Multiple sclerosis and related disorders最新文献

{"title":"Corrigendum to “The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis” [Multiple Sclerosis and Related Disorders 83 (2024) 105391]","authors":"Esra Taşkıran , Murat Terzi , Elif Merve Helvacı , Meltem Zeycan Eser , Bahattin Avcı , Turan Ömer Faruk , Mehmet Fatih Yetkin , Vedat Çilingir , Levent Sinan Bir , Sibel Canbaz Kabay , Nuray Bilge , Turan Poyraz , Caner Feyzi Demir , Dilcan Kotan Dündar , Emrah Emre Deveci , Mustafa Çam , Hatice Mavioğlu , Yaşar Altun , Adnan Karaibrahimoğlu","doi":"10.1016/j.msard.2025.106307","DOIUrl":"10.1016/j.msard.2025.106307","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"95 ","pages":"Article 106307"},"PeriodicalIF":2.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348346","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 cognitive performance explain the gap between physiological and perceived fall-risk in people with multiple sclerosis?","authors":"Tobia Zanotto ,&nbsp;Danya Pradeep Kumar ,&nbsp;Daniel Golan ,&nbsp;Jeffrey Wilken ,&nbsp;Glen M Doniger ,&nbsp;Myassar Zarif ,&nbsp;Barbara Bumstead ,&nbsp;Marijean Buhse ,&nbsp;Joanna Weller ,&nbsp;Sarah A Morrow ,&nbsp;Iris-Katharina Penner ,&nbsp;Laura Hancock ,&nbsp;Thomas J Covey ,&nbsp;Edward Ofori ,&nbsp;Daniel S Peterson ,&nbsp;Robert W Motl ,&nbsp;Hans Bogaardt ,&nbsp;Marissa Barrera ,&nbsp;Riley Bove ,&nbsp;Herbert Karpatkin ,&nbsp;Mark Gudesblatt","doi":"10.1016/j.msard.2025.106322","DOIUrl":"10.1016/j.msard.2025.106322","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is linked with increased risk of falls in people with multiple sclerosis (pwMS), but it is not clear whether cognitive performance may help to account for the discordance between fall-risk due to actual physiological functioning and the individual's perception of their fall-risk. This study examined the relationship between cognitive performance and the concordance/discordance of physiological and perceived fall-risk in pwMS.</div></div><div><h3>Methods</h3><div><strong>:</strong> In this single-center cross-sectional analysis of 201 pwMS, proxies for physiological (gait speed) and perceived (Modified Falls Efficacy Scale) fall-risk were collected. Participants were categorized into 4 groups using established cut-off values: high physiological – high perceived (H_phy-H_per), high physiological – low perceived (H_phy-L_per), low physiological – low perceived (L_phy-L_per), and low physiological – high perceived (L_phy-H_per) fall-risk. Cognitive performance was evaluated using the NeuroTrax computerized cognitive battery, which generates a global cognitive score (GCS) as well as scores for individual cognitive domains.</div></div><div><h3>Results</h3><div>Overall, 27.4 % of participants exhibited a discordance between physiological and perceived fall-risk. Individuals with discordant fall-risk did not have worse cognitive scores than individuals with concordant fall-risk, whether GCS or individual cognitive domains. However, among concordant groups, participants in the H_phy-H_per group had worse cognitive scores (GCS) as well as information processing, attention, motor skills, executive function and visual spatial domain scores than participants in the L_phy-L_per group.</div></div><div><h3>Conclusion</h3><div>In this study, one in 4 pwMS had a discordance between their physiological and perceived fall-risk. This discordance was not explained by cognitive performance.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"95 ","pages":"Article 106322"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372737","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":"Assessment of the enhanced paper grip test for quantifying balance deficits in people with multiple sclerosis: A reliability and applicability study","authors":"Eva Žura ,&nbsp;Gregor Brecl Jakob ,&nbsp;Panagiotis Chatzistergos ,&nbsp;Žiga Kozinc","doi":"10.1016/j.msard.2025.106321","DOIUrl":"10.1016/j.msard.2025.106321","url":null,"abstract":"<div><div>This study assessed the reliability and applicability of the Enhanced Paper Grip Test (EPGT) for quantifying balance deficits in people with multiple sclerosis (MS). Thirty individuals with MS (mean age: 41.9 ± 9.66 years, mean Expanded Disability Status Scale (EDSS) score: 2.13 ± 0.94; mean disease duration: 8.3 ± 6.0 years) were recruited. The EPGT demonstrated excellent intra-visit reliability, with intraclass correlation coefficients (ICC) of 0.96 (95 % CI: 0.93–0.98) for the weaker side and 0.94 (95 % CI: 0.89–0.97) for the stronger side. Inter-visit reliability, assessed in 15 participants, also showed excellent ICCs (0.97–0.99), with coefficients of variation ranging from 4.23 % to 5.50 %. Additionally, high and statistically significant correlations were observed between EPGT performance and balance, as assessed by the modified Mini-BESTest (<em>r</em> = 0.81–0.87, <em>p</em> &lt; 0.001). Small but statistically significant correlations were found between EPGT results and EDSS scores (<em>r</em> = −0.36 to −0.38, <em>p</em> &lt; 0.05). These findings suggest that the EPGT can reliably assess foot/ankle strength and identify balance deficits in people with MS, with potential clinical application for monitoring disease progression and guiding rehabilitation interventions. The EPGT may provide a simple and effective method for identifying balance impairments in MS, potentially supporting early interventions and fall prevention strategies</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"95 ","pages":"Article 106321"},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348344","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":"Effectiveness and safety of glucocorticoids bridging rituximab in neuromyelitis spectrum disorder","authors":"Chunyang Wang ,&nbsp;Jia Liu ,&nbsp;Xue Gao ,&nbsp;Yi Shen ,&nbsp;Jing Pan ,&nbsp;Shu Yang ,&nbsp;Moli Fan ,&nbsp;Dongmei Jia ,&nbsp;Chao Zhang","doi":"10.1016/j.msard.2025.106314","DOIUrl":"10.1016/j.msard.2025.106314","url":null,"abstract":"<div><h3>Background</h3><div>Anti-CD20 monoclonal antibody rituximab have been widely used to prevent relapses in patients with neuromyelitis optica spectrum disorder (NMOSD), but data on early use of oral prednisone overlapping with rituximab for effective reduction of relapses are limited. In this study, we evaluated the long-term efficacy of oral prednisone bridging rituximab therapy in NMOSD patients with anti-aquaporin-4 antibody (AQP4-IgG).</div></div><div><h3>Methods</h3><div>We collected the medications and disease activities in patients with AQP4-IgG+ NMOSD patients in this retrospective study. Time to first relapse was evaluated after starting stable doses of prednisone and/or initiating rituximab. We compared the efficacy and safety of different doses of prednisone with sequential rituximab treatment in NMOSD.</div></div><div><h3>Results</h3><div>211 patients fulfilled the inclusion criteria for the study, including 91 patients who were treated with prednisone monotherapy and 120 patients who were treated with prednisone bridging rituximab. In total, 59.3% (54/91) of patients in the prednisone monotherapy group experienced new relapses. The proportions of patients with relapses were different in the subgroups of prednisone monotherapy, with 100% (23/23) in the group of dose ≤ 5mg/d, 64.1% (25/39) in the group of doses 7.5–10mg/d, and 20.7% (6/29) in the group of dose ≥ 12.5mg/d. 24.2% (29/120) of patients in the prednisone bridging rituximab group experienced relapses. Bridging rituximab regimen significantly reduced the risk of relapses compared to prednisone monotherapy (hazard ratio: 0.24, 95% CI: 0.15–0.38, <em>p</em> &lt; 0.0001). Patients with prolonged usage of prednisone tapering (6–12 months) had a significant reduction in the relapse risk compared to those with prednisone tapering 3–6 months (hazard ratio: 0.3119, 95% CI: 0.09125–1.066, <em>p</em> = 0.0264). The most common adverse events were hyperlipidemia in the prednisone monotherapy group (17.6%) and infections in the prednisone bridging rituximab group (25.8%).</div></div><div><h3>Conclusions</h3><div>Prednisone bridging rituximab therapy is associated with the reduced relapse risk in patients with AQP4-IgG+ NMOSD, especially when the bridging time is over 6 months.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"95 ","pages":"Article 106314"},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348823","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":"Cerebrospinal fluid interleukin-6 may be a biomarker for conversion of clinically isolated syndrome to neuromyelitis optica spectrum disorder","authors":"Yuzhen Wei ,&nbsp;Huabing Wang ,&nbsp;Decai Tian ,&nbsp;Tian Song ,&nbsp;Jiali Sun ,&nbsp;Ping Lu ,&nbsp;Lulin Zhang ,&nbsp;Xinghu Zhang ,&nbsp;Linlin Yin","doi":"10.1016/j.msard.2025.106313","DOIUrl":"10.1016/j.msard.2025.106313","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluated the predictive value of several cerebrospinal fluid (CSF) cytokines in the conversion of clinically isolated syndrome (CIS) patients to neuromyelitis optica spectrum disorder (NMOSD) or multiple sclerosis (MS).</div></div><div><h3>Methods</h3><div>We enrolled 33 CIS patients whose CSF samples were collected during the acute phase of the first onset before immunotherapy. The CSF levels of interleukin (IL)-2, IL-4, IL-6, IL-10, IL-13, IL-17A, IL-21, IL-23, interferon-γ (IFN-γ) and transforming growth factor beta 1 (TGF-β1) were measured using the human cytokine multiplex assay or ELISA. Patients were seen every 3 to 6 months. Unscheduled visits occur in case of exacerbations. Clinical measures of disease progression were recorded.</div></div><div><h3>Results</h3><div>The mean follow-up of CIS patients was 23.2 ± 7.9 months. Six patients converted to NMOSD, six patients converted to MS. The CSF IL-21 and IL-6 levels were significantly elevated in CIS patients converted to NMOSD than those who did not. High CSF IL-6 levels are a predictor of conversion to NMOSD in patients with CIS and are associated with a shorter time to conversion. Increased CSF IL-6 levels correlated with CSF WBC count, protein level and IgG index, segment of myelitis, EDSS scores. There was no significant difference in cytokine levels between patients who converted to MS and those who did not.</div></div><div><h3>Conclusions</h3><div>These findings validate CSF IL-6 as an independent predictive factor for the risk of clinical conversion to NMOSD in CIS. The above CSF cytokines levels in CIS patients can't predict conversion to MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"95 ","pages":"Article 106313"},"PeriodicalIF":2.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143277789","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":"Can serum C3/C4 complement ratio be used in the differential diagnosis of central nervous system demyelinating diseases?","authors":"Melike Cakan ,&nbsp;Bariscan Cimen ,&nbsp;Nazire Pınar Acar-Ozen ,&nbsp;Yildirim Sara ,&nbsp;Rana Karabudak ,&nbsp;Aslı Tuncer","doi":"10.1016/j.msard.2025.106312","DOIUrl":"10.1016/j.msard.2025.106312","url":null,"abstract":"<div><h3>Background</h3><div>Neuromyelitis Optica Spectrum Disorders (NMOSD) and Multiple Sclerosis (MS) are primary demyelinating diseases of the central nervous system (CNS) with similar clinical features, complicating early differential diagnosis and treatment decisions. While both humoral and cellular immunity contribute to their immunopathogenesis, the complement system's role remains unclear. We considered complement-dependent cytotoxicity might have different roles in the pathophysiology of these diseases. Predictive value of C3 and C4 complement levels at the first attack for the definitive diagnosis aimed to be investigated.</div></div><div><h3>Methods</h3><div>Treatment-naive, 14 seronegative (SN) NMO, 28 aquaporin-4-positive [AQP4(+)] NMO, 23 myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and 15 MS adult patients were included. Serum C3 and C4 levels were evaluated retrospectively. Complement levels were statistically adjusted according to the age of the patients and C3/C4 ratio was used to increase statistical power.</div></div><div><h3>Results</h3><div>We found that C4 levels were lower and C3/C4 ratio was higher in SN<img>NMO and AQP4(+)-NMO groups compared to the MS group. It has been determined that 5.32 and 4.85 cut-off values of the C3/C4 ratio can discriminate SN<img>NMO and AQP4(+)-NMO groups from MS.</div></div><div><h3>Conclusion</h3><div>The classical complement pathway in SN<img>NMO and AQP4(+)-NMO was thought to be more affected compared to MS, as activation of the classical pathway predominantly decreases the level of C4. Since the involvement of the complement system pathways at different levels may be presented with the C3/C4 ratio, it seems likely that this ratio may have value as a candidate biomarker in the differential diagnosis of primary CNS demyelinating diseases.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"95 ","pages":"Article 106312"},"PeriodicalIF":2.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348347","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":"Real-world infection risk in multiple sclerosis patients on long-term immunomodulatory treatments","authors":"Clare McGarvey Lambert ,&nbsp;Taimoor Hussain ,&nbsp;John Peters ,&nbsp;Erin E Longbrake","doi":"10.1016/j.msard.2024.106236","DOIUrl":"10.1016/j.msard.2024.106236","url":null,"abstract":"<div><h3>Introduction</h3><div>Numerous immunomodulatory treatments exist for multiple sclerosis (MS), including those that deplete immune cells (e.g. anti-CD20 medications), relocate immune cells (e.g. natalizumab, S1P modulators), or modulate immune subsets (e.g. fumarates). All disease-modifying treatments (DMTs) can increase infection risk which could worsen with prolonged use.</div></div><div><h3>Methods</h3><div>This is a retrospective, single-center, observational cohort study. We analyzed medical records of adult people with MS who took natalizumab, S1P modulators, fumarates or anti-CD20 medications for over two years between January 2013 and April 2021 at Yale. We identified severe infections (requiring hospitalization) and mild infections (identified through outpatient antibiotic prescriptions or chart reference to “infection”). We used a zero-inflated negative binomial regression to assess the effects of DMT use, treatment duration, and patient characteristics on infection likelihood and frequency, while controlling for biologic sex, body mass index, ambulatory status, Charlson Comorbidity Index (CCI), diagnosis, disease modifying therapy and treatment duration.</div></div><div><h3>Results</h3><div>104 patients received natalizumab, 61 fumarates, 17 S1P modulators and 291 anti-CD20 medications, with significant baseline differences in age, diagnosis, duration of DMT use, and CCI. Mild infection rates did not differ across DMTs, but severe infections were more common in patients on fumarates. Patients with longer DMT duration or requiring a walking aid had higher mild infection rates, while those with progressive MS or on long-term fumarates had higher severe infection rates, even after controlling for other variables.</div></div><div><h3>Discussion</h3><div>This study demonstrates how real-life practice patterns, patient factors and DMT choice can influence infection rates, differing from randomized trial patterns. Natalizumab appears safe over extended use, while fumarates were linked to more severe infections, potentially due to the clinical selection of patients with poorer baseline health. The duration of DMT use may predict mild infection rates.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"94 ","pages":"Article 106236"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927592","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":"Improvement of measured and perceived disability in overweight patients with Multiple Sclerosis trough different patterns of Mediterranean hypocaloric diet","authors":"Federica Felicetti ,&nbsp;Serena Ruggieri ,&nbsp;Ilaria Ruotolo ,&nbsp;Chiara Livi ,&nbsp;Giovanni Sellitto ,&nbsp;Giorgia D'Ambrosi ,&nbsp;Riccardo Nistri ,&nbsp;Antonio Ianniello ,&nbsp;Giovanna Borriello ,&nbsp;Carlo Pozzilli ,&nbsp;Maria Petracca","doi":"10.1016/j.msard.2025.106271","DOIUrl":"10.1016/j.msard.2025.106271","url":null,"abstract":"<div><h3>Objectives</h3><div>overweight and other cardiovascular risk factors are known contributors to disability accrual in Multiple Sclerosis (MS). We aimed to explore the impact of three hypocaloric dietetic patterns, based on the Mediterranean diet, on cardiovascular risk and clinical status in overweight persons with MS (pwMS).</div></div><div><h3>Material and Methods</h3><div>overweight pwMS (body mass index-BMI ≥25 kg/m²) were prospectively enrolled, randomly allocated to three hypocaloric dietetic plans differing in macronutrients composition (carbohydrates/proteins/lipids: diet A 65 %/15 %/20 %; diet B 35 %/25 %/40 %; diet C 50 %/20 %/30 %) and followed-up for 1 year (6 months of dietetic intervention + 6 months of observation). The Multiple Sclerosis Performance Test, a self-administered, iPad®-based system for quantifying cognition, upper and lower extremity motor function, and vision was performed at baseline, 6 and 12 months. Questionnaires for the evaluation of sleep quality, fatigue, anxiety, depression, stigma, social participation and satisfaction were administered. Information about cardiovascular risk parameters (BMI, waist circumference-WC, umbilical circumference-UC, hip circumference-HP, blood pressure, HDL and LDL cholesterol, triglycerides, glycemia) were collected. Adherence to the dietetic plan was quantified as days of complete to insufficient adherence across the treatment period. Between-group comparisons were performed with Chi-square and ANOVA; longitudinal analyses with one-way ANOVA for repeated measures and mixed-design ANOVA.</div></div><div><h3>Results</h3><div>fifty-three patients completed the study (diet A <em>n</em> = 19, diet B <em>n</em> = 18, diet C <em>n</em> = 16). The three groups were well matched for sex, age, disease duration and EDSS. Along the 6 months of dietetic intervention, no difference in adherence was detected across the three dietetic plans (<em>p</em> = 0.84). Overall, patients showed a significant weight loss over time (<em>p</em> &lt; 0.001) with no difference across diets (<em>p</em> = 0.34). BMI, WC, UC, HC and cholesterol improved over time (p ranging from 0.06 to 0.001), with no differences across diets (<em>p</em> ranging from 0.16 to 0.58). Among all tested clinical variables, fatigue, anxiety, information processing speed and manual dexterity improved significantly (<em>p</em> = 0.005, <em>p</em> = 0.012, <em>p</em> = 0.013, <em>p</em> = 0.005), with no differences across diets (<em>p</em> = 0.84, <em>p</em> = 0.89, <em>p</em> = 0.53, <em>p</em> = 0.72).</div></div><div><h3>Conclusion</h3><div>dietetic interventions in overweight pwMS, irrespective of their specific macronutrients composition, are able to improve the cardiovascular profile, the perception of subjective symptoms as well as objective disability scores.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"94 ","pages":"Article 106271"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007701","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":"Functional neurological disorder in multiple sclerosis: A prospective study","authors":"Sofia Cuoco ,&nbsp;Sara Scannapieco ,&nbsp;Francesca Barra ,&nbsp;Caterina Giordano ,&nbsp;Maria Di Gregorio ,&nbsp;Paolo Barone ,&nbsp;Roberto Erro","doi":"10.1016/j.msard.2025.106264","DOIUrl":"10.1016/j.msard.2025.106264","url":null,"abstract":"<div><h3>Background</h3><div>There is increasing recognition Functional Neurological disorder (FND) is comorbid with other neurological conditions, but little is known about patients with Multiple Sclerosis (MS). We therefore systematically evaluated the presence of FND in consecutive patients with MS and its clinical correlates<strong>.</strong></div></div><div><h3>Methods</h3><div>Three-hundred and ten consecutive MS patients, seen at our center on either elective or emergent basis, underwent a structured protocol to gather demographics and data about clinical features, previous and current treatments and presence of mood disorders and were additionally assessed by an expert in FND. Patients with and without FND were then compared to identify clinical correlates with the functional comorbidity.</div></div><div><h3>Results</h3><div>Overall, we found that 5.8 % of patients with MS had comorbid FND. Of note, 22.6 % (7/31) of MS patients admitted on an emergent basis for a suspected relapse were found to have incident FND. Patients with comorbid FND had higher rates of clinically significant mood disturbances and a higher number of previous therapeutic switches due to treatment failure or to side effects than patients without FND. Depression, relapsing remitting MS and disability were found to independently predict the presence of FND.</div></div><div><h3>Conclusions</h3><div>FND is relatively frequent in patients with MS. As the two conditions might have similar phenomenological presentations, it is important to properly screen and recognize FND because of crucial treatment implications.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"94 ","pages":"Article 106264"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008651","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":"Development and validation of a scoring system for predicting disease activity in treatment-naïve patients with relapsing-remitting multiple sclerosis","authors":"Magd Zakaria ,&nbsp;Nevin Mohieldin Shalaby ,&nbsp;Farouk Talaat ,&nbsp;Alaa Elmazny ,&nbsp;Eman Hamdy ,&nbsp;Mahmoud Saad Swelam ,&nbsp;Mohamed Kamal ,&nbsp;Mohamad Taha ,&nbsp;Maged Abdel Naseer","doi":"10.1016/j.msard.2025.106278","DOIUrl":"10.1016/j.msard.2025.106278","url":null,"abstract":"<div><h3>Background</h3><div>Relapsing-remitting MS (RRMS) exhibits significant heterogeneity and different treatment responses. Up to date, there is no international consensus on defining disease activity which foretells potential prognosis. This study aims to develop and validate a “Scoring System for Disease Activity Prognosis in Treatment-Naïve RRMS Patients” (DAPS-RRMS) to help guiding treatment decisions.</div></div><div><h3>Methods</h3><div>A set of clinical and radiological factors predicting RRMS disease activity based on an extensive literature review were identified. Real-world data from 520 treatment-naïve RRMS patients were extracted from the Egyptian MS registry dataset by independent neurologists and were disseminated among a group of MS experts for evaluation of each case separately. To convert this clinical impression into a validated score, ordinal logistic regression was used to develop the scoring system and nomogram; validation was conducted using Receiver Operating Characteristic (ROC); interrater reliability was assessed using Kendall's coefficient of concordance and the Intraclass Correlation Coefficient (ICC).</div></div><div><h3>Results</h3><div>According to cut off values based on the sum of scores of involved parameters, patients were classified into four categories predicting disease activity, “Active” (0–9), “Highly Active” (9.5–14), “Very Highly Active” (14.5–19), and “Aggressive” (&gt;19). The scoring tool demonstrated excellent performance metrics with high inter-rater agreement (Kendall's W 0.764), and reliability including a high area under the curve (AUC) for discriminating between categories.</div></div><div><h3>Conclusion</h3><div>This validated scoring system provides a practical and reliable tool for predicting RRMS disease activity and guiding treatment decisions in treatment-naïve patients, particularly in resource-limited countries. The model is combined with a user-friendly nomogram.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"94 ","pages":"Article 106278"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039457","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}