Multiple sclerosis and related disorders最新文献

{"title":"Characterization of distinct cognitive domain patterns in AQP4-IgG-positive NMOSD: A MoCA-based factor analysis and risk profiling.","authors":"Tingting Zhang, Yizuo Ma, Lai Wei, Yujie Su, Fangxia Meng, Wenli Zhu, Ruili Wei","doi":"10.1016/j.msard.2026.108005","DOIUrl":"https://doi.org/10.1016/j.msard.2026.108005","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI) is common in neuromyelitis optica spectrum disorder (NMOSD), yet subdomain-specific patterns, modifiable risk factors, and underlying cognitive structure remain unclear. This study aimed to characterize cognitive deficits in AQP4-IgG-positive NMOSD patients in stable remission, identify correlates of domain-specific impairment, and explore the latent factor structure using MoCA subscales.</p><p><strong>Methods: </strong>Sixty-one definite AQP4-IgG-positive NMOSD patients in stable remission were enrolled. Assessments included MoCA, MMSE, Digit Span Test, and Hamilton Depression/Anxiety Scales. Demographic and clinical data were collected. Pearson correlation, partial correlation (controlling for age, education, and mood), multiple regression, and exploratory factor analysis (PCA with varimax rotation) were performed.</p><p><strong>Results: </strong>Overall, 63.9% of patients had CI (MoCA < 26). Episodic memory (delayed recall: 42.6%), language repetition (36.1%), and visuospatial/executive function (34.4%) were most affected. Education (β = 0.386, p = 0.003) was the only statistically significant independent predictor in multivariate analysis; age, EDSS, depression, and anxiety showed domain-specific associations. Factor analysis revealed three networks-visuospatial-executive-language, memory-abstraction, and naming-attention networks-explaining 63.2% of variance (Cronbach's α = 0.637), suggesting three distinct cognitive domain patterns; given the modest sample size, this solution should be considered exploratory.</p><p><strong>Conclusion: </strong>AQP4-IgG-positive NMOSD patients in stable remission show a characteristic cognitive profile with predominant episodic memory, executive, and linguistic deficits. Lower education was the only significant independent predictor of cognitive performance, while age, disability, and mood disturbances showed domain-specific associations. The three-factor cognitive structure may support domain-specific screening and targeted rehabilitation in clinical practice. Routine MoCA assessment may be considered for NMOSD patients, with priority given to older, less educated individuals and those with higher disability or comorbid depression.</p>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"116 ","pages":"108005"},"PeriodicalIF":3.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224475","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":"Comment on \"Lacosamide effects on pain management in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled clinical trial\".","authors":"Antonio Alcántara Montero, Almudena Holguera Palacios","doi":"10.1016/j.msard.2026.107990","DOIUrl":"https://doi.org/10.1016/j.msard.2026.107990","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"116 ","pages":"107990"},"PeriodicalIF":3.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224499","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":"Letter to the editor on “Epidemiology of Multiple Sclerosis in Iran: An Updated Systematic Review and Meta-analysis”","authors":"Yaseen Eghbal,&nbsp;Farinaz Amirikar","doi":"10.1016/j.msard.2026.107987","DOIUrl":"10.1016/j.msard.2026.107987","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"116 ","pages":"Article 107987"},"PeriodicalIF":3.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149204796","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":"Walking and strength outcomes of targeted hip resistance training may be predicted by both MRI and clinical measures in multiple sclerosis.","authors":"Nora E Fritz, Ani Eloyan, Jennifer Keller, Kathleen M Zackowski","doi":"10.1016/j.msard.2026.107970","DOIUrl":"https://doi.org/10.1016/j.msard.2026.107970","url":null,"abstract":"<p><strong>Background: </strong>Compromised neural function contributes sensation, strength, and walking deficits in persons with multiple sclerosis (PwMS). Progressive resistance training (PRT) promotes neural adaptations, leading to favorable functional outcomes, while advances in MRI enable the evaluation of white matter tract pathology in vivo. The purpose of this work was to examine the utility of MRI with clinical measures to predict exercise responsiveness to PRT.</p><p><strong>Methods: </strong>Twenty-eight PwMS (mean age: 49.3 and EDSS: 3.8) and 26 controls (mean age: 50) participated in 12-weeks of PRT. Primary outcomes were change in walk velocity and hip strength. Model predictors included baseline demographics, falls, walk velocity, strength, cognitive performance, quality of life, vibration sensation and 3T MRI measures of spinal cord area (SCA) and corticospinal tract (CST) fractional anisotropy (FA), mean diffusivity (MD) and magnetization transfer ratio (MTR). A random forest procedure was used as an exploratory analysis for prediction of exercise responsiveness. The predictive accuracy was measured using the normalized mean squared error (MSE) within a leave-one-out cross-validation procedure, but was not externally validated.</p><p><strong>Results: </strong>Strength change predictors included baseline strength, diagnosis, age, disease severity, falls, cognitive performance, quality of life, vibration, and CST (FA, MD, and MTR) (normalized MSE: 0.1792). Walk velocity change predictors included baseline walk velocity, age, disease severity, sex, cognitive performance, vibration, and CST (FA, MD, and MTR) (normalized MSE: 0.2147).</p><p><strong>Conclusion: </strong>A combination of motor, cognitive, and MRI measures may predict responsiveness to a PRT program in PwMS. These data confirm that optimizing function relies on knowledge of pathology, disability level and intervention selection in pwMS, and that using imaging information in combination with functional performance may offer advantages to optimizing functional recovery for pwMS.</p>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"116 ","pages":"107970"},"PeriodicalIF":3.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220514","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":"Reduced perivascular diffusion in multiple sclerosis is associated with aging, disease duration, and mobility impairment.","authors":"Sumire D Sato, Sutton B Richmond, Brett W Fling, Rachael D Seidler","doi":"10.1016/j.msard.2026.107958","DOIUrl":"https://doi.org/10.1016/j.msard.2026.107958","url":null,"abstract":"<p><strong>Background: </strong>The glymphatic system supports brain homeostasis by facilitating perivascular fluid transport and metabolic waste clearance. Diffusion-tensor imaging along the perivascular space (ALPS-index) provides a non-invasive surrogate marker of glymphatic activity. The objectives of this study were to: (1) compare the ALPS-index between individuals with relapsing-remitting MS (RRMS) and non-MS controls, (2) examine the role of age in the association between ALPS-index and disease duration, and (3) examine the relationship between ALPS-index and walking speed in RRMS.</p><p><strong>Methods: </strong>Individuals with RRMS and age‑ and sex-matched controls underwent 3T MRI, including diffusion‑weighted imaging. ALPS‑index was calculated using standardized regions of interest. Walking function was assessed using a two‑minute walk test.</p><p><strong>Results: </strong>Individuals with RRMS have significantly lower ALPS‑index compared to controls (p = 0.001). Across participants, older age was associated with lower ALPS‑index (p < 0.001), with no evidence that age effects differed by group (group effect: p = 0.311, group x age: p = 0.954). In RRMS, a lower ALPS‑index was associated with longer disease duration (p = 0.028); however, mediation analyses showed that chronological age largely explained this relationship (p = 0.012). In a multivariable model, both lower ALPS‑index and slower gait speed were independently associated with longer disease duration, with an interaction effect (p = 0.032) suggesting functional compensation between perivascular diffusion and mobility.</p><p><strong>Conclusions: </strong>These findings highlight the interconnected roles of aging, perivascular fluid transport, and mobility in MS and support the ALPS‑index as a feasible, non‑invasive imaging marker of age‑related vulnerability.</p>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"116 ","pages":"107958"},"PeriodicalIF":3.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224449","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":"After Parkinson’s, Does the GLP-1 Hypothesis Still Hold in Multiple Sclerosis?","authors":"Mobeen Sajjad","doi":"10.1016/j.msard.2026.107258","DOIUrl":"10.1016/j.msard.2026.107258","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"111 ","pages":"Article 107258"},"PeriodicalIF":2.9,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988133","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":"Relapse risk factors in double seronegative neuromyelitis optica spectrum disorder: Insights from a multicenter study","authors":"Gerome Vallejos ,&nbsp;Takahisa Mikami ,&nbsp;Joao Vitor Mahler ,&nbsp;Ahmetcan Sezen ,&nbsp;Guilherme Diogo Silva ,&nbsp;Marina Solti ,&nbsp;Samira Apóstolos-Pereira ,&nbsp;Dagoberto Callegaro ,&nbsp;Marcelo Matiello ,&nbsp;Ayşe Altıntaş ,&nbsp;Michael Levy","doi":"10.1016/j.msard.2026.107123","DOIUrl":"10.1016/j.msard.2026.107123","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the risk factors associated with the relapse rate in patients with DSN-NMOSD.</div></div><div><h3>Methods</h3><div>This is a multicenter retrospective study of cases of DSN-NMOSD at the Mass General Brigham, the University of Sao Paulo, and Koc University. Patients were excluded if they had an alternative diagnosis. To examine the association of the different clinical and paraclinical factors on relapses, we calculated the incidence rate ratio (IRR) using a Poisson regression analysis.</div></div><div><h3>Results</h3><div>A total of 35 relapsing DSN-NMOSD patients were analyzed. In a univariate Poisson regression analysis, non-Caucasian patients showed a higher rate of relapse (IRR: 1.58, 95 % CI 1.06-2.32; p=0.022) and simultaneous ON and transverse myelitis (TM) at onset resulted in a lower IRR of 0.04 (95 %CI 0.010-0.13; p &lt;0.001). After adjusting for confounding factors, sex, race, laterality of ON, and use of disease-modifying therapy, age at onset at <span><math><mo>&gt;</mo></math></span>32 years old was associated with a higher rate of relapses (IRR 1.82, 95 % CI 1.16-2.82; p = 0.008), while initial clinical manifestations of TM only (IRR 0.41, 95 % CI 0.22-0.74; p=0.004) and simultaneous ON and TM (IRR 0.04, 95 % CI 0.01-0.15; p &lt;0.001) were linked to low relapse rates when compared to ON only.</div></div><div><h3>Conclusion</h3><div>Older adult onset (&gt;32 years old) is linked to a higher relapse rate and patients presenting with TM only and simultaneous ON and TM at onset were found to be associated with a lower relapse rate.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107123"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387463","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":"Bridging the gap: A symptom network analysis of depression, anxiety, and fatigue in multiple sclerosis","authors":"Charles J. Strathdee ,&nbsp;Isabel Krug ,&nbsp;Charles Malpas ,&nbsp;Litza Kiropoulos","doi":"10.1016/j.msard.2026.107102","DOIUrl":"10.1016/j.msard.2026.107102","url":null,"abstract":"<div><h3>Background</h3><div>Depressive, anxiety, and fatigue symptoms are highly prevalent in people with multiple sclerosis (pwMS) and have been found to co-occur. Together, these symptoms result in poorer outcomes for pwMS. However, the network topology of comorbid depression, anxiety, and fatigue in pwMS has been to be investigated.</div></div><div><h3>Methods</h3><div>We estimated depressive, anxiety, and fatigue symptom networks using data from the same people with multiple sclerosis at two time points: at baseline (<em>N</em> = 272) and at 6-months follow-up (<em>N</em> = 141). Expected influence (EI) centrality analyses were performed to estimate the relative influence of each symptom within the two networks. Bridge EI and community analyses were performed to identify potential bridge symptoms and densely connected symptom groups.</div></div><div><h3>Results</h3><div>‘Worthlessness’ and ‘anhedonia’ emerged with the highest EI at baseline and follow-up, respectively. In terms of bridging symptoms, ‘worthlessness’, ‘afraid something awful would happen’, and ‘fatigue severity’ emerged as potential bridging symptoms that clustered depressive, anxiety, and fatigue symptoms in pwMS. This changed to ‘restlessness’, ‘uncontrollable worry’, and ‘suicidal ideation’ at follow-up. Further analyses indicated that the two networks remained similar with respect to global strength (<em>p = .</em>97)</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that depressive, anxiety, and fatigue symptoms are highly interconnected in MS. Identifying bridging symptoms may allow for a renewed therapeutic focus and avenue for symptomatic improvement across board areas of psychopathology in MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107102"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372971","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":"Genetic and environmental mediators of multiple sclerosis susceptibility but not early severity run in families","authors":"Cato E.A. Corsten ,&nbsp;Ana M. Marques ,&nbsp;Yifan van Hasselt ,&nbsp;Jeroen van Rooij ,&nbsp;Ide Smets ,&nbsp;Marvin M. van Luijn ,&nbsp;Rinze F. Neuteboom ,&nbsp;Beatrijs Wokke ,&nbsp;Joost Smolders","doi":"10.1016/j.msard.2026.107101","DOIUrl":"10.1016/j.msard.2026.107101","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) susceptibility and severity are mediated by different genetic and environmental risk factors. Familial aggregation in MS is partially explained by susceptibility determinants, yet impact on early disease course after clinically isolated syndrome (CIS) is uncertain. We investigated associations of reported familial MS with genetic and environmental risk factors, and with clinical presentation and disease course after CIS.</div></div><div><h3>Methods</h3><div>CIS participants were included in a prospective cohort within six months after symptom onset. Family history was assessed at baseline. We evaluated weighted genetic risk scores (wGRS) for MS susceptibility, 25-hydroxyvitamin D (25(OH)D) and body mass index (BMI), and determined HLA-DRB1*15:01 and MS severity SNP rs10191329 carriership. Anti-Epstein Barr virus Nuclear Antigen-1 (anti-EBNA1) IgG antibodies and 25(OH)D levels were measured. Disease course associations were estimated with Cox regression.</div></div><div><h3>Results</h3><div>Family members with MS were reported by 81/415 (19.5%) CIS participants. Familial MS was associated with higher MS susceptibility wGRS (7.54 (SD1.17) vs. 7.19 (SD1.22), p=0.04) and more frequent HLA-DRB1*15:01 carriership (first-degree 66.7%, other-degree 30.2%, no 38.4%, p=0.02). Anti-EBNA1 IgG and 25(OH)D levels did not differ, yet wGRS for lower 25(OH)D and higher adult BMI characterised MS participants with first-degree MS relatives. Baseline characteristics and disease severity measures were similar between participants with and without familial MS.</div></div><div><h3>Conclusion</h3><div>Our results confirm that familial MS is associated with enrichment of genetic risk for MS susceptibility, low 25(OH)D and high BMI, but not with early disease course after CIS. These data support that MS susceptibility and disease course are driven by different pathophysiological processes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107101"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378154","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 cycling ergometry with or without electrical stimulation in individuals with secondary progressive multiple sclerosis: A randomized controlled trial","authors":"Alexandra C. Simpson ,&nbsp;Jennifer Keller ,&nbsp;Thomas Shoemaker ,&nbsp;Julie Fiol ,&nbsp;Michael Comisac ,&nbsp;Daniel Becker ,&nbsp;Sandra D. Cassard ,&nbsp;Kathleen Zackowski ,&nbsp;Scott D. Newsome","doi":"10.1016/j.msard.2026.107095","DOIUrl":"10.1016/j.msard.2026.107095","url":null,"abstract":"<div><h3>Background</h3><div>People with secondary progressive multiple sclerosis (PwSPMS) experience symptoms impacting their ability to walk or exercise. Functional electrical stimulation (FES) cycling is a promising, safe therapeutic intervention for MS, but relatively little is known about its use in PwSPMS with moderate to severe disability.</div></div><div><h3>Objective</h3><div>To determine effects of active FES and passive cycling on walking speed and other disability measures in PwSPMS.</div></div><div><h3>Methods</h3><div>PwSPMS and Expanded Disability Status Scale (EDSS) 5.0–7.0 were randomized to a 12-week FES-assisted or passive (control) cycling intervention. The primary outcome was change in Timed 25-Foot Walk (T25FW [s]) pre-post intervention. Secondary outcomes assessed functional mobility (Timed Up and Go [TUG], 2-Minute Walk Test), strength, disability, cognition and quality of life.</div></div><div><h3>Results</h3><div>Fourteen participants completed the intervention (8 active FES; 6 passive). One active FES cyclist with an unrelated injury was excluded from analysis. Mean ±SD age was 54.1 ± 8.9 years and 85 % were female. Participants tolerated the intervention. No significant differences were observed between participants receiving FES compared to passive cycling in any measures. Within groups, FES cyclists trended towards but did not reach significant improvement in T25FW (10.2 to 8.4 s; <em>p</em> = 0.08), while passive cyclists significantly improved in TUG (12.4 to 11.6 s; <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Change in ambulatory function did not differ in participants receiving FES versus passive cycling. Within-group improvement occurred in isolated measures and no adverse events occurred, demonstrating feasibility and acceptability. Longer interventions may be necessary to demonstrate improvements beyond lack of decline, given greater baseline disability in this population.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107095"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387461","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}