Multiple sclerosis and related disorders最新文献

{"title":"Cerebrospinal fluid alpha-internexin is increased in patients with multiple sclerosis and correlates strongly with neurofilament light protein.","authors":"Johnsson M, Meda Fj, Lycke J, Novakova L, Rosenstein I, Johansson K, Malmeström C, Zetterberg H, Kvartsberg H, Axelsson M","doi":"10.1016/j.msard.2025.106805","DOIUrl":"https://doi.org/10.1016/j.msard.2025.106805","url":null,"abstract":"<p><strong>Background: </strong>Alpha-internexin (AINX) is an intermediate filament protein predominantly found in the central nervous system (CNS) and is one of the core structural components of the neuronal cytoskeleton, along with the neurofilament triplet proteins. Because AINX is CNS-specific it has the potential to differentiate between peripheral and CNS neuroaxonal injury.</p><p><strong>Method: </strong>We measured cerebrospinal fluid (CSF) AINX in patients with multiple sclerosis (MS) and healthy controls (HC) using an in-house AINX Simoa (Single molecule array) assay developed and validated at the Clinical Neurochemistry Laboratory at Sahlgrenska University Hospital, University of Gothenburg. The primary outcome measure was the difference in AINX between patients with MS and HCs. We also calculated correlations with age, sex, MS disease duration, magnetic resonance imaging (MRI) results, CSF biomarkers (cell count, albumin quotient, neurofilament light (NfL), glial fibrillary acidic protein (GFAP), T-Tau, C-X-C motif ligand 13 (CXCL13)), and the influence of MS phenotype, and disease-modifying therapies.</p><p><strong>Results: </strong>We included 34 patients with MS and 8 HCs in the analysis. AINX was detected in all samples (range: 0.16-38.4 ng/L). The median AINX was significantly increased in patients with MS (1.19 ng/L; IQR 0.69-2.34) compared with HCs (0.44 ng/L; IQR 0.36-0.51) (p < 0.001) and correlated strongly with CSF NfL (R = 0.90; p < 0.001). AINX also correlated significantly with expanded disability status scale (EDSS) score (R=-0.4; p = 0.02), number of contrast-enhancing lesions (CELs) (R = 0.6; p < 0.001), CSF cell count (R = 0.6; p < 0.001), and CSF CXCL13 (R = 0.6; p = 0.001).</p><p><strong>Conclusion: </strong>We conclude that CSF AINX, similarly to NfL, is a marker of axonal nerve injury in patients with MS.</p>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"106805"},"PeriodicalIF":2.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355541","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":"Rituximab regimens and lymphocyte counts in patients with neuromyelitis optica: A systematic review","authors":"Paola Andrea Ortiz-Salas ,&nbsp;Maria Alejandra Quilaguy-Jimenez ,&nbsp;Juan Sebastian Castañeda ,&nbsp;Natalia Gómez-Salazar ,&nbsp;Eliana Pineda-Mateus","doi":"10.1016/j.msard.2025.106798","DOIUrl":"10.1016/j.msard.2025.106798","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the utility of peripheral blood B-cell counts, specifically CD19+ and CD27+ lymphocytes by flow cytometry, in patients with neuromyelitis optica (NMO) treated with rituximab.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following the PRISMA guidelines. Searches were performed in PubMed, LILACS, Cochrane, and ClinicalTrials databases up to July 2024, including studies in English, Spanish, and French. Studies were selected based on predefined eligibility criteria, and data extraction was performed independently by two reviewer teams. Risk of bias was assessed using the JBI Critical Appraisal Tool, and the certainty of evidence was evaluated with the GRADE methodology.</div></div><div><h3>Results</h3><div>A total of 3325 studies were identified, of which 22 met the inclusion criteria, analyzing 633 patients. Most studies used rituximab induction schemes of 375 mg/m² weekly (46%) or 1 g biweekly (38%). Retreatment protocols varied widely, and 84.6% of studies measured CD19+ cells, while 42.3 % also included CD27+ memory B cells. The most common depletion thresholds were &lt;1% for CD19+ and &lt;0.05% for CD27+. Repopulation occurred between 2.5 and 12.72 months, with 26% peaking at 6 months. Recurrent disease was reported in 200 patients (31.5%), with 64.5% of relapses associated with B-cell repopulation. However, 35% of relapses occurred without B-cell return. The quality of evidence was limited due to methodological heterogeneity, small sample sizes, and variability in monitoring protocols.</div></div><div><h3>Conclusión</h3><div>B-cell repopulation appears to be temporally associated with relapses in NMO, highlighting the potential value of CD19+ and CD27+ monitoring by flow cytometry to guide retreatment strategies. However, relapses also occurred in the absence of repopulation, suggesting other pathophysiological mechanisms. There is a pressing need for standardized treatment protocols and prospective, multicenter studies to define the optimal use of B-cell monitoring in clinical practice.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106798"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313334","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":"The influence of manual dexterity on processing speed assessment in multiple sclerosis: A comparison of the PST and oral SDMT","authors":"Sarah A. Morrow ,&nbsp;Marina Everest ,&nbsp;David Beniameen ,&nbsp;Heather Rosehart","doi":"10.1016/j.msard.2025.106799","DOIUrl":"10.1016/j.msard.2025.106799","url":null,"abstract":"<div><div>Cognitive impairment (CI) is a common symptom in persons with Multiple Sclerosis (PwMS), specifically information processing speed (IPS) impairment. The Symbol Digit Modalities Test (SDMT), which requires in-person testing, is a well-established measure for screening for IPS and CI in clinic settings. The Processing Speed Test (PST), a self-administered iPad-based tool, has been proposed as an alternative. Preliminary studies suggest that the PST can effectively differentiate PwMS from healthy controls and correlates with MRI results. This study aims to investigate if the relationship between the PST and oral SDMT is affected by manual dexterity or level of disability. A cohort of 100 PwMS completed both the PST and SDMT, as well the 9-Hole Peg Test (9HPT) and Expanded Disability Status Scale (EDSS). The strong positive correlation found between the PST and SDMT was maintained across all subgroups based on 9HPT performance and EDSS functional system scores. Our findings indicate that the PST is comparable to the SDMT for PwMS regardless of manual dexterity. This validates PST as a time-efficient, self-administered alternative that can reduce clinical burden in MS care.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106799"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325436","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":"Vitamin supplementation in the treatment of optic neuritis: A systematic review and meta-analysis.","authors":"Patrick J Gaffney, Rajesh K Gupta","doi":"10.1016/j.msard.2025.106797","DOIUrl":"https://doi.org/10.1016/j.msard.2025.106797","url":null,"abstract":"<p><strong>Objective: </strong>Previous research has demonstrated an association between vitamin D deficiency and the risk of developing optic neuritis (ON) and multiple sclerosis (MS). However, the role of vitamin supplementation as an intervention for ON has not been thoroughly investigated. This systematic review and meta-analysis assesses whether vitamin supplementation improves visual parameters and disease status among ON patients.</p><p><strong>Results: </strong>A systematic literature search within PubMed, Embase, Web of Science, and the Cochrane Central Register of Clinical Trials yielded a total of 2465 peer-reviewed articles, from which 5 studies met inclusion criteria. The effect of MD1003 (high-dose biotin), vitamin A, and vitamin D on retinal nerve fiber layer (RNFL) thickness from pooled results showed a mean change of 0.15 (SMD 0.15, 95 % CI, -0.33 to 0.64, I² = 61 %, τ² = 0.11, p = 0.08), which was not significant. Meta-analysis of visual acuity due to MD1003 and vitamin A from two studies showed a mean change of 0.01 (SMD 0.01, 95 % CI, -0.34 to 0.35, I² = 0 %, τ² = 0, p = 0.36). Significant improvements in RNFL thickness due to vitamin A, visual acuity due to vitamins B1, B6, and B12, foveal sensitivity due to vitamins B1, B6, and B12, and the rate of conversion of ON to MS due to vitamin D were observed in individual studies.</p><p><strong>Conclusions: </strong>Although meta-analysis showed no significant effect of vitamins A, B1, B6, B7, B12, and D on several visual parameters, improvements observed in individual studies point to the essential role of vitamin sufficiency in ON. Due to the limited available evidence, additional high-quality studies are needed to determine the efficacy of vitamin supplementation as a potential therapeutic for ON.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"106797"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346288","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":"Does foot morphology influences postural control in people with multiple sclerosis?","authors":"Giulia Casu ,&nbsp;Micaela Porta ,&nbsp;Federico Arippa ,&nbsp;Bruno Leban ,&nbsp;Jessica Frau ,&nbsp;Giancarlo Coghe ,&nbsp;Eleonora Cocco ,&nbsp;Massimiliano Pau","doi":"10.1016/j.msard.2025.106793","DOIUrl":"10.1016/j.msard.2025.106793","url":null,"abstract":"<div><div>Postural instability is a common impairment in people with Multiple Sclerosis (pwMS) and is primarily attributed to delayed somatosensory conduction and deficits in central sensory integration. However, the full range of factors contributing to dysfunctions in the postural control system remains partly unclear. This study aimed to investigate the role of the foot-ground interface—closely associated with foot morphology, particularly the height of the medial longitudinal arch—in modulating postural stability. To this end, 94 pwMS (mean age: 47.5 years; mean Expanded Disability Status Scale score: 3.3) underwent concurrent assessments of postural sway and plantar pressure distribution using a pressure platform, during quiet upright stance performed under both eyes-open and eyes-closed conditions. Postural sway was quantified through analysis of the center of pressure (COP) time series, and foot morphology was classified as high, normal, or low arch according to cut-off values of the Arch Index (AI), a parameter calculated on the basis of the regional contact area at forefoot, midfoot and rearfoot. Results revealed that, only in the absence of visual input, pwMS with high-arched feet—and to a lesser extent those with low arches—demonstrated significantly increased postural sway compared to those with normal arches, as indicated by larger sway areas, greater COP path lengths, and increased maximum COP displacements in anteroposterior and mediolateral directions. These findings suggest that foot morphology may serve as a relevant factor in identifying pwMS at elevated risk of balance impairments and falls, supporting the potential value of incorporating foot structure analysis into individualized rehabilitation strategies.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106793"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313322","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":"Characterizing post-COVID-19 syndrome in multiple sclerosis: Vaccine status, infection burden, and therapy categories as predictors","authors":"Deepak Sharma ,&nbsp;Christian P. Kamm ,&nbsp;Robert Hoepner ,&nbsp;Iris-Katharina Penner ,&nbsp;Thomas Nyffeler ,&nbsp;Lara Diem","doi":"10.1016/j.msard.2025.106792","DOIUrl":"10.1016/j.msard.2025.106792","url":null,"abstract":"<div><h3>Background</h3><div>Post-COVID-19 syndrome (PCS) is a significant long-term complication of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, yet its prevalence and risk factors in people with multiple sclerosis (pwMS) under disease-modifying therapies (DMTs) remain underexplored.</div></div><div><h3>Objective</h3><div>This study aimed to characterize the clinical course of coronavirus disease 2019 (COVID-19) and identify predictors of PCS in pwMS, focusing on vaccination status, infection severity and frequency, and DMT categories.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 107 pwMS from two centers completed a survey assessing COVID-19 history, persistent symptoms, immunotherapy, and vaccination status. PCS was defined as symptoms persisting &gt;12 weeks after infection. Participants were stratified by DMT categories, infection number, and vaccination status.</div></div><div><h3>Results</h3><div>Of 107 participants, 7 (6.5 %) reported PCS. The most frequent symptoms were fatigue (71.4 %), pain (57.1 %), and headache (42.9 %). Patients with PCS had a higher mean number of SARS-CoV-2 infections (2.1, 95 % CI: 1.3–3.0) compared to those without (1.3, 95 % CI: 1.2–1.4; <em>p</em> = 0.004). A significant association was found with DMT category: 71.4 % (5/7) of affected individuals were on category I therapies (Interferon/Glatiramer acetate, Dimethyl fumarate, Teriflunomide) compared to 17 % of pwMS without PCS (<em>p</em> &lt; 0.001). No significant effect was observed for COVID-19 severity or vaccination status.</div></div><div><h3>Conclusions</h3><div>PCS prevalence in this MS cohort was lower than in the general population, but category I DMTs and repeated infections were key risk factors. Findings suggest the need for individualized risk assessment, indicating that higher efficacy DMTs do not appear to pose an increased risk of PCS in pwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106792"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318454","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":"Assessing disability in multiple sclerosis: concordance between patient-recorded and neurologist-recorded EDSS ratings in a 10-year single-center experience","authors":"Mónica Daniela Salgado-Cabrera ,&nbsp;Lidia Joanna Alberto-López ,&nbsp;Sofía Chávez-Martínez ,&nbsp;Michelle Lavoignet-Cisneros ,&nbsp;Miguel Angel Viveros-Lugo ,&nbsp;Max Robles-Nasta ,&nbsp;Griselda Fuentes-Fuentes ,&nbsp;David Blumenkron-Marroquín ,&nbsp;Clara Elena Soto-Zurita ,&nbsp;Guillermo José Ruiz-Delgado ,&nbsp;Guillermo José Ruiz-Argüelles","doi":"10.1016/j.msard.2025.106794","DOIUrl":"10.1016/j.msard.2025.106794","url":null,"abstract":"<div><h3>Background</h3><div>The Expanded Disability Status Scale (EDSS) is the standard tool for assessing disability in multiple sclerosis (MS). While traditionally conducted by clinicians, patientreported versions have emerged as viable alternatives for remote monitoring. However, the concordance between self-reported and neurologist-assessed EDSS scores remains crucial for clinical utility.</div></div><div><h3>Objective</h3><div>To evaluate the agreement between patient-reported and neurologist-assessed EDSS scores in a large cohort of MS patients and explore the applicability of self-reported EDSS in routine practice.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 1,425 patients with confirmed MS who underwent autologous hematopoietic stem cell transplantation (HSCT) at Clínica Ruiz in Mexico between 2015 and 2025. EDSS scores from patients and neurologists were collected within a 30-day interval. Analyses included Spearman’s correlation, intraclass correlation coefficients (ICC), Wilcoxon signed-rank tests, and Bland–Altman plots.</div></div><div><h3>Results</h3><div>There was a strong and statistically significant correlation between patient-reported and neurologist-assessed EDSS scores (<em>r</em>= 0.846, <em>p</em>&lt; 0.001). The single-measure ICC demonstrated excellent reliability (0.845–0.846), with average measure ICCs Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation ranging from 0.916 to 0.923. A discrepancy of ≥1 EDSS point was found in 35 % of cases. Subgroup analysis showed consistent correlations across neurologists.</div></div><div><h3>Conclusion</h3><div>Patient-reported EDSS scores demonstrate strong concordance with neurologist assessments and may be a reliable alternative for monitoring MS-related disability, especially in settings with limited access to specialists. Nonetheless, clinicians should remain aware of potential discrepancies and consider combining self-reported data with clinical evaluation for optimal decision-making.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106794"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302248","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":"Does sensor-based gait assessment reflect self-perception of gait impairment in people with multiple sclerosis? A cross- sectional study","authors":"Sandra Schulthess,&nbsp;Eveline Graf,&nbsp;Bettina Sommer","doi":"10.1016/j.msard.2025.106795","DOIUrl":"10.1016/j.msard.2025.106795","url":null,"abstract":"<div><h3>Background</h3><div>Mobility limitations are common among people with Multiple Sclerosis (MS), with gait impairments significantly impacting daily life. Gait assessments and patient-reported outcome measures are essential for assessing these gait impairments. However, it remains unclear which specific gait metrics best reflect the perceived walking impairments of people with MS. This study aimed to investigate the association between spatiotemporal gait metrics and the perceived walking impairments of people with MS.</div></div><div><h3>Methods</h3><div>A cross-sectional study with 23 people with MS was conducted. The patients’ perceived walking impairments were assessed by the 12- items MS walking scale (MSWS-12) and the gait metrics were measured by the sensor-based movement analysis system GAITrite® during the timed 25-foot walking test. To calculate the strength of the association between the gait metrics and the MSWS-12 the Spearman’s rank correlation coefficient was applied.</div></div><div><h3>Results</h3><div>A positive correlation with the MSWS-12 score was found for mean double support time (r_s=0.53, CI [0.12; 0.78]), swing time variability (r_s=0.51, CI [0.09; 0–77]) and -symmetry (r_s =0.53, CI [0.12; 0.78]), while mean step length (r_s =-0.54, CI [-0.79; -0.13]), mean stride length (r_s =-0.53, CI [-0.78; -0.12]) and gait velocity (r_s =-0.60, CI [-0.82; -0.21]) showed a negative correlation.</div></div><div><h3>Conclusion</h3><div>Velocity remains a valuable metric, reflecting perceived walking impairments of people with MS. The findings to the association between the patient perceived walking impairments and the gait metrics mean double support time, swing time symmetry and swing time variability may highlight the relevance of balance-related metrics in assessing self-perceived walking impairments.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106795"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308557","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":"Comparative analysis of AQP4-IgG-positive and AQP4-IgG-negative NMOSD: A multicenter study in Latin America","authors":"Ricardo Alonso ,&nbsp;Carlos Navas ,&nbsp;María Eugenia Balbuena ,&nbsp;Nora Aurora Rosa Fernández Liguori ,&nbsp;Saúl Reyes ,&nbsp;Enrique Gómez Figueroa ,&nbsp;Edgar Carnero Carnero Contentti ,&nbsp;Ibis Soto ,&nbsp;Luis Zarco ,&nbsp;José de Jesús Flores Rivera ,&nbsp;María Isabel Zuluaga Rodas ,&nbsp;Nayeli A. Sánchez Rosales ,&nbsp;Jefferson Becker ,&nbsp;Irene Treviño Frenk ,&nbsp;Ethel Ciampi ,&nbsp;Edgar Patricio Correa Díaz ,&nbsp;Fernando Gracia ,&nbsp;César Franco ,&nbsp;Carolina Restrepo-Aristizábal ,&nbsp;Valeria Uribe-Vizcarra ,&nbsp;Lorna Galleguillos","doi":"10.1016/j.msard.2025.106787","DOIUrl":"10.1016/j.msard.2025.106787","url":null,"abstract":"<div><h3>Background</h3><div>NMOSD is a rare autoimmune disorder with variable clinical presentations depending on AQP4-IgG serostatus. While AQP4-IgG-positive NMOSD is well described, data on seronegative cases, especially in Latin America, remain limited.</div></div><div><h3>Objective</h3><div>To characterize the demographic and clinical features of NMOSD in Latin America, comparing AQP4-IgG-positive and AQP4-IgG-negative cases.</div></div><div><h3>Methods</h3><div>A retrospective multicenter cohort study was conducted across Latin American NMOSD-specialized centers. Patients meeting the 2015-IPND diagnostic criteria were included.</div></div><div><h3>Results</h3><div>Of the of 875 patients, 791 were included: 613 AQP4-IgG-positive and 178 AQP4-IgG-negative. AQP4-IgG-positive patients were more often female (87.4 % vs. 81.5 %, <em>p</em> = 0.05) and had a higher age at onset (41.4 vs. 38.0 years, <em>p</em> &lt; 0.01). They more frequently presented with unilateral optic neuritis (30.1 % vs. 20.2 %, <em>p</em> &lt; 0.01) and area postrema syndrome (9.3 % vs. 3.9 %, <em>p</em> &lt; 0.01). Median EDSS at diagnosis was higher in the seronegative group (4.2 vs. 3.9, <em>p</em> &lt; 0.01). Diagnostic delay was longer in this group as well, though not statistically significant. Older age at onset was the only independent predictor of AQP4-IgG positivity (OR = 1.02, <em>p</em> = 0.028).</div></div><div><h3>Conclusions</h3><div>AQP4-IgG-positive and seronegative NMOSD differ in clinical and demographic features, underscoring the need for tailored diagnostic and therapeutic approaches.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106787"},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318497","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":"Hospital volume impact on multiple sclerosis outcomes: a retrospective cohort study using a nationwide administrative database in Japan","authors":"Hiromichi Otaka ,&nbsp;Shinobu Imai ,&nbsp;Kiyohide Fushimi","doi":"10.1016/j.msard.2025.106790","DOIUrl":"10.1016/j.msard.2025.106790","url":null,"abstract":"<div><h3>Background</h3><div>Hospital volume (HV) effect on multiple sclerosis (MS) outcomes remains largely unexplored, particularly in Japan, where access to advanced medical resources is abundant. This study evaluates the association between treatment at high-volume hospitals and improved MS outcomes, focusing on time to readmission due to relapse and length of stay (LOS) during relapse admissions.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using the Diagnosis Procedure Combination database and included 6647 patients admitted for MS relapse. HV was defined as the mean annual number of patients hospitalized with the MS diagnostic code and categorized into high and low groups with a median of 14.4. Time to readmission due to MS relapse was the primary outcome, while LOS was the secondary outcome. Inverse probability of treatment weighting was applied for covariate adjustment, and Cox proportional hazards model for evaluating primary outcomes.</div></div><div><h3>Results</h3><div>The high-volume group had a significantly longer time to readmission due to MS relapse than did the low-volume group (hazard ratio, 0.87; 95 % confidence interval [CI]: 0.79–0.96, <em>p</em> = 0.005). This finding was consistent across different subgroups and remained robust in sensitivity analyses. In contrast, the LOS difference between the high and low-volume groups was insignificant (difference: −1.11 days, 95 % CI: −2.95 to 0.72, <em>p</em> = 0.234).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that high-volume hospitals may provide more optimized relapse prevention therapies. Despite the modest effect size and inherent study limitations, further research is needed to explore the potential benefits of centralized MS care in Japan and other countries.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106790"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258657","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}