Multiple sclerosis and related disorders最新文献

{"title":"Efficacy and safety of Bruton’s tyrosine kinase inhibitors compared to Teriflunomide in relapsing multiple sclerosis: A systematic review and meta-analysis","authors":"Milene Vitória Sampaio Sobral ,&nbsp;Helen Michaela de Oliveira ,&nbsp;Altair Pereira de Melo Neto ,&nbsp;Thales Pardini Fagundes","doi":"10.1016/j.msard.2026.106974","DOIUrl":"10.1016/j.msard.2026.106974","url":null,"abstract":"<div><h3>Introduction</h3><div>Traditional disease-modifying therapies (DMTs) reduce relapse frequency in relapsing–remitting multiple sclerosis (MS) but have a limited impact on relapse-independent progression, underscoring the need for novel therapies. Bruton’s tyrosine kinase inhibitors (BTKis), with dual immunomodulatory effects and central nervous system penetration, offer a promising alternative for comparison with established agents such as teriflunomide.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Cochrane CENTRAL up to June 2025 for randomized controlled trials (RCTs) comparing BTKis with teriflunomide in patients with relapsing MS. The primary outcome was confirmed disability worsening (CDW) at 3 and 6 months. Secondary outcomes included annualized relapse rate (ARR), magnetic resonance imaging (MRI) lesion activity, and adverse events. Random-effects meta-analyses were performed using hazard ratios (HRs), rate ratios, risk ratios, and mean differences, as appropriate.</div></div><div><h3>Results</h3><div>Four RCTs with 4136 participants were included. ARR was similar between the groups (Rate Ratio: 1.03; 95% CI: 0.90–1.19). BTK inhibitors reduced the risk of 3-month CDW compared with teriflunomide (HR: 0.81; 95% CI: 0.67–0.97) but not 6-month CDW (HR: 0.88; 95% CI: 0.63–1.24). The slight but significant difference in new T1 gadolinium-enhancing lesions favored teriflunomide (MD: 0.20; 95% CI: 0.15–0.25), whereas no difference was found in new or enlarging T2 lesions (MD:0.07; 95% CI:0.85 to 0.71). The incidence of serious adverse events was comparable between the groups (RR: 1.13; 95% CI: 0.92–1.40).</div></div><div><h3>Conclusion</h3><div>Compared with teriflunomide, BTK inhibitors were associated with a reduced risk of short-term disability progression, whereas no differences were observed in relapse rates, MRI activity, or safety outcomes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106974"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939983","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":"Neurological and paraclinical features differentiating Systemic lupus erythematosus, Sjögren’s disease, and neuromyelitis optica spectrum disorders","authors":"Ivna Lacerda Pereira Nóbrega ,&nbsp;Melissa Macedo Peixoto Nascimento ,&nbsp;Igor Bessa Santiago ,&nbsp;Jozélio Freire de Carvalho ,&nbsp;Milena Sales Pitombeira ,&nbsp;Carlos Ewerton Maia Rodrigues","doi":"10.1016/j.msard.2026.106972","DOIUrl":"10.1016/j.msard.2026.106972","url":null,"abstract":"<div><h3>Purpose of Review</h3><div>To compare and elucidate the distinguishing clinical, laboratory, and imaging features of neuromyelitis optica spectrum disorder (NMOSD) when it occurs alone and when it coexists with systemic lupus erythematosus (SLE) or Sjögren’s disease (SjD).</div></div><div><h3>Recent Findings</h3><div>NMOSD is a chronic inflammatory autoimmune astrocitophaty that causes multifocal central nervous system involvement, primarily affecting the optic nerves and spinal cord. Serological testing for AQP4-IgG is the hallmark of NMOSD diagnosis. These antibodies are highly specific for NMOSD and are essential for differentiating it from SLE and SS, which usually test negative for this marker. Around 20–30% of NMOSD patients have associated autoimmune comorbidities, most commonly SLE and SjD, suggesting shared underlying autoimmune mechanisms. In SLE with NMOSD, central nervous system events are more frequent, while SjD often presents with predominant peripheral nervous system involvement.</div></div><div><h3>Summary</h3><div>Patients with NMOSD and concurrent SLE or SjD have higher morbidity, with increased risk of complications such as paraplegia and seizures, and longer hospital stays compared to those without these comorbidities. NMOSD represents a distinct disease process rather than a neurological complication of SLE or SjD. Identifying distinguishing clinical, laboratory, and imaging features is crucial for accurate diagnosis, guiding treatment strategies, and improving outcomes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106972"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030418","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":"Brain states analysis of EEG predicts multiple sclerosis and mirrors disease duration and burden","authors":"István Mórocz ,&nbsp;Mojtaba Jouzizadeh ,&nbsp;Amir Hossein Ghaderi ,&nbsp;Hamed Cheraghmakani ,&nbsp;Seyed Mohammad Baghbanian ,&nbsp;Reza Khanbabaie ,&nbsp;Andrei Mogoutov","doi":"10.1016/j.msard.2026.106981","DOIUrl":"10.1016/j.msard.2026.106981","url":null,"abstract":"<div><h3>Background:</h3><div>Any treatment of multiple sclerosis should preserve mental function, considering how cognitive deterioration interferes with quality of life. However, mental assessment is still realized with neuro-psychological tests without monitoring cognition on neurobiological grounds whereas the ongoing neural activity is readily observable and readable.</div></div><div><h3>Objective:</h3><div>The proposed method deciphers electrical brain states which as multi-dimensional cognetoms quantitatively discriminate normal from pathological patterns in an EEG.</div></div><div><h3>Method:</h3><div>Baseline recordings from a prior EEG study of 88 subjects, 36 with MS, were analyzed. Spectral bands served to compute cognetoms and categorize subsequent feature combination sets.</div></div><div><h3>Result:</h3><div>The brain states predictor correlates with disease burden and duration. Using cognetoms and spectral bands, a cross-sectional comparison separated patients from controls with a precision of 85% while using bands alone arrived at 79%.</div></div><div><h3>Conclusion:</h3><div>We demonstrate the efficiency of the quantitative data-driven method based on brain states analysis by contrasting EEG data of patients with MS and healthy subjects. The congruity with disease severity and duration is a neurophysiological indicator for disease accumulation over time. We discuss potential applications of the approach for the monitoring of disease time course and treatment efficacy in longitudinal clinical studies in psychiatry and neurology.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106981"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978467","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":"Chronic stress amplifies multidimensional disease activity in multiple sclerosis patients: A year-long within-person analysis","authors":"Omri Zveik-Lavi ,&nbsp;Dvir Green ,&nbsp;Ariel Rechtman ,&nbsp;Tal Ganz ,&nbsp;Tal Friedman-Korn ,&nbsp;Garrick Hoichman ,&nbsp;Lyne Shweiki ,&nbsp;Dana Ekstein ,&nbsp;Adi Vaknin-Dembinsky","doi":"10.1016/j.msard.2026.106965","DOIUrl":"10.1016/j.msard.2026.106965","url":null,"abstract":"<div><h3>Background</h3><div>Chronic psychological stress is suspected to intensify disease activity in multiple sclerosis (MS), yet longitudinal real-world evidence remains limited. This study aims to determine whether the first year of the war in Israel during 2023-2024, a period of sustained nationwide stress, was associated with increased composite evidence of disease activity (EDA-3) in people with MS (pwMS).</div></div><div><h3>Methods</h3><div>We conducted a retrospective case-control study of 930 pwMS followed at Hadassah Medical Center who had ≥1 annual visit across three consecutive years. Within-person comparisons were made between the war year (P3, 07/10/2023-06/10/2024) and the preceding year (P2). The primary outcome was EDA-3 (clinical relapse, confirmed EDSS worsening, or magnetic resonance imaging [MRI] activity). Each component of EDA-3, as well as treatment modifications, was also evaluated independently.</div></div><div><h3>Results</h3><div>EDA-3 prevalence was significantly higher during the war year (17.42%, 162/930) than pre-war (13.87%, 129/930; odds ratio [OR]=1.34, 95%-confidence interval [CI]: 1.02-1.76, p=0.034). Effects were more pronounced in males (OR=1.72, 95%-CI: 1.07-2.83; p=0.024) and in patients with EDSS≥4 (OR=1.77, 95%-CI: 1.20-2.63; p=0.0034). MRI activity increased from 11.77% to 17.54% (OR=1.83, 95%-CI: 1.14-2.98; p=0.011). Annualized relapse rate (ARR) showed a non-significant increase (p=0.068), and treatment modification rates were stable (switches: p=0.92; escalations: p=0.42). Results persisted after excluding pre-war DMT switchers (OR=1.55, 95%-CI: 1.147-2.122; p=0.004).</div></div><div><h3>Conclusion</h3><div>Sustained war-related stress coincided with clinically significant, multidimensional increases in MS disease activity, predominantly driven by MRI activity, with disproportionate impacts on males and higher-disability patients. These findings position chronic stress as a modifiable risk factor, advocating for integrated stress mitigation and proactive enhanced monitoring in MS care during prolonged crises.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106965"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978569","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 detection of paramagnetic rim lesions and their association with disease burden in multiple sclerosis","authors":"Olavi Misin ,&nbsp;Anni Piispanen ,&nbsp;Markus Matilainen ,&nbsp;Riitta Parkkola ,&nbsp;Mikko Nyman ,&nbsp;Teija Sainio ,&nbsp;Jussi Hirvonen ,&nbsp;Laura Airas","doi":"10.1016/j.msard.2026.107012","DOIUrl":"10.1016/j.msard.2026.107012","url":null,"abstract":"<div><h3>Background</h3><div>Paramagnetic rim lesions (PRLs) are an emerging MRI biomarker in multiple sclerosis (MS). On susceptibility-sensitive MRI, PRLs are characterized by a paramagnetic shift at the lesion rim corresponding to iron-laden macrophages and microglia, and PRL detection can hence be viewed as a proxy for lesion-associated smoldering inflammation in MS brain. The aim of this study was to identify PRLs in a standard university hospital setting to explore the associations between PRL burden and MS-related clinical and paraclinical parameters.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed all 3T brain MRI studies performed as part of MS patient management at a tertiary university hospital in Finland between September 2021 and December 2023. PRLs were visually identified on filtered phase images from susceptibility-weighted imaging (SWI) sequences. Brain volumetric data were extracted from post-contrast 3D T1-weighted images using an automated quantification tool (cNeuro® cMRI). Clinical and laboratory variables were obtained by manual chart review from electronic medical records.</div></div><div><h3>Results</h3><div>The final cohort included 206 patients. 34% of patients had at least one PRL (the PRL1+ group). The median number of PRLs in the PRL1+ group was 2 and the maximum number was 11. Within the PRL1+ group, PRL count correlated positively with Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS) and T2 lesion volume. Patients with PRLs had significantly smaller thalami compared to those without PRLs.</div></div><div><h3>Discussion</h3><div>Our real-world data reinforce evidence that PRLs are linked to more severe disease and demonstrate that PRL identification using manufacturer-reconstructed SWI filtered phase images provides a feasible imaging parameter to assess progression-associated pathology in MS in a standard clinical setting.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107012"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019191","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":"Dynamics of plasma fibrinogen unveils hepatic initiating role in the pathogenesis of multiple sclerosis","authors":"Jiaji Lin ,&nbsp;Xinyan Han ,&nbsp;Chuanping Zhao ,&nbsp;Yanan Bai ,&nbsp;Weitai He ,&nbsp;Xiaoli Liu ,&nbsp;Daidi Zhao ,&nbsp;Hongzeng Li ,&nbsp;Jun Guo","doi":"10.1016/j.msard.2025.106896","DOIUrl":"10.1016/j.msard.2025.106896","url":null,"abstract":"<div><h3>Background</h3><div>Fibrinogen deposition in the central nervous system (CNS) is a hallmark of multiple sclerosis (MS), but its peripheral dynamics and hepatic contribution remain unclear.</div></div><div><h3>Methods</h3><div>We integrated a retrospective analysis of 100 MS patients with longitudinal proteomic and transcriptomic profiling of experimental autoimmune encephalomyelitis (EAE) mice, validated by flow cytometry, western blotting, and AAV8-mediated liver-specific fibrinogen overexpression.</div></div><div><h3>Results</h3><div>MS patients during relapse showed reduced plasma fibrinogen (2.43 ± 0.61 vs. 2.79 ± 0.60 g/L, <em>P</em> &lt; 0.001) and altered hepatic indices. In EAE, fibrinogen chains and complement–coagulation cascades peaked at the pre-onset phase but declined at peak disease, coinciding with hepatic transcriptional exhaustion. Cross-tissue analysis identified hepatic activity as a major driver of plasma proteome remodeling (Variable importance in projection (VIP) = 1.32) with increased hepatic CD45⁺Ly6G⁺CD11b⁺ neutrophils. Liver-specific fibrinogen overexpression induced intrahepatic neutrophil recruitment and CNS fibrinogen deposition.</div></div><div><h3>Conclusions</h3><div>Hepatic fibrinogen synthesis precedes CNS deposition, revealing a liver–CNS axis in early neuroinflammation.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106896"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834452","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":"Inter-assay variability in anti–JC virus testing for natalizumab: A Spanish cohort","authors":"Luis Fernández Espigares ,&nbsp;Alicia Fernández Panadero ,&nbsp;María Díaz Sánchez ,&nbsp;José Luis Casado Chocán ,&nbsp;Eduardo Durán Ferreras","doi":"10.1016/j.msard.2026.107023","DOIUrl":"10.1016/j.msard.2026.107023","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate anti–JC virus (JCV) antibody testing is essential for progressive multifocal leukoencephalopathy (PML) risk stratification in natalizumab-treated patients. This study assessed evaluated inter-assay concordance between ImmunoWELL™ JCV IgG and STRATIFYJCV™ DxSelect™.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional inter-assay concordance study including 48 patients with multiple sclerosis treated with natalizumab. Paired serum samples were analyzed using both assays. Binary serostatus and ordinal risk categories (negative, low, intermediate, high) according to antibody index value were compared.</div></div><div><h3>Results</h3><div>STRATIFYJCV™ identified 4.2% of patients as JCV positive versus 33.3% with ImmunoWELL™, an eightfold difference. Overall binary agreement was 66.7%, with PABAK 0.33 (95% CI 0.12–0.54) and significant directional discordance (p = 0.0005). Most discordant results reflected upward reclassification from negative to low or intermediate categories. Only one patient changed high-risk status. A single discordant negative result was identified.</div></div><div><h3>Conclusions</h3><div>ImmunoWELL™ and STRATIFYJCV™ show relevant inter-assay variability, predominantly affecting low antibody index values, while preserving substantial agreement at clinically decisive high-risk thresholds. These findings support cautious interpretation of ImmunoWELL™ results and highlight the need for further virological validation.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107023"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034581","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":"Cognitive reserve and its contribution to predicting cognitive performance in multiple sclerosis","authors":"Sadra Habibi Moini ,&nbsp;Majid Hamidi ,&nbsp;Ali Rezaei ,&nbsp;Zahra Sarvestani ,&nbsp;Zahra Azizan ,&nbsp;Seyed Ehsan Mohammadianinejad ,&nbsp;Mohammad Hossein Harirchian","doi":"10.1016/j.msard.2026.106985","DOIUrl":"10.1016/j.msard.2026.106985","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a prevalent challenge in individuals with multiple sclerosis (MS). Cognitive reserve (CR), a multifaceted concept has been shown to have a protective role against cognitive decline. This study explores the association between cognitive reserve as measured by Cognitive Reserve Index questionnaire (CRIq), cognitive scores, and patients’ characteristics in MS patients. Additionally, we compared the predictive value of CR in cognitive function when measured by education alone versus the CRIq to examine the advantages of latter model.</div></div><div><h3>Materials and methods</h3><div>A total of 81 patients (39.22 ± 8.09 years old, 64 female) were recruited for the study and completed the interview. Cognitive function was evaluated with the “Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). CRIq and depression questionnaires were also obtained.</div></div><div><h3>Results</h3><div>CRIq score had significant correlation with all three age-adjusted cognitive test scores (rho = 0.551, 0.392, 0.418 for information processing speed, verbal memory and visuospatial memory respectively, p &lt; 0.001 for all tests). The inclusion of CRIq significantly improved the cognitive function models, accounting for an additional 10.8% to 18.7% of the explained variance beyond age, and clinical predictors. In hierarchical regression models, education did not provide significant additional predictive value beyond CRIq scores across all three cognitive tests.</div></div><div><h3>Conclusions</h3><div>The CRIq provides a more comprehensive measure of CR than formal education alone, underscoring the multidimensional nature of cognitive enrichment in adults.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106985"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034583","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":"Transcranial magnetic stimulation outcomes as biomarkers of multiple sclerosis disease progression: A structured literature review","authors":"Nicholas J. Snow,&nbsp;Basel O. Mohamed ,&nbsp;Sarah A. Duraid ,&nbsp;Michelle Ploughman","doi":"10.1016/j.msard.2026.107035","DOIUrl":"10.1016/j.msard.2026.107035","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is an immune-mediated central nervous system (CNS) disease and a leading cause of disability in young adults. Chronic disability progression is an unmet challenge for persons with MS and an area of interest for the development of biomarkers. Transcranial magnetic stimulation (TMS) is a putative technique for the development of MS biomarkers. However, TMS outcomes have not been extensively reviewed as biomarkers of disability progression in MS to date. This structured literature review assessed longitudinal and cross-sectional studies of TMS and disability progression in MS. Of the TMS techniques reviewed, central motor conduction time (CMCT), motor evoked potential (MEP) onset latency, and MEP amplitude demonstrated the best clinical performance as markers of CNS demyelination and neuro-axonal damage. While studies showed notable cross-sectional differences in TMS outcomes between persons with progressive and relapsing MS, these findings were less well-supported by longitudinal studies. Across studies, effect sizes were variable, sensitivity and specificity were underreported, and correlations with disability outcomes were heterogeneous. Studies were limited by small sample sizes, short follow-up periods, lack of standardized disability progression definition and TMS methods, and low reporting of diagnostic accuracy. We found insufficient evidence to presently justify the use of TMS techniques as biomarkers of MS disease progression. Future studies should address current limitations.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107035"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078477","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":"Rare demyelinating autoimmune diseases and pregnancy outcomes","authors":"Dorothy Gheorghiu ,&nbsp;Danielle Kapustin ,&nbsp;Monica Diaz ,&nbsp;Robert Sharkus ,&nbsp;Benjamin Osborne ,&nbsp;Taegan Vinarsky ,&nbsp;Francesca Bagnato ,&nbsp;Michael Lutz ,&nbsp;Suma Shah","doi":"10.1016/j.msard.2026.106975","DOIUrl":"10.1016/j.msard.2026.106975","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are demyelinating autoimmune diseases that often occur in women of reproductive age. The aim of this study is to characterize pregnancy outcomes in women with NMO or MOGAD.</div></div><div><h3>Methods</h3><div>Retrospective chart review data were collected from four academic medical institutions in the Southeast United States using a REDCap-based tool.</div></div><div><h3>Results</h3><div>Data from 59 patients representing 101 NMO and 59 MOGAD pregnancies were included. The present sample showed reduced rates of spontaneous abortion (SAB) at 6.9% in patients with NMO compared to patients with MS (17.3%, <em>p</em> = 0.045). Intrauterine fetal demise (IUFD) was more frequent in patients with NMO (1.98%) than in the general population (0.38%, <em>p</em> = 0.042). Only 10.2% of MOGAD pregnancies and 20.8% of NMO pregnancies were uncomplicated. No differences between groups existed for preeclampsia or preterm delivery. This cohort demonstrated similar rates of vaginal and cesarean delivery between groups. Relapse rates were lowest during pregnancy and highest postpartum for both groups.</div></div><div><h3>Discussion</h3><div>Women with NMO and MOGAD had fewer spontaneous abortions than both comparison groups, but more frequent complications. Unlike prior studies evaluating MS and NMO in pregnancy, this cohort did not demonstrate higher rates of preeclampsia or preterm birth. This study observed significantly fewer relapses during pregnancy and significantly more relapses postpartum for NMO and MOGAD subgroups. Patients who received disease-modifying therapy had the fewest relapses. These data show that MOGAD and NMO have similarities with MS in terms of pregnancy outcomes but suggest differences that require tailored treatment through pregnancy.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106975"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934440","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}