Multiple sclerosis and related disorders最新文献

{"title":"Prevalence and incidence of multiple sclerosis in the Netherlands","authors":"Cynthia. M.C. Lemmens ,&nbsp;Joost W. Vanhommerig ,&nbsp;Bart J. Knottnerus ,&nbsp;Bernard M.J. Uitdehaag ,&nbsp;Jop P. Mostert ,&nbsp;Brigit A. de Jong","doi":"10.1016/j.msard.2024.106207","DOIUrl":"10.1016/j.msard.2024.106207","url":null,"abstract":"<div><h3>Background</h3><div>The rising prevalence estimates of multiple sclerosis (MS) globally underscore the imperative for up-to-date epidemiological data specific to the Netherlands.</div></div><div><h3>Methods</h3><div>Data from two Dutch healthcare databases (Nivel Primary Care Database and Vektis Database) comprising both general practices and hospital electronic health records in 2019 were combined to assess age- and sex-standardized MS prevalence and incidence estimates. Differences in prevalence estimates based on latitude and between primary versus secondary care records were examined.</div></div><div><h3>Results</h3><div>The age and sex-standardized prevalence estimate was 210.4 per 100,000 inhabitants. Incidence estimate of MS was 7.1 per 100,000 person-years within the year 2019. One-third of the MS cohort from primary care records was not documented in the hospital database over two consecutive years. Prevalence estimates were higher in northern areas versus southern areas (respectively 240.6 versus 208.3 per 100,000 inhabitants).</div></div><div><h3>Conclusion</h3><div>Aligning results from different global regions, prevalence estimates of MS in the Netherlands have increased significantly over the last decennia, while incidence estimates are stable. The discrepancy between MS records within the primary and secondary care setting could indicate that a substantial proportion of Dutch patients with MS are not under specialized neurological care.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106207"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807704","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":"Association between paramagnetic rim lesions and pulvinar iron depletion in persons with multiple sclerosis","authors":"Jack A. Reeves ,&nbsp;Fahad Salman ,&nbsp;Maryam Mohebbi ,&nbsp;Niels Bergsland ,&nbsp;Dejan Jakimovski ,&nbsp;Simon Hametner ,&nbsp;Bianca Weinstock-Guttman ,&nbsp;Robert Zivadinov ,&nbsp;Michael G. Dwyer ,&nbsp;Ferdinand Schweser","doi":"10.1016/j.msard.2024.106187","DOIUrl":"10.1016/j.msard.2024.106187","url":null,"abstract":"<div><h3>Background</h3><div>The deep gray matter (DGM), especially the pulvinar, and the white matter surrounding chronic active lesions have demonstrated depleted iron levels, indicating a possible mechanistic link. However, no studies have investigated the potential relationship between these phenomena.</div></div><div><h3>Objectives</h3><div>The study aimed to determine whether PRLs were associated with pulvinar iron depletion and, if so, whether this relationship was spatially mediated.</div></div><div><h3>Methods</h3><div>This retrospective analysis included 139 people with MS (pwMS) and 43 healthy controls (HCs) scanned at 3T MRI at baseline and after 5.4 ± 0.6 years. Pulvinar iron concentrations (cFe) and iron masses (mFe) were estimated from quantitative susceptibility maps and tested for associations with PRLs. A separate cohort of 96 pwMS with PRLs and propensity-matched HCs was included to evaluate peri‑plaque normal-appearing white matter (NAWM) abnormalities.</div></div><div><h3>Results</h3><div>PRL number was associated with greater decline in pulvinar cFe (β = -0.265, <em>p</em> = 0.005) and mFe (β = -0.256, <em>p</em> = 0.006). Peri-plaque NAWM susceptibility was increased 11 mm surrounding PRLs, outside which shorter PRL-to-pulvinar distance was associated with greater decline in pulvinar cFe (β = 0.380, <em>p</em> = 0.005) and mFe (β = 0.348, <em>p</em> = 0.022).</div></div><div><h3>Conclusions</h3><div>Our findings support a spatially-mediated relationship between PRLs and chronic pulvinar iron depletion.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106187"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791779","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":"Corrigendum to “A pilot study comparing treatments for severe attacks of neuromyelitis optica spectrum disorders: Intravenous methylprednisolone (IVMP) with add-on plasma exchange (PLEX) versus simultaneous ivmp and PLEX” [Multiple Sclerosis and Related Disorders (2020) 1;38:101506]","authors":"Thanapon Songthammawat ,&nbsp;Tayanan Srisupa-Olan ,&nbsp;Sasitorn Siritho ,&nbsp;Kulvara Kittisares ,&nbsp;Jiraporn Jitprapaikulsan ,&nbsp;Chanjira Sathukitchai ,&nbsp;Naraporn Prayoonwiwat","doi":"10.1016/j.msard.2024.106233","DOIUrl":"10.1016/j.msard.2024.106233","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106233"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877552","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":"Biomarkers in patients with autoimmune optic neuritis not associated with multiple sclerosis: Demographic, clinical and prognostic features","authors":"Hüseyin Nezih Özdemir,&nbsp;Mine Topçuoğlu Karakoç,&nbsp;Figen Gökçay,&nbsp;Neşe Çelebisoy","doi":"10.1016/j.msard.2024.106227","DOIUrl":"10.1016/j.msard.2024.106227","url":null,"abstract":"<div><h3>Background</h3><div>The new optic neuritis (ON) classification leads to a change in how ON patients are grouped. Our aim is to appraise the clinical features and prognoses of patients with autoimmune ON not associated with MS. Methods: Patients referred to our neuro-ophthalmology laboratory were enrolled to this retrospective study. Patients with ON associated with MS were excluded. The remaining patients were divided into three groups: aqauaporin-4 (AQP4) antibody ON group, myelin oligodendrocyte glycoprotein (MOG) antibody ON group, and seronegative ON group. The patients were examined on admission, one month after acute treatment, and at the third-year follow-up. We compared demographic, clinical, radiologic, laboratory data, and treatment responses among these three groups.</div></div><div><h3>Results</h3><div>The study included 92 patients. The older age of onset, bilateral simultaneous involvement of the optic nerves, severe vision loss at onset, and need for aggressive treatment were more common in the AQP-ON and the MOG-ON groups than the seronegative ON group (<em>P</em> = 0.01, <em>P</em> = 0.003, <em>P</em> = 0.011, <em>P</em> = 0.007, <em>P</em> &lt; 0.001, <em>P</em> &lt; 0.001, respectively). The presence of optic disc edema was a significant feature of MOG-ON as well as long-length contrast enhancement on MRI (<em>P</em> = 0.003, <em>P</em> = 0.002). Additional autoimmune antibodies and CNS lesions outside the optic nerve were the features of AQP4-ON patients (<em>P</em> &lt; 0.001, <em>P</em> = 0.015). Generalized estimating equations analysis revealed that the presence of AQP4 antibody, increased age and recurrence were associated with visual acuity over time (<em>P</em> = 0.014, <em>P</em> = 0.002, <em>P</em> = 0.016, respectively).</div></div><div><h3>Conclusion</h3><div>The association of serum biomarker status with demographic, clinical features, and visual outcomes indicate the importance of biomarker detection in these patients.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106227"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877548","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":"Exploring the Potential of Immersive Virtual Reality (VR) as a tool to enhance cognitive functions and alleviate clinical symptoms in Multiple Sclerosis (MS)","authors":"María Zaragoza-Mezquita ,&nbsp;Sonia Felix-Esbrí ,&nbsp;Alba Sebastián-Tirado ,&nbsp;Pablo Guinot ,&nbsp;Carlos Melero ,&nbsp;Cristina Forn ,&nbsp;Carla Sanchis-Segura","doi":"10.1016/j.msard.2024.106235","DOIUrl":"10.1016/j.msard.2024.106235","url":null,"abstract":"<div><div>People with multiple sclerosis (PwMS) suffer cognitive and motor impairments that significantly impact their work life and daily functioning. Because virtual reality (VR) technologies have shown promise in the field of neurorehabilitation, in this study we developed a VR-based cognitive training program and assessed whether it could improve cognitive functioning in a cohort of PwMS (<em>n</em> = 33) and healthy control participants (<em>n</em> = 26). We observed that, in both groups of participants, repeated practice led to a day-by-day increase in correct responses and a progressive reduction in errors in the VR task. More importantly, as revealed by comparisons of the participants’ pre- and post-training scores, practice in the VR task also significantly improved performance in non-trained neuropsychological tests working assessing memory, information processing speed, and upper limb motor functions. Taken together, these findings suggest that training programs using VR technologies can positively impact both cognitive and motor functions in multiple sclerosis, thus offering new tools to prevent or attenuate the cognitive and motor decline experienced by PwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106235"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896207","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":"Sarcopenia in older people with multiple sclerosis: A cross-sectional study","authors":"Tobias Gaemelke ,&nbsp;Ida S Pedersen ,&nbsp;Ulrik Dalgas ,&nbsp;Lars G Hvid","doi":"10.1016/j.msard.2024.106190","DOIUrl":"10.1016/j.msard.2024.106190","url":null,"abstract":"<div><h3>Background</h3><div>Older people with multiple sclerosis (pwMS) make up over one-third of the MS population. Ageing increases the risk of sarcopenia, characterised by reduced muscle mass, strength, and function. MS symptoms likely exacerbate sarcopenia, but its impact on older pwMS remains largely unexplored</div></div><div><h3>Objectives</h3><div>The primary aim of this study was to investigate how the diagnosis of sarcopenia using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) diagnostic tool in older pwMS is influenced by using upper extremity-based or lower extremity-based tests.</div></div><div><h3>Methods</h3><div>The present cross-sectional study analysed baseline data from the PoTOMS trial. A total of <em>n</em> = 41 older pwMS and <em>n</em> = 27 healthy controls (HC) were included. Participants were assessed for sarcopenia using the EWGSOP2 diagnostic tools and a lower extremity muscle strength test.</div></div><div><h3>Results</h3><div>Older pwMS had a preferentially lower muscle mass and strength in the lower extremities compared to HC. According to EWGSOP2 criteria, 5 % of older pwMS had reduced upper extremity strength, 7 % had reduced lower extremity strength, and 15 % had sarcopenic muscle mass. However, only 5 % were diagnosed with sarcopenia despite these reductions.</div></div><div><h3>Conclusion</h3><div>The present study shows that the sarcopenia diagnosis in older pwMS is more sensitive when using a lower extremity test, underlined by the preferentially lower muscle mass and strength in older pwMS compared to HC. Hence, when evaluating sarcopenia in older pwMS the diagnostics test should rely on the lower extremity test.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106190"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780641","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":"Effect of alemtuzumab on fatigue, quality of life, and patient/caregiver-reported outcomes in relapsing-remitting multiple sclerosis—A real-world evidence study","authors":"Jette Lautrup Frederiksen ,&nbsp;Luca Massacesi ,&nbsp;Helle Hvilsted Nielsen ,&nbsp;Augusto Rini ,&nbsp;Eleonora Baldi ,&nbsp;Massimiliano Mirabella ,&nbsp;Falzone Francesca Maria Antonella ,&nbsp;Giacomo Lus ,&nbsp;Damiano Paolicelli ,&nbsp;Matthias Kant ,&nbsp;Giuseppe Salemi ,&nbsp;Umberto Aguglia ,&nbsp;Cristoforo Comi ,&nbsp;Milena De Riz ,&nbsp;Valeria Barcella ,&nbsp;Heidi Ø. Flemmen ,&nbsp;Alessandra Protti ,&nbsp;Elisabeth Farbu ,&nbsp;Job van Exel ,&nbsp;Øivind Torkildsen","doi":"10.1016/j.msard.2024.106214","DOIUrl":"10.1016/j.msard.2024.106214","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Alemtuzumab is approved in the European Union for treating highly active relapsing-remitting multiple sclerosis (RRMS). Patient-reported outcomes measure the treatment impact on quality of life (QoL), including fatigue, a common symptom in multiple sclerosis (MS). Chronic diseases like MS also affect the patient's caregiver. Thus, understanding the impact on both patients and caregivers is essential for a comprehensive view of MS treatment outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This multi-center prospective, observational study assessed RRMS patients undergoing alemtuzumab treatment, and their caregivers across three European countries (Denmark, Norway, and Italy). The study visits were conducted at baseline, and at Months 3, 6, 12, 18, 24, and 36 (± 1 month). The primary endpoint assessed the effect of alemtuzumab on MS-related fatigue (Fatigue Scale for Motor and Cognitive Functions [FSMC] score). Secondary endpoints included changes in cognition (Symbol Digit Modalities Test [SDMT]), depression (Beck Depression Inventory-Version II [BDI-II]), QoL (29-item Multiple Sclerosis Impact Scale [MSIS-29]), treatment satisfaction (Treatment Satisfaction Questionnaire for Medication [TSQM]), working capacity/daily life activity (Health-Related Productivity Questionnaire [HRPQ]), and clinical evaluation (number of relapses, improvement in Expanded Disability Status Scale [EDSS] score, and need for re-treatment with alemtuzumab/any other treatment). Exploratory endpoints included caregiver perception of patient's QoL, caregiver QoL, and caregiver burden. The sample size (&lt;em&gt;N&lt;/em&gt; = 80) was determined based on the 2-sided &lt;em&gt;t&lt;/em&gt;-test at 5 % significance level. Data were analyzed descriptively. Safety was also evaluated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 87 enrolled patients, 72.4 % (&lt;em&gt;n&lt;/em&gt; = 63) completed all follow-ups. Significant improvement was observed in fatigue (&lt;em&gt;p&lt;/em&gt; &lt; 0.01), with a median (min, max) FSMC score change of −7.3 (−56.0, 34.0) units at the end-of-study (EOS), and clinically relevant improvement (≥ 9 units) noted in approximately 12.5 months. SDMT (3–5 units, &lt;em&gt;p&lt;/em&gt; &lt; 0.05), BDI-II (median score of 9.5, i.e., no depression, &lt;em&gt;p&lt;/em&gt; &lt; 0.01), and MSIS-29 (median change in physical and psychological impact scores -9.2, &lt;em&gt;p&lt;/em&gt; &lt; 0.01 and −14.8, &lt;em&gt;p&lt;/em&gt; &lt; 0.001, respectively) improved significantly from baseline to EOS. Global treatment satisfaction (&lt;em&gt;p&lt;/em&gt; &lt; 0.001), effectiveness (&lt;em&gt;p&lt;/em&gt; &lt; 0.05), and side effects (&lt;em&gt;p&lt;/em&gt; &lt; 0.05) significant improved exept at EOS, whereas treatment convenience remained same throughout the study. The percentage of patients with at least one relapse was similar each year of the study (10.8–13.2 %). A statistically significant improvement (&lt;em&gt;p&lt;/em&gt; &lt; 0.05) in EDSS was reported over time. At EOS, 4.5 % patients needed retreatment with alemtuzumab. Caregivers also reported improvement in patients’ QoL ","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106214"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791794","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":"8. Agreement of Large Language Models with Humans in Extracting Data from Unstructured Records of Multiple Sclerosis Patients","authors":"Zainab Ali Alnhwi ,&nbsp;Faisal Saleh Aleisa ,&nbsp;Walaa Fahad Almutawa ,&nbsp;Hamad Saleh Alamro ,&nbsp;Atheer Hussain Alanazi ,&nbsp;Abdulrhman Aljouie ,&nbsp;Ahmad Abulaban","doi":"10.1016/j.msard.2024.105969","DOIUrl":"10.1016/j.msard.2024.105969","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background/Objective(s)&lt;/h3&gt;&lt;div&gt;Multiple Sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system, leading to progressive neurological dysfunction, occurs in individuals aged 20-40 years. Monitoring MS progression often involves the Expanded Disability Status Scale (EDSS), though its accuracy can be compromised in elderly patients with comorbidities. Artificial Intelligence (AI) and Large Language Models (LLMs) have revolutionized data analysis and decision-making processes in healthcare. Machine Learning (ML), a core component of AI, enhances its efficacy through data-driven learning, particularly in Natural Language Processing (NLP) applications which extract information from narrative data. LLMs, exemplified by models like GPT-4, generate human-like responses by utilizing self-supervised learning techniques and extensive text training.&lt;/div&gt;&lt;div&gt;Recent studies have highlighted the capabilities of LLMs in medical data tasks, such as calculating medical scores and extracting information from clinical notes. However, no studies have compared LLMs with human performance in extracting data specifically from unstructured MS patient records.&lt;/div&gt;&lt;div&gt;This study aims to measure the agreement between LLMs and humans in extracting data from unstructured records of MS patients at the National Guard Health Affairs (NGHA) in Saudi Arabia, highlighting the potential and limitations of LLMs in this context.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material(s) and Method(s)&lt;/h3&gt;&lt;div&gt;This cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) and King Abdullah International Medical Research Centre (KAIMRC). A total of 382 patients diagnosed with MS, aged over 14 years, were included. Patients with atypical MS presentations or incomplete medical records were excluded. The primary variables of interest were EDSS scores, Disease-Modifying Therapies (DMTs), and the number and characteristics of relapses. Secondary variables included patient demographics, smoking status, body metrics, date of first MS symptoms, diagnosis date, secondary diseases, and MRI findings. Data were extracted from clinical notes using a Phi-3 Mini 128K LLM running on a local AI workstation, with manual data extraction for comparison by trained students. Statistical analyses included the Kappa coefficient for categorical variables and the Intraclass Correlation Coefficient (ICC) for numerical variables, with significance set at p &lt; 0.05. Analyses were conducted using SAS 9.4 on an AI workstation equipped with an AMD threadripper pro CPU, 258 GB of memory, and two NVIDIA RTX A6000 GPUs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result(s)&lt;/h3&gt;&lt;div&gt;The analysis revealed that the agreement between human annotators and the Phi-3 Mini LLM for extracting clinical data from unstructured MS patient records was lower than expected. The ICC for the EDSS and the number of clinical relapses were -0.4123 and 0.3848, respectively, indicating weak agreement. The model demonstrated limited ","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 105969"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155794","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":"9. Clinical Profile of Seizures in Multiple Sclerosis Patients in a Tertiary Care Center","authors":"Eythar Alrushid ,&nbsp;Thamer S. Alhowaish ,&nbsp;Noof Alamri ,&nbsp;Nora Zaid Bensaeed ,&nbsp;Ali Alanazi ,&nbsp;Ahmad Abulaban","doi":"10.1016/j.msard.2024.105970","DOIUrl":"10.1016/j.msard.2024.105970","url":null,"abstract":"<div><h3>Background/Objective(s)</h3><div>Seizures can occur in patients with multiple sclerosis (MS). The mechanisms underlying seizures and their impact on MS progression remain unclear. The aim of this cohort is to explore the relationship between multiple sclerosis and seizures and investigate aspects such as prevalence, manifestations, risk factors, management, and outcomes to improve our understanding of this association.</div></div><div><h3>Material(s) and Method(s)</h3><div>A single-center retrospective cohort study that included 55 patients. All patients with a confirmed diagnosis of multiple sclerosis and had one or more seizures were included from 2016 to 2022. Data collected included patient demographics, multiple sclerosis characteristics, course of seizures or epilepsy, medications, and MRI findings.</div></div><div><h3>Result(s)</h3><div>Of 1244 MS patients, 55 patients had at least one seizure, with a prevalence of 4.4%. Of the 55 MS patients with seizures, two-thirds were females, predominantly exhibiting Relapsing-Remitting MS (RRMS). In more than two-thirds (72.7%) of the patients, the seizures occurred before the age of 30. In 31 patients (56.4 %), seizures occurred more than twice. Infection was the most common risk factor for seizures (10.9%). Seizures were controlled in 31 patients (56.4%) and the majority were dependent on a single anticonvulsant; the most commonly prescribed medication was levetiracetam. Of patients diagnosed with MS under the age of 20, 54.5% experienced early-onset seizures compared to 33.3% diagnosed at age 30 or older (P=.011). In addition, 63.6% of MS patients diagnosed early had more than two seizures, compared with 40% of those diagnosed after 30 years (P=0.048). Common MRI findings included cortical atrophy, particularly in the temporal lobe.</div></div><div><h3>Conclusion(s)</h3><div>Seizures occurred in 4.4% of patients and were more common in women and young patients. RRMS MS is the predominant type. In more than half of the patients, seizures occurred more than twice. The most common risk factor for seizures was infection. In more than half of the patients, the seizure could be controlled with a single medication. The younger the patients were, the more likely they were to have an early onset of seizures and a recurrence of seizures. Common MRI findings included cortical atrophy, particularly in the temporal lobe. This study provides valuable insight into the complicated relationship between MS and seizures, taking into account demographic trends, predominant MS subtypes, clinical manifestations, therapeutic approaches, and radiologic features.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 105970"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155795","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":"25. Disconnection and Atrophy in Brain Regions of MS Converters: Insights into Disease Progression","authors":"Salem Hannoun ,&nbsp;Sola Ghazal ,&nbsp;Lean Halawi ,&nbsp;Cezar Al-Dahouk ,&nbsp;Nabil K. El-Ayoubi ,&nbsp;Samia J. Khoury","doi":"10.1016/j.msard.2024.105986","DOIUrl":"10.1016/j.msard.2024.105986","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background/Objective(s)&lt;/h3&gt;&lt;div&gt;Multiple sclerosis (MS) is a neurodegenerative disorder characterized by demyelination, axonal loss, and brain atrophy, leading to progressive disability. Differentiating patients who convert from relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS) remains a critical challenge, as early identification of converters can significantly impact treatment strategies. This study explores specific brain regions associated with disconnection probabilities and volume reductions, aiming to identify potential MRI biomarkers predictive of conversion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material(s) and Method(s)&lt;/h3&gt;&lt;div&gt;We conducted a retrospective analysis of 47 RRMS patients (17 Converters and 30 non-converters) who underwent baseline and follow-up MRI scans approximately 1.5 years apart. Mixed-effects models were employed to evaluate the interaction between conversion status (converters vs. non-converters) and time across various brain regions, focusing on disconnection probabilities and volumetric changes measured using the Vol2Brain tool.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result(s)&lt;/h3&gt;&lt;div&gt;Converters exhibited significant disconnection in several key white matter tracts, including the uncinate fasciculus (left), corticobulbar tract (left), superior longitudinal fasciculus (left), and cingulum parahippocampal parietal (right). These disconnections are linked to the neural circuits involved in cognitive, emotional, and motor functions, suggesting that their disruption may contribute to the clinical progression observed in SPMS. Additionally, converters showed increased disconnection in the corticostriatal tract superior (right) and corpus callosum forceps minor, highlighting the widespread impact of MS on interhemispheric communication and motor coordination.&lt;/div&gt;&lt;div&gt;Grey matter atrophy was also more pronounced in converters, particularly in the precentral gyrus, temporal lobe, and thalamus, regions critical for motor and cognitive functions. The reduction in grey matter volume was paralleled by significant decreases in the volumes of the caudate, amygdala, and thalamus, suggesting a broad impact on brain structures essential for motor control, emotion regulation, and executive function.&lt;/div&gt;&lt;div&gt;Interestingly, lesion burden and volume, especially in juxtacortical areas, were significantly greater in converters, reinforcing the relationship between lesion load and disease progression. Increased third ventricle volume in converters further indicated a higher degree of global brain atrophy, reflecting overall disease severity. Notably, the corpus callosum forceps major showed increased disconnection, pointing to its role in the advanced stages of MS as a critical area for interhemispheric integration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion(s)&lt;/h3&gt;&lt;div&gt;The findings highlight that specific patterns of white matter disconnection and regional brain atrophy are strongly associated with conversion from RRMS to SPMS. These MRI biomarkers provid","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 105986"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155838","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}