Multiple sclerosis and related disorders最新文献

{"title":"Strength training attenuates neuropathic pain by Preventing dendritic Spine dysgenesis through Suppressing Rac1 and inflammation in experimental autoimmune encephalomyelitis","authors":"Amir Hossein Saffar Kohneh Quchan,&nbsp;Mohammad Reza Kordi,&nbsp;Golrokh Mohammadi,&nbsp;Raheleh Amiri Raeez,&nbsp;Siroos Choobineh","doi":"10.1016/j.msard.2024.106192","DOIUrl":"10.1016/j.msard.2024.106192","url":null,"abstract":"<div><div>Chronic pain is a challenge and major health problem to basic science and clinical practice. Pain is one of the worst symptoms of multiple sclerosis (MS), which has a significant impact on their quality of life. Rac1 is an important intracellular signaling molecule involved in spinal dendritic spine pathology and activation of IL-1β and TNF-α that are associated with chronic neuropathic pain. As a result, targeting Rac1 presents a promising approach to managing neuropathic pain. Clinical studies have demonstrated that physical exercise is a non-pharmacological strategy that positively influences disease progression in individuals with MS, but underlying mechanism of exercise on Rac1- induced neuropathic pain is not well understood. This study examined the effects of a 4-week strength training on Rac1 expression, IL-1B, TNF-α, TGF-β1 levels, MDA concentrations, SOD activity, dendritic spine abnormalities in the dorsal horn of the spinal cord, as well as nociceptive behaviors (formalin test) and motor function (Rotarod test) during the chronic phase of experimental autoimmune encephalomyelitis (EAE). The findings indicated that strength training increased TGF-β1 expression and SOD activity while decreasing the expression of Rac1, IL-1β, TNF-α, and MDA and reducing dendritic spine dysgenesis in the dorsal horn of the spinal cord. We observed strength training effectively reduced nociceptive behaviors and improved motor function in mice with EAE. In summary, regular physical exercise may modulate neuropathic pain through inhibition of dendritic spine dysgenesis, inflammation and oxidative stress in the dorsal horn of the spinal cord.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106192"},"PeriodicalIF":2.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757345","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":"Adaptation, construct validity, and test-retest reliability of the Cognitive Reserve Index Questionnaire for the Israeli multiple sclerosis population","authors":"Hazar Massalha ,&nbsp;Shay Menascu ,&nbsp;Sapir Dreyer Alster ,&nbsp;Roy Aloni ,&nbsp;Alon Kalron","doi":"10.1016/j.msard.2024.106189","DOIUrl":"10.1016/j.msard.2024.106189","url":null,"abstract":"<div><h3>Introduction</h3><div>A common tool used to measure cognitive reserve is the Cognitive Reserve Index questionnaire (CRIq). In the present study, we aimed to adapt and determine the psychometric properties (validity and intra-rater test-retest reliability) of the Hebrew version of the CRIq in a cohort of people with multiple sclerosis (pwMS).</div></div><div><h3>Methods</h3><div>Fifty pwMS (30 women aged 48.3 (SD=10.2)) completed the CRIq and the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which were used for validation. Secondary outcome measures included the evaluation of depression, anxiety, and perceived fatigue. Twenty-five (of the 50) pwMS were randomly selected and participated in the CRIq intra-rater test-retest reproducibility study based on a 7–12-day interval between tests.</div></div><div><h3>Results</h3><div>The mean CRIq total was 101.8 (S.D.=13.04), which is considered at the medium level. The CRIq section scores were at a similar medium level. According to Pearson's Rho correlation analysis, the CRIq total score and sections of education, work, and leisure were significantly correlated at a medium level (Rho ranging between 0.282 to 0.415) with the SDMT score, a measurement of cognitive information processing speed. The intraclass correlation coefficient (ICC) values of the CRIq total and CRIq sections ranged between 0.942 to 0.998, indicating a strong correlation.</div></div><div><h3>Conclusions</h3><div>The Hebrew version of the CRIq is a reliable and valid tool for assessing cognitive reserve in pwMS, hence enabling clinicians and researchers to effectively monitor cognitive reserve in this population.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106189"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748668","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":"Incorporation of the central vein sign into the McDonald criteria","authors":"Moein Amin ,&nbsp;Kunio Nakamura ,&nbsp;Lynn Daboul ,&nbsp;Carly O'Donnell ,&nbsp;Quy Cao ,&nbsp;Paulo Rodrigues ,&nbsp;John Derbyshire ,&nbsp;Christina Azevedo ,&nbsp;Amit Bar-Or ,&nbsp;Eduardo Caverzasi ,&nbsp;Peter A. Calabresi ,&nbsp;Bruce A.C. Cree ,&nbsp;Leorah Freeman ,&nbsp;Roland Henry ,&nbsp;Erin E. Longbrake ,&nbsp;Jiwon Oh ,&nbsp;Nico Papinutto ,&nbsp;Daniel Pelletier ,&nbsp;Vesna Prčkovska ,&nbsp;Praneeta C. Raza ,&nbsp;Daniel Ontaneda","doi":"10.1016/j.msard.2024.106182","DOIUrl":"10.1016/j.msard.2024.106182","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosis of multiple sclerosis (MS) frequently relies on MRI dissemination in time (DIT) and space (DIS), as codified in 2017 McDonald criteria (McD 2017). The central vein sign (CVS) is a proposed MS diagnostic biomarker, but its optimal incorporation into McD 2017 has not been extensively studied.</div></div><div><h3>Objective</h3><div>Evaluate the diagnostic performance of several methods incorporating CVS into McD 2017 radiological DIS criteria.</div></div><div><h3>Methods</h3><div>Data were obtained from the CAVS-MS Pilot, a cross-sectional, international multi-center study conducted by the North American Imaging in MS Cooperative (NAIMS) that recruited adults referred for suspicion/diagnosis of demyelinating disease. Diagnostic performance of methods incorporating CVS into McD 2017 radiological DIS were evaluated by comparing sensitivity, specificity, and accuracy.</div></div><div><h3>Results</h3><div>78 participants (37 MS, 41 others) were included. For MS diagnosis, sensitivity, specificity, and accuracy of DIS based on brain imaging (DIS-B) alone was 92 %, 69 %, and 78 %. Requiring at least one lesion with CVS in any brain location in addition to DIS-B increased specificity (sensitivity 92 %, specificity 81 %, accuracy 86 %). Presence of 2 deep white matter lesions with CVS as an additional topography for DIS-B had higher sensitivity (sensitivity 97 %, specificity 59 %, accuracy 77 %).</div></div><div><h3>Conclusions</h3><div>Incorporation of CVS in McD 2017 DIS criteria can be used to improve diagnostic accuracy. Validation in additional prospective studies is needed.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106182"},"PeriodicalIF":2.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757343","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":"Curriculum innovation: Interactive educational workshop improves neurology resident knowledge of multiple sclerosis","authors":"Monica M. Diaz,&nbsp;Winnie Lau,&nbsp;Dena Williams,&nbsp;Irena Dujmovic Basuroski","doi":"10.1016/j.msard.2024.106188","DOIUrl":"10.1016/j.msard.2024.106188","url":null,"abstract":"<div><h3>Introduction</h3><div>Establishing a solid resident knowledge of multiple sclerosis (MS) during neurology residency is crucial for independent clinical practice. We created a case-based and interactive educational workshop on MS with the aim of improving neurology resident clinical and theoretical knowledge of various aspects of MS diagnosis and care.</div></div><div><h3>Methods</h3><div>MS neurologists from the University of North Carolina (UNC) School of Medicine designed a 4-hour in-person case-based interactive educational workshop for all neurology residents. Covered topics included: MS definition, epidemiology, pathogenesis, risk factors, MS clinical course/disease phenotypes, MS diagnostic criteria and differential diagnosis, acute MS attack treatment, symptomatic therapy, disease modifying therapy. Case-based and knowledge-based questions with multiple-choice questions were utilized using interactive online polls that residents participated in during the workshop. Additionally, a 10-question pre- and post-workshop test was administered and the change in exam results was analyzed using paired <em>t</em>-tests. Descriptive statistics were used in the analysis of percentile rank changes in Residency In-Service Training Examination (RITE) exam scores by UNC Neurology residents 2022 - 2023 (pre-MS Workshop) and 2023–2024 (post- MS Workshop).</div></div><div><h3>Results</h3><div>A total of 21 residents completed the workshop and pre- and post-workshop exam. Pre-workshop scores (mean, 6.14/10; standard deviation [SD], 1.20; range, 4–9) and post-workshop test scores (mean, 8.67/10; SD, 0.97; range, 7–10) were compared. There was a mean improvement of 2.52 points between pre- and post-workshop test results (t-ratio 8.97 [95% confidence interval 1.94–3.11]; <em>p</em>&lt;.0001). Percentile rank on RITE exam scores by UNC Neurology residents (postgraduate years 2–4) after attending MS Workshop improved by 136.8% compared with the prior academic year when the traditional virtual didactic program on MS was conducted.</div></div><div><h3>Conclusion</h3><div>Interactive workshops for residents can improve resident education on MS, creating a solid basis for future continuing education activities in the rapidly developing field of MS with a goal of improving patient outcomes. Residency programs may consider incorporating interactive, case-based MS workshops into their educational curricula.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106188"},"PeriodicalIF":2.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748743","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":"Hypogammaglobulinemia and severe infections in Multiple Sclerosis patients on anti-CD20 agents: A multicentre study","authors":"K. Smolik ,&nbsp;F. Camilli ,&nbsp;I. Panzera ,&nbsp;A. Fiore ,&nbsp;A. Franceschini ,&nbsp;M. Foschi ,&nbsp;A. Surcinelli ,&nbsp;I. Pesci ,&nbsp;C. Ferri ,&nbsp;V. Bazzurri ,&nbsp;L. Mancinelli ,&nbsp;C. Zini ,&nbsp;A.M. Simone ,&nbsp;A. Lugaresi ,&nbsp;F. Falzone ,&nbsp;F. Granella ,&nbsp;M.G. Piscaglia ,&nbsp;A. Guareschi ,&nbsp;E. Baldi ,&nbsp;P. Immovilli ,&nbsp;D. Ferraro","doi":"10.1016/j.msard.2024.106191","DOIUrl":"10.1016/j.msard.2024.106191","url":null,"abstract":"<div><h3>Background</h3><div>Hypogammaglobulinemia (HG) is a known side effect of treatment with anti-CD20 monoclonal antibodies, and it is associated with the risk of infections.</div></div><div><h3>Objectives</h3><div>Aim of this retrospective multicentre study was to assess the frequency of HG in Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder patients treated with Ocrelizumab or Rituximab and its association with the occurrence of severe infections (SI). Furthermore, predictors of HG and SI were sought.</div></div><div><h3>Methods</h3><div>We included 556 patients (190M, 366F, mean age: 47 years) with a mean follow-up of 28 months (range 12-90 months).</div></div><div><h3>Results</h3><div>IgG HG occurred in 20% and IgM HG in 34% of patients. At multivariable analysis, the risk of IgG HG was influenced by an older age (≥50 years) (OR 1.64, 95%CI: 1.06-2.54, p=0.027), and by the number of treatment cycles (OR: 1.20, 95%CI: 1.09-1.33, p&lt;0.001).</div><div>A total of 25 SI occurred (100 person-years rate: 1.8), with a disease phenotype other than relapsing-remitting (OR 1.50, 95%CI: 1.02-2.20; p=0.039) and IgG HG (OR 2.65, 95%CI: 1.15-6.12; p=0.022) increasing its risk.</div></div><div><h3>Conclusions</h3><div>IgG and IgM HG occurred in a considerable proportion of patients. IgG HG increased the risk of SI, which were, nevertheless, relatively infrequent. Our results highlight the importance of monitoring immunoglobulin levels during treatment with anti-CD20 agents, to personalize treatment strategies.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106191"},"PeriodicalIF":2.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748667","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":"History of head trauma and the risk of multiple sclerosis: A systematic review and meta-analysis","authors":"Moaz Elsayed Abouelmagd ,&nbsp;Maickel AbdelMeseh ,&nbsp;Atef A. Hassan ,&nbsp;Mohamed Ahmed Ali ,&nbsp;Rashad G. Mohamed ,&nbsp;Abdelrahman Mady ,&nbsp;Mahmoud Diaa Hindawi ,&nbsp;Mostafa Meshref","doi":"10.1016/j.msard.2024.106183","DOIUrl":"10.1016/j.msard.2024.106183","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a chronic disease of the central nervous system with unclear etiology involving genetic, environmental, and immunological factors. The potential link between head trauma and MS is controversial, with conflicting evidence. This systematic review and meta-analysis aim to assess the risk of developing MS following head trauma.</div></div><div><h3>Methods</h3><div>A systematic search of electronic databases was conducted, including studies that investigated the risk of MS in individuals with a history of head trauma compared to those without. Observational studies, including cohort and case-control designs, were included. Data synthesis was conducted using RevMan software. GRADE was used to assess the certainty of evidence.</div></div><div><h3>Results</h3><div>Fifteen studies comprising 1,619,640 participants were included in the meta-analysis. The overall odds of developing MS were significantly higher in the head trauma group compared to the control group (OR = 1.41;95 % CI = [1.23, 1.61]; <em>P</em> &lt; 0.00001; <em>I</em>² = 62 %). Sensitivity analyses based on the number of participants and quality further supported our results. Subgroup analysis showed that results remained consistent across different head trauma identification methods (<em>P</em> = 0.92), early age head trauma and head trauma defined as TBI, or concussion were also significant predictors of MS (<em>P</em> &lt; 0.0001). Analysis of the number of hits suggested a dose-response relationship between the number of head injuries and the risk of MS. According to the GRADE, all outcomes were classified as low or very low certainty of the evidence.</div></div><div><h3>Conclusion</h3><div>This meta-analysis suggests that a history of head trauma may be associated with an increased risk of developing MS. Further research is warranted to support our findings and explore the mechanisms linking head trauma to MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106183"},"PeriodicalIF":2.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722475","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":"Pediatric, adult, and late-onset multiple sclerosis patients: A unified analysis of clinical profiles and treatment responses","authors":"Abdulkadir Tunç ,&nbsp;Meral Seferoğlu ,&nbsp;Ali Özhan SIVACI ,&nbsp;Mevrehan Dilber Köktürk ,&nbsp;Ayşe Kristina POLAT","doi":"10.1016/j.msard.2024.106184","DOIUrl":"10.1016/j.msard.2024.106184","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to conduct a unified analysis comparing the clinical characteristics, disease progression, and treatment responses of pediatric-onset multiple sclerosis (POMS), adult-onset multiple sclerosis (AOMS), and late-onset multiple sclerosis (LOMS) patients.</div></div><div><h3>Methods</h3><div>Utilizing a retrospective cohort design, we analyzed the records of 269 patients from MS clinics and categorized them into the POMS (&lt;18 years), AOMS (≥18 and &lt;50 years), and LOMS (≥50 years) groups based on age at diagnosis. Data collection focused on demographics, clinical manifestations, disability scores, MRI findings, and treatment outcomes.</div></div><div><h3>Results</h3><div>Our findings indicate that while there was a consistent female majority across all groups, distinct smoking habits and differences in disease onset and progression were observed. Disease onset showed substantial differences, with 38.5 % of LOMS patients having a progressive onset. Disability scores increased from the POMS to the LOMS, with a baseline mean EDSS score of 1.81, and the LOMS group had the highest current EDSS score of 3.33. The ARR was greater in the LOMS group. Brainstem and spinal cord lesions were more common in patients with POMS and LOMS, but the difference was not statistically significant. Among those tested, 89.6 % showed OCB positivity. There was a notable shift toward second-line therapies, especially among LOMS patients, with 49.1 % achieving disease control with their initial DMT. Disease control was achieved by 59.7 % of the POMS patients, 47 % of the AOMS patients, and 38.5 % of the LOMS patients. Progression independent of relapse activity (PIRA) was observed in 19.7 % of patients, with higher second-line treatment requirements and higher EDSS scores in the PIRA group.</div></div><div><h3>Conclusion</h3><div>Significant differences in clinical profiles and treatment responses among POMS, AOMS, and LOMS patients underscore the necessity for age-specific management strategies for MS, emphasizing the unique challenges faced by LOMS patients.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106184"},"PeriodicalIF":2.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723917","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":"Time between the first symptom, diagnosis and treatment of multiple sclerosis in a Brazilian cohort. The impact of early diagnosis","authors":"Jéssica Resende Vaz de Melo ,&nbsp;Lucas Alexandre Santos Marzano ,&nbsp;Rodrigo Kleinpaul ,&nbsp;Juliana Santiago-Amaral","doi":"10.1016/j.msard.2024.106178","DOIUrl":"10.1016/j.msard.2024.106178","url":null,"abstract":"<div><h3>Introduction</h3><div>Multiple Sclerosis (MS) diagnosis can be challenging, especially in populations where the disease is rare. In Brazil, the average prevalence is 14/100,000 inhabitants, lower than the worldwide. Early treatment initiation can markedly reduce disease activity and accumulation of disability. Therefore, delayed diagnosis and access to disease modifying therapy (DMT) can have a negative impact on the course of MS.</div></div><div><h3>Objectives</h3><div>The aim of this study was to estimate the mean time between the first relapse, the diagnosis of MS and initiation of treatment in a cohort of Brazilian MS patients.</div></div><div><h3>Material and method</h3><div>We retrospectively analyzed the medical records of MS patients who met the 2017 McDonald diagnostic criteria followed in a MS reference center in Belo Horizonte, Minas Gerais. We assessed demographic and clinical data with focus on time to first symptom, time to diagnosis and treatment begging. The last Expanded Disability Status Scale (EDSS) was collected to access disability.</div><div>The program GraphPad Prism 8.4.3. was used for the statistical analysis.</div></div><div><h3>Results</h3><div>Data of 66 patients were analyzed, 77 % (51) were women. The mean age of the first symptom, diagnosis and DMT initiation was, respectively, 30,06 (± 12,43), 35,2 (± 13,59) and 36,10 (± 13,89) years. In 32 (46,38 %) patients the diagnosis was early (&lt;1 year of disease), in 18 (26,09 %) between 1 and 5 years and in 19 (27,54 %) after to five years. Once the diagnosis was established, 65,5 % had access to DMT within 6 months and 79,71 % in the first year.</div><div>Patients with diagnosis in the two first years had their first symptom at a younger age (<em>p</em> &lt; 0.05). Comparing these two groups, patients with an earlier diagnosis presented less disability (EDSS: 3,5 vs 1,5; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>MS diagnosis can be challenging especially in low prevalence population of diseased and developing countries. Our study demonstrated the importance of early recognition of MS and its precocious intervention, impacting in reducing of disability a long term</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106178"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757344","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 perspectives of neurologists on positron emission tomography utility in multiple sclerosis: A qualitative study","authors":"Daniel Ezzat ,&nbsp;Sion Haest ,&nbsp;Seger Hertogs ,&nbsp;Eren Kalemkus ,&nbsp;Sara Leroi-Werelds ,&nbsp;Niels Hellings","doi":"10.1016/j.msard.2024.106177","DOIUrl":"10.1016/j.msard.2024.106177","url":null,"abstract":"<div><h3>Background</h3><div>Magnetic resonance imaging (MRI) is the gold standard for imaging disease activity in multiple sclerosis (MS) patients. However, recent studies indicate that positron emission tomography (PET) may provide added value in visualizing MS disease in the future.</div></div><div><h3>Objective</h3><div>This study aims to investigate the barriers to implementing PET for MS patients and its potential added value in the context of MS.</div></div><div><h3>Methods</h3><div>11 semi-structured in-depth interviews with neurologists specialized in MS were conducted. The neurologists were selectively recruited from six medical centers in Belgium and the Netherlands. Inductive thematic analysis was used to analyze the data.</div></div><div><h3>Results</h3><div>The interviews revealed several hurdles that play a role in using PET for MS, including financial and scientific considerations. Potential clinical applications of PET were also identified, such as understanding unexplained symptoms, making a more accurate prognosis, evaluating the nature and seriousness of a lesion, and assessing disease activity. In addition, research applications were highlighted, including unraveling the pathophysiology of MS and developing new treatment options for MS.</div></div><div><h3>Conclusion</h3><div>Using PET is advancing our understanding of MS and can accelerate the development of novel therapies to combat its progression. However, its integration into routine clinical practice for MS remains a future prospect, contingent upon further technological advancements and supportive healthcare frameworks.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106177"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706599","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":"Epstein-Barr nuclear antigen 1 antibody-based indices are increased in patients with multiple sclerosis","authors":"Rimsha Ali ,&nbsp;Nicole Hartwig Trier ,&nbsp;Gunnar Houen ,&nbsp;Jette Lautrup Frederiksen","doi":"10.1016/j.msard.2024.106173","DOIUrl":"10.1016/j.msard.2024.106173","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a chronic central nervous system (CNS) disease, which is diagnosed by a combination of clinical symptoms and magnetic resonance imaging and measurement of an increased intrathecal antibody synthesis. Genetic as well as environmental factors influence onset of the disease, where especially Epstein-Barr virus (EBV) infection is directly involved in MS development. In this open retrospective study, we aimed to elaborate whether various serum and cerebrospinal fluid (CSF)-based EBV antibody indices may aid in the diagnosis of MS.</div></div><div><h3>Methods</h3><div>Epstein-Barr nuclear antigen (EBNA)1 IgG concentrations in serum and CSF of relapsing-remitting (RR)MS patients (n=61) (M:F 28:33, average 40 years), optic neuritis patients (n=26) (M:F 9:17, average 47 years) and healthy controls (HCs) (n=15) (M:F 8:7, average 43 years) were determined by enzyme-linked immunosorbent assay. The obtained EBNA1 IgG levels were compared to factors such as total IgG, albumin concentrations, specific antibody index, and various serum- and CSF-based indices.</div></div><div><h3>Results</h3><div>Significantly elevated EBNA1 IgG levels were detected in serum and CSF of RRMS patients compared to HCs. CSF EBNA1 IgG and indices based on specific CSF EBNA1 IgG associated with CSF albumin or serum EBNA1 IgG associated with total serum IgG obtained the highest sensitivities and complemented the IgG index and oligoclonal bands.</div></div><div><h3>Conclusion</h3><div>These findings indicate that aforementioned indices may supplement existing indices and aid in the diagnosis of MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106173"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693298","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}