fatigue management.</div></div><div><h3>Methods</h3><div>A 60-day mixed-methods pilot study was conducted with 20 participants recruited from Oulu University Hospital, Finland. Participants, meeting predefined criteria for MS diagnosis and digital health literacy, tracked daily activities using More Stamina. Standardized instruments assessed fatigue: Fatigue Severity Scale (FSS), QoL (15D), System Usability Scale (SUS), and eHealth literacy (eHEALS). App engagement patterns were analyzed using log data, while think-aloud protocols and semi-structured interviews captured qualitative insights into user experience.</div></div><div><h3>Results</h3><div>Participants were segmented into power, regular, and light users based on level of engagement. Power users reported higher fatigue severity (mean FSS = 6.31) but better QoL (mean inverted HRQoL = 0.58) compared to light users. More Stamina usability scores improved over time (SUS mean: Day 1 = 27.75; Day 60 = 35.88), reflecting growing fluency of use. Activity tracking included physical, cognitive, and social tasks, revealing subjective differences in perceived energy costs. Participants highlighted the app's role in increasing self-awareness of fatigue and facilitating communication with family and healthcare providers. Emerging uses included journaling and tracking fatigue patterns for medical consultations. Challenges included technical issues and the cognitive burden of repetitive data entry.</div></div><div><h3>Conclusions</h3><div>More Stamina is a feasible and acceptable gamified mHealth app for MS fatigue management. It seems to improve self-awareness and supports proactive energy planning, particularly for users with severe fatigue. Despite initial technical challenges, the app shows potential for integration into broader MS management strategies. Larger, long-term studies are needed to evaluate clinical efficacy and optimize design for sustained engagement.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"97 ","pages":"Article 106379"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kappa-free light chain as a practical alternative to oligoclonal bands in the diagnosis of multiple sclerosis","authors":"Yesim Beckmann , Dilan Düztaş , Cihat Uzunköprü , Sedat Şen , Gökhan Arslan , Demet Gür Vural , Murat Terzi","doi":"10.1016/j.msard.2025.106377","DOIUrl":"10.1016/j.msard.2025.106377","url":null,"abstract":"<div><h3>Objectives</h3><div>Kappa free light chains (κ-FLC) have emerged as a reliable biomarker for diagnosing multiple sclerosis (MS). Compared to oligoclonal band (OCB) measurement, κ-FLC presents distinct advantages, including enhanced accessibility in clinical practice. This study evaluates κ-FLC index values in MS patients and explores its potential as a practical alternative to the OCB test.</div></div><div><h3>Methods</h3><div>Cerebrospinal fluid (CSF) and serum κ-FLC concentrations were quantified using an immunonephelometry analyzer, while OCB analysis was performed via agarose isoelectric focusing combined with immunoblotting. The cut-off values were set at ≥0.7 for the CSF IgG index and ≥6.6 for the κ-FLC index, with values exceeding these thresholds considered positive. κ -FLC index values were compared between OCB-negative and OCB-positive patients, between patients with negative and positive CSF IgG index, and across different OCB types.</div></div><div><h3>Results</h3><div>OCB positivity was detected in 82.7 % of patients, whereas a positive κ-FLC index was observed in 91.7 %. The IgG index was positive in 51.9 % and negative in 48.1 %. Among patients with a negative IgG index, 84.3 % exhibited a positive κ-FLC index. Additionally, CSF κ-FLC values were significantly higher in patients with a positive IgG index compared to those with a negative IgG index. On the other hand, patients with type 2 (+) OCBs had higher κ-FLC index values than those with negative OCBs.</div></div><div><h3>Conclusions</h3><div>The κ-FLC index may serve as a valuable tool for identifying OCB-negative patients with a high likelihood of MS, offering a practical and accessible alternative for diagnostic evaluation.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"97 ","pages":"Article 106377"},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of pharmacologic treatments for fatigue in multiple sclerosis: A systematic review and meta-analysis","authors":"Karlo Toljan , Albert Aboseif , Moein Amin","doi":"10.1016/j.msard.2025.106352","DOIUrl":"10.1016/j.msard.2025.106352","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is commonly experienced amongst persons with multiple sclerosis (PwMS), decreasing quality of life and increasing the economic burden of care. Several pharmacologic treatments have been studied in randomized clinical trials (RCTs) for fatigue in MS, with conflicting results.</div></div><div><h3>Methods</h3><div>We performed a systematic search for RCTs through PubMed and CENTRAL to determine the efficacy and tolerability of amantadine, modafinil, methylphenidate, and 4-aminopyridine as treatments for fatigue in adults with MS in comparison to placebo or other interventions. Outcomes were fatigue severity as measured by Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), or Visual Analog Scale, and frequency of discontinuation due to side effects. Forest plots were generated (random effects model), standardized mean differences (SMD) were used for continuous outcomes, and risk ratio was calculated for the dichotomous outcome. The risk of bias was assessed with the Cochrane risk-of-bias tool, and GRADEpro GDT was used to summarize the evidence.</div></div><div><h3>Results</h3><div>Of 259 screened studies, 16 met the inclusion criteria for this review. SMD showed a change of -0.26 (95 % CI, -0.54, 0.01) in the direction of medications, representing a decrease of 0.29 in FSS or 3.90 in MFIS (minimally important difference is 0.45 for FSS and 4 for MFIS). The pooled risk ratio for discontinuation was 2.11 (95 % CI, 1.19, 3.77), favoring controls. Most studies were without substantial risk of bias, but the certainty of evidence was low.</div></div><div><h3>Conclusion</h3><div>The studied medications have minimal to no efficacy and an uncertain clinical significance in reducing fatigue in PwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"96 ","pages":"Article 106352"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hajar Mazahery , Lucinda J Black , Alison Daly , Maja Banjac , Catherine P Bondonno , Liezhou Zhong , Lauren C Blekkenhorst , Jonathan M Hodgson , the Ausimmune Investigator Group, Eleanor Dunlop
{"title":"Higher dietary nitrate intake is associated with lower likelihood of first clinical diagnosis of central nervous system demyelination in Australian women","authors":"Hajar Mazahery , Lucinda J Black , Alison Daly , Maja Banjac , Catherine P Bondonno , Liezhou Zhong , Lauren C Blekkenhorst , Jonathan M Hodgson , the Ausimmune Investigator Group, Eleanor Dunlop","doi":"10.1016/j.msard.2025.106376","DOIUrl":"10.1016/j.msard.2025.106376","url":null,"abstract":"<div><div>Dietary nitrate is a precursor to nitric oxide, for which plausible mechanisms exist for both beneficial and detrimental influences in first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to the diagnosis of multiple sclerosis (MS). Whether dietary nitrate has any role in FCD onset is unclear. We tested associations between nitrate intake from food sources (plant, vegetable, animal, processed meat, and unprocessed meat) and likelihood of FCD. We used data from the Ausimmune Study (264 cases, 474 controls) and logistic regression with full propensity score matching. In females, higher nitrate intake from plant-based foods (odds ratio [OR] per 60 mg/day = 0.50; 95 % confidence interval [CI] 0.31, 0.81; <em>p</em> = <0.01) and vegetables (OR per 60 mg/day = 0.39; 95 % CI 0.22, 0.70; <em>p</em> = <0.01), but not other sources, was statistically significantly associated with lower likelihood of FCD. In males, no associations were found between any source of nitrate intake and likelihood of FCD. Our results support further research to explore a possible beneficial role for plant-derived nitrate in people at higher risk of MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"96 ","pages":"Article 106376"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahsa Ghajarzadeh, Yishang Huang, Ellen M Mowry, Kathryn C Fitzgerald, Bardia Nourbakhsh
{"title":"Baseline physical and cognitive functions associate with the longitudinal trajectory of stigma in patients with multiple sclerosis (MS)","authors":"Mahsa Ghajarzadeh, Yishang Huang, Ellen M Mowry, Kathryn C Fitzgerald, Bardia Nourbakhsh","doi":"10.1016/j.msard.2025.106367","DOIUrl":"10.1016/j.msard.2025.106367","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis is a chronic disease, and the lived experience of a person with MS is highly heterogeneous.</div></div><div><h3>Objective</h3><div>To analyze longitudinal trajectories of stigma in MS, the associated baseline predictors, and how the stigma trajectories relate to the longitudinal changes in physical disability.</div></div><div><h3>Method</h3><div>In a cohort of people from the MS Partners Advancing Technology and Health Solutions (MS PATHS) network with at least two stigma measures, we analyzed the trajectory of stigma and physical disability by applying a group-based trajectory modeling (GBTM) to longitudinal measures of Neuro-QoL stigma T-score and Patient Determined Disease Steps (PDDS), respectively.</div></div><div><h3>Results</h3><div>We included 8,404 MS PATHS participants with a mean follow-up duration of 2.8 ± 1.4 years. We found four stigma trajectories, which remained stable over the follow-up period. Compared to the no stigma trajectory group, the odds of being in the high stigma group were higher in people with higher baseline PDDS (OR=1.9, 95 % CI: 1.7–2.1) and stigma (OR=2.4, 95 % CI: 2.3–2.5), and worse processing speed test scores (OR=0.7, 95 % CI: 0.6–0.8). The trajectory of stigma was strongly associated with the PDDS trajectory.</div></div><div><h3>Conclusions</h3><div>Baseline severity of stigma, physical disability, and performance on the processing speed test were the strongest predictors of belonging to a higher stigma trajectory group.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"96 ","pages":"Article 106367"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Markedly elevated cerebrospinal fluid white blood cell count in multiple sclerosis: How high is too high?","authors":"Samar Ikram , B. Mark Keegan","doi":"10.1016/j.msard.2025.106338","DOIUrl":"10.1016/j.msard.2025.106338","url":null,"abstract":"<div><h3>Background</h3><div>The diagnosis of multiple sclerosis (MS) is based on the revised McDonald's criteria, which includes clinical history, neurological examination, MRI findings and cerebrospinal fluid (CSF) analysis necessitating the exclusion of alternative explainable diagnoses. Markedly elevated CSF white blood cells (WBCs) over 50 (units) is considered a “red flag” for an alternative diagnosis apart from MS.</div></div><div><h3>Objective</h3><div>To present a man with typical relapsing-remitting MS (RRMS) despite markedly elevated CSF WBCs.</div></div><div><h3>Case</h3><div>A 33-year-old man presented with progressive bilateral numbness and weakness following a mild respiratory infection. Initial brain MRI showed cerebral white matter lesions and a left lateral pontine T2 hyperintense lesion. Cervical spine MRI showed demyelinating lesions at C3, C5 and C6 levels. CSF analysis revealed elevated white blood cell counts of 1,347 with lymphocytic predominance of 79 %, elevated unique oligoclonal bands, and immunoglobulin (Ig)G index. Comprehensive tests excluded other diagnoses, including infectious such as meningitis and encephalitis, autoimmune disorders such as neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein-associated disease (MOGAD), and nutritional deficiencies.</div></div><div><h3>Results</h3><div>Follow-up cervical spine MRI at 22 months revealed a new demyelinating C2 lesion, and he initiated ocrelizumab. Over four years of follow-up, he had no new clinical attacks or radiological activity and maintained a normal neurological examination.</div></div><div><h3>Conclusion</h3><div>Markedly elevated CSF WBC counts may occur in otherwise typical RRMS and are not always a red flag to an alternative diagnosis.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"96 ","pages":"Article 106338"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher J. Cagna , Ekaterina Dobryakova , Erica Weber , Diana Maloku , Nancy D. Chiaravalloti , Helen M. Genova , Silvana L. Costa , John DeLuca
{"title":"Trait fatigue impacts Symbol Digit Modalities Test (SDMT) performance in multiple sclerosis: The role of working memory","authors":"Christopher J. Cagna , Ekaterina Dobryakova , Erica Weber , Diana Maloku , Nancy D. Chiaravalloti , Helen M. Genova , Silvana L. Costa , John DeLuca","doi":"10.1016/j.msard.2025.106369","DOIUrl":"10.1016/j.msard.2025.106369","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment and fatigue are two prevalent symptoms of multiple sclerosis (MS). Fatigue is often thought to be associated with slower processing speed. The Symbol Digit Modalities Test (SDMT) is a widely used assessment of processing speed in MS, but it has also been shown to tap into working memory as well. Investigation into fatigue's influence on SDMT performance in MS and potential mechanisms for this relationship are lacking. The present study examined the effect of trait fatigue on SDMT performance and its associated mechanisms in MS and healthy control (HC) participants. Working memory performance was specifically examined as a potential mechanism, given its frequent association with processing speed in MS.</div></div><div><h3>Methods</h3><div>In a secondary data analysis, performance on the SDMT and other neuropsychological assessments, as well as self-reported trait fatigue, were examined in 80 MS and 45 HC participants. Trait fatigue was measured via self-report on the Modified Fatigue Impact Scale (MFIS).</div></div><div><h3>Results</h3><div>Higher MFIS ratings were significantly associated with worse SDMT performance in MS (<em>r</em> = -0.33, <em>p</em> = .002), but not HC (<em>r</em>= 0.06, <em>p</em> = .71), participants. A mediation analysis further revealed that for MS participants, working memory performance (WAIS-IV Digit Span Backward condition) partially mediated the relationship between trait fatigue and SDMT performance. Higher MFIS scores significantly predicted lower Digit Span Backward scores (<em>b</em> = -0.04, <em>95</em> % <em>CI</em>: [-0.08, -0.002], <em>p</em> = .04], which in turn, significantly predicted lower SDMT response accuracy (<em>b</em> = 0.23, <em>95</em> % <em>CI</em>: [0.10, 0.35], <em>p</em> = .001). No such relationship was observed in HC participants.</div></div><div><h3>Conclusions</h3><div>Elevated trait fatigue may reduce SDMT performance via its negative impact on working memory performance in people with MS. Future research should focus on additional factors that may also contribute to this relationship.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"96 ","pages":"Article 106369"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Dahshan , Hala Rashad El Habashy , Shahenda Al Menabbawy , Alaa Ahmed Shalan , Noha El Sawy
{"title":"Electric vs. magnetic: Which brain stimulation wins for bothering symptoms in multiple sclerosis?","authors":"Ahmed Dahshan , Hala Rashad El Habashy , Shahenda Al Menabbawy , Alaa Ahmed Shalan , Noha El Sawy","doi":"10.1016/j.msard.2025.106365","DOIUrl":"10.1016/j.msard.2025.106365","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a chronic disease marked by fatigue, pain, cognitive impairment, and mood disorders. Pharmacological treatments often provide limited relief and have side effects, prompting interest in non-invasive neuromodulation techniques like transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS). We aimed to compare the short-term efficacy of tDCS and TMS in alleviating fatigue, pain, depression, and cognitive impairment in MS patients.</div></div><div><h3>Methods</h3><div>In a randomized, single-blinded, three-arm trial, 30 patients with relapsingremitting MS were assigned to active tDCS, active TMS, or placebo. The tDCS group received 2 mA anodal stimulation over the motor cortex for 20 min daily for five days, while the TMS group received 10 Hz stimulation at 80 % of the resting motor threshold for the same duration. The placebo group received sham stimulation. Outcomes were assessed using the Fatigue Severity Scale (FSS), Visual Analogue Scale (VAS) for pain, Beck Depression Inventory (BDI), and Brief International Cognitive Assessment for MS (BICAMS).</div></div><div><h3>Results</h3><div>Both tDCS and TMS groups showed significant improvements in fatigue, pain, and depression compared to placebo (<em>p</em> < 0.05). No significant cognitive changes were observed in any group.</div></div><div><h3>Conclusion</h3><div>Short-term tDCS and TMS are effective for reducing fatigue, pain, and depression in MS patients, with tDCS showing potential for home use and TMS for clinical settings. Cognitive improvements may require longer treatment durations or combined therapies.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"96 ","pages":"Article 106365"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}