Multiple sclerosis and related disorders最新文献

{"title":"Appointment non-attendance is associated with disease modifying therapy persistence the following year","authors":"Elizabeth S. Gromisch ,&nbsp;Aaron P. Turner ,&nbsp;Steven L. Leipertz ,&nbsp;John Beauvais ,&nbsp;Jodie K. Haselkorn","doi":"10.1016/j.msard.2024.106179","DOIUrl":"10.1016/j.msard.2024.106179","url":null,"abstract":"<div><h3>Background</h3><div>It is recommended that healthcare providers and persons with multiple sclerosis (MS) have discussions prior to discontinuing a disease modifying therapy (DMT). However, if these appointments missed, either as a no show (NS) or short-notice cancellation (SNC), these discussions do not take place and may result in premature discontinuation. This study aimed to explore whether appointment non-attendance was predictive of DMT persistence the following year.</div></div><div><h3>Methods</h3><div>Electronic health record data from Veterans with MS (<em>n</em> = 3,742) in the Department of Veterans Affairs (VA) MS Center of Excellence Data Repository were examined during two time frames: January 2013 – December 2013 (Year 1) and January 2014 – December 2014 (Year 2). DMT non-persistence was defined as discontinuing a DMT and not restarting another one within 90 days. The proportion of each type of missed appointment in Year 1 was calculated by dividing the number of NS and SNC by the total number of scheduled appointments during that time frame, respectively. Logistic regressions were run for each appointment non-attendance behavior, with Year 2 non-persistence as the outcome and age, sex, race, number of comorbidities, time since initial DMT, and Year 1 non-persistence as covariates.</div></div><div><h3>Results</h3><div>Veterans who were non-persistent in Year 2 (<em>n</em> = 563) had a higher proportion of NS (6.5 % vs. 4.6 %, <em>p</em> &lt; .001) and SNC (6.7 % vs 5.7 %, <em>p</em> = .002) in Year 1. After adjusting for demographics and DMT history, both the proportion of NS (<em>aOR</em> = 5.01, 95 % CI: 1.82, 13.29, <em>p</em> = .001) and SNC (<em>aOR</em> = 3.86, 95 % CI: 1.09, 12.90, <em>p</em> = .032) in Year 1 were significantly associated with non-persistence the following year.</div></div><div><h3>Conclusions</h3><div>Appointment non-attendance was associated with DMT non-persistence the following year, with both higher proportions of NS and SNC being significant contributors after controlling for demographics and DMT history. These findings highlight the potential effects of disruption to care for persons with MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106179"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The real-world impact of biologics for NMOSD: A retrospective single-center study compared with natural course and conventional treatments in Japanese","authors":"Naoya Yamazaki ,&nbsp;Tatsuro Misu ,&nbsp;Yuki Matsumoto ,&nbsp;Yoshiki Takai ,&nbsp;Chihiro Namatame ,&nbsp;Hirohiko Ono ,&nbsp;Kimihiko Kaneko ,&nbsp;Shuhei Nishiyama ,&nbsp;Hiroshi Kuroda ,&nbsp;Toshiyuki Takahashi ,&nbsp;Ichiro Nakashima ,&nbsp;Kazuo Fujihara ,&nbsp;Masashi Aoki","doi":"10.1016/j.msard.2024.106176","DOIUrl":"10.1016/j.msard.2024.106176","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Neuromyelitis optica spectrum disorder (NMOSD), a central nervous system inflammatory disease associated with aquaporin-4 immunoglobulin G (AQP4-IgG), is conventionally treated with oral steroids and immunosuppressants (IS) in Japan. Several biologics which show great efficacy in the clinical trials have been developed recently. However, studies on their efficacy, especially those comparing them with conventional treatments in real-world situations are lacking.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Here, we conducted a single-center retrospective cohort study in Japan comparing the efficacy of biologics, over conventional drugs, in treating AQP4-IgG-positive NMOSD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We extracted the medical history of patients with AQP4-IgG-positive NMOSD who visited the Tohoku University Hospital between 2000 and 2023, from the hospital patient database. All patients were diagnosed according to the international consensus diagnostic criteria for NMOSD 2015. We then classified the disease duration of each patient into four periods based on their prescription history as: no-treatment, prednisolone monotherapy (PSL-mono), immunosuppressants (IS) treatment, and biologics (Bio) treatment. Subsequently, the efficacy of Bio treatment, over the conventional treatment, in alleviating AQP4-IgG-positive NMOSD was estimated. We used univariate Poisson regression analysis to compare the annualized relapse rate (ARR), log-rank test for the first attack, and the hazard ratios (HR)—calculated using multivariate Andersen-Gill model for recurrent attacks—of the Bio and conventional treatment period groups. The safety of each treatment period group was assessed by comparing infection and mortality rates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 109 patients (92 % females) met the eligibility criteria of the study. We could extract a total of 1,283 patient years with 289 NMOSD attacks from their medical history data. The mean ARR of no-treatment group was 0.60. Most of the Bio group initially received combined treatments with PSL or IS. The mean ARR of the Bio group was 0.01 [95 % confidence interval (CI): 0.002 to 0.08], which was significantly lower than the PSL-mono group (0.16, 95 % CI: 0.13 to 0.19, &lt;em&gt;p&lt;/em&gt; = 0.03) and the IS group (0.17, 95 % CI: 0.13 to 0.22, &lt;em&gt;p&lt;/em&gt; = 0.02). In the survival analysis, the Bio group showed a significantly prolonged attack-free period than the other groups, suggesting its potential in reducing 79 % of relapses in the no-treatment group, 33 % in the PSL-mono group, and 31 % in the IS group during the two years. The multivariate analysis using Andersen-Gill model showed that the Bio group had significantly lower HR (log HR −2.75, 95 % CI: −4.71 to −0.8, &lt;em&gt;p&lt;/em&gt; = 0.006), relative to the PSL-mono group. Importantly, the patients needed significantly lower PSL (median 5 mg/day) during the Bio group treatment period than in the PSL-mono group treatment period (median ","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106176"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695720","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":"Anticonvulsant and gabapentinoids pharmacotherapy in the multiple sclerosis prodrome: A population-based matched cohort study","authors":"Himali Bergeron-Vitez ,&nbsp;Fardowsa LA Yusuf ,&nbsp;Feng Zhu ,&nbsp;Yinshan Zhao ,&nbsp;Charity Evans ,&nbsp;John D Fisk ,&nbsp;Ruth Ann Marrie ,&nbsp;John LK Kramer ,&nbsp;Helen Tremlett","doi":"10.1016/j.msard.2024.106167","DOIUrl":"10.1016/j.msard.2024.106167","url":null,"abstract":"<div><h3>Background</h3><div>Before disease onset, multiple sclerosis (MS) persons fill more prescriptions than controls, including for pain. However, knowledge regarding neuropathic pain-related medications is lacking</div></div><div><h3>Objective</h3><div>Compare odds of anticonvulsant/gabapentinoid prescriptions for 4,862 MS-cases versus 22,669 controls, pre-MS onset (defined as first demyelinating disease-related event).</div></div><div><h3>Methods</h3><div>Matched-cohort study using administrative data (1996–2013), comparing the odds of anticonvulsant/gabapentinoid prescriptions pre-MS onset using multivariable logistic regression.</div></div><div><h3>Results</h3><div>Versus controls, MS-cases were more likely to fill prescriptions for anticonvulsants (aOR[adjusted odds ratios] = 3.1,95 % confidence interval[CI]:2.8,3.4), gabapentinoids (aOR = 4.1,95 %CI:3.6,4.6), and gabapentinoids without anticonvulsants (aOR = 3.9,95 %CI:3.4,4.5).</div></div><div><h3>Conclusion</h3><div>MS-cases filled anticonvulsant and gabapentinoid prescriptions more than matched controls pre-MS onset.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"93 ","pages":"Article 106167"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748669","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":"Multiple Sclerosis and biological definitions in neurodegenerative diseases","authors":"Carlos R. Camara-Lemarroy","doi":"10.1016/j.msard.2024.106175","DOIUrl":"10.1016/j.msard.2024.106175","url":null,"abstract":"<div><div>Recently, biological definitions in Alzheimer´s disease (AD) and Parkinson´s disease (PD) have been proposed, where clinical descriptors such as “dementia” or “parkinsonism” lost the spotlight. Similar changes are in the horizon in Multiple Sclerosis (MS). However, in MS there is no single molecule (like amyloid) to call the main driver of MS pathogenesis. In fact, there has not been a historically steady candidate. Decades ago T-cells were thought to be paramount, then brain atrophy, and recently the heterogeneous concept of \"smoldering disease\". There are no established minimal necessary <em>and</em> sufficient conditions for disease pathogenesis in MS. Ethical issues will be important. Technology for biological/biomarker assessments is not universally available and there is risk of overmedicalization. Groups such as the Movement Disorders Society have expressed reservations about pure biological definitions for PD. In MS, we are just in time to tackle these issues in a critical and constructive way.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106175"},"PeriodicalIF":2.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706600","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":"Frequency of anti-MOG antibodies in serum and CSF of patients with possible autoimmune encephalitis: Results from a Brazilian multicentric study","authors":"Bruna de Freitas Dias ,&nbsp;Fabio Fieni Toso ,&nbsp;Maria Eduarda Slhessarenko Fraife Barreto ,&nbsp;Alessandra Dellavance ,&nbsp;Rodrigo Barbosa Thomaz ,&nbsp;Pedro André Kowacs ,&nbsp;Hélio Teive ,&nbsp;Mariana Spitz ,&nbsp;Aline Freire Borges Juliano ,&nbsp;Letícia Januzi de Almeida Rocha ,&nbsp;Valéria Nogueira Tobias Granja ,&nbsp;Pedro Braga-Neto ,&nbsp;Paulo Ribeiro Nóbrega ,&nbsp;Jamary Oliveira-Filho ,&nbsp;Ronaldo Maciel Dias ,&nbsp;Jaene Andrade Pacheco Amoras ,&nbsp;Renata Brasileiro Reis Pereira ,&nbsp;Clécio de Oliveira Godeiro Júnior ,&nbsp;Fernanda Martins Maia ,&nbsp;Mara Lúcia Santos ,&nbsp;Lívia Almeida Dutra","doi":"10.1016/j.msard.2024.106171","DOIUrl":"10.1016/j.msard.2024.106171","url":null,"abstract":"<div><h3>Introduction</h3><div>MOGAD encephalitis and ADEM share several clinical features with autoimmune encephalitis (AE) associated with antineuronal antibodies (ANeA); nonetheless, treatment and prognosis differ. Anti-MOG antibodies (abs) are not routinely tested in possible AE, and epidemiological studies on MOGAD encephalitis are scarce.</div></div><div><h3>Objectives</h3><div>To determine the frequency of anti-MOG abs in the serum and CSF in a cohort of possible AE and to compare the clinical characteristics of MOGAD patients and those with seropositive AE.</div></div><div><h3>Methods</h3><div>481 patients with possible AE from the Brazilian Autoimmune Encephalitis Network underwent tissue-based assay and cell-based assay (CBA) for ANeA. Anti-MOG abs were assessed in serum and CSF with in-house CBA. Clinical and laboratory characteristics of MOGAD and seropositive AE patients were compared.</div></div><div><h3>Results</h3><div>Of the 481 patients, 87 (18 %) had ANeA, and 17 (3.5 %) had anti-MOG abs. Three AE patients with anti-MOG abs and ANeA were excluded from further analysis. Anti-MOG abs were detected in 4 (1.2 %) of the 328 adults and 10 (6.5 %) of the 153 children. Of the 14 patients with MOGAD, nine had ADEM (mostly children), and five had encephalitis (including three adults). Only one patient with ADEM had anti-MOG abs exclusively in CSF. All patients with MOGAD encephalitis were seropositive for anti-MOG abs, and three had normal brain MRI. Patients with MOGAD had fewer behavioral changes (MOGAD 21 % x AE 96 %, <em>p</em> ≤ 0.0001) and movement disorders (MOGAD 42 % x AE 81 %, <em>p</em> = 0.0017) and more demyelinating symptoms, such as myelitis and optic neuritis (MOGAD 14 % x AE 0 %, <em>p</em> = 0.013).</div></div><div><h3>Conclusion</h3><div>Approximately 3.5 % of patients with possible AE harbor anti-MOG abs, and 0.9 % of the adults had MOGAD encephalitis. Anti-MOG abs were more frequent than other ANeAs regularly tested in AE. We provide evidence that MOGAD is a differential diagnosis in possible AE, even in adult patients with normal brain MRI, and that serum anti-MOG should be considered as an add-on diagnostic tool in AE among adults and pediatric patients.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106171"},"PeriodicalIF":2.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695701","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":"Psychometric properties of patient-reported outcome measures, measuring fatigue in patients with multiple sclerosis, a systematic review","authors":"Miguel Angel Jorquera Ruzzi ,&nbsp;Martí Boix Coll ,&nbsp;María Jose Dura Mata ,&nbsp;María Cristina Ramo Tello ,&nbsp;Irma Casas García","doi":"10.1016/j.msard.2024.106169","DOIUrl":"10.1016/j.msard.2024.106169","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a chronic, inflammatory, degenerative disease of the central nervous system. One of the most common and disabling symptoms is fatigue. More than 80% of people with MS experience fatigue, which has a negative impact on their quality of life and level of independence in daily activities. The multidimensional nature of fatigue makes it essential to understand its impact from the patient's perspective. Patient-reported outcomes (PROs), defined by the FDA as \"any report of a patient's health status that comes directly from the patient, without interpretation of the patient's response by the physician or other health care professional,\" were created to address this need.</div></div><div><h3>Objectives</h3><div>To identify and describe patient-reported outcomes (PROs) that measure the level of fatigue specific to patients with multiple sclerosis.</div><div>To evaluate and analyze the quality of psychometric properties, methodological quality, and risk of bias of patient-reported outcomes that measure the level of fatigue specific to patients with multiple sclerosis.</div></div><div><h3>Methods</h3><div>A systematic psychometric review was conducted and framed according to the standards of the Consensus for the Selection of Measurement Instruments (COSMIN) (Mokkink et al., 2010).</div></div><div><h3>Results</h3><div>A total of 34 studies were included, from which a total of 40 references were extracted, as some studies reported two or more PROMs simultaneously. The evaluation and analysis of the risk of bias shows that the studies present a heterogeneous classification depending on the psychometric property evaluated, i.e. while the frequency of studies classified with low risk of bias is higher in measurement properties such as; structural validity; 25 studies (64.10%), internal consistency 25 studies (64.10%), criterion validity: 29 studies (74.36%). There is also a high frequency of studies rated as high or unclear risk of bias, mainly in psychometric properties such as reliability 19 studies (48.71%), cross-cultural validity measurement invariance 13 studies (33.33%).</div></div><div><h3>Conclusions</h3><div>PRO instruments are the best way to know the patients' perception of their symptomatology in this case of fatigue, which will undoubtedly contribute to a better approach and better intervention strategies in a personalized way, another component in the improvement of the quality of care and in line with the new paradigm of patient-centered care, which requires an assessment of fatigue by means of a PRO instrument. Therefore, it is of utmost importance to consider the current standards in the development of these instruments for a correct use and interpretability of their results.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106169"},"PeriodicalIF":2.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695703","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":"Physical activity improves cardiovascular fitness and reduces cardiovascular risk factors in adults with multiple sclerosis: A systematic review and meta-analysis","authors":"Chun-Chen Lin ,&nbsp;Dominique Kinnett-Hopkins ,&nbsp;Alaa Alawamleh ,&nbsp;Melissa Siemen ,&nbsp;Abbi Lane ,&nbsp;Libak Abou","doi":"10.1016/j.msard.2024.106170","DOIUrl":"10.1016/j.msard.2024.106170","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity is known to be vital for cardiovascular health in the general population, but there is no comprehensive review on the effectiveness of physical activity to modify cardiovascular risk in multiple sclerosis (MS). This systematic review and meta-analysis aims to synthesize the evidence regarding the effectiveness of physical activity programs on modifying traditional cardiovascular risk factors in adults with MS.</div></div><div><h3>Methods</h3><div>Six electronic databases (PubMed, Scopus, Web of Science, CINAHL, Embase, and SPORTDiscuss) provided literature from inception until August 2024. Randomized clinical trials examining physical activity interventions vs control (no intervention/alternative physical activity modality) and targeting cardiovascular risk factors in adults with MS were included. Study screening and quality was assessed using the Cochrane risk of bias tool were conducted by two independent reviewers. Meta-analysis was conducted using RevMan 5.3.</div></div><div><h3>Results</h3><div>Thirty studies were included in the qualitative synthesis and 21 were included in the meta-analysis involving 1,052 participants. Significant improvements in cardiovascular fitness indicators such as VO2 peak, mean difference [MD] = 166.77; 95 % CI: 62.77 to 272.77; <em>P</em> = 0.002, and HR peak [MD] = 3.02; 95 % CI: 1.16 to 4.87; P = 0.001, and peak power output [MD] = 24.28; 95 % CI: 5.73 to 42.83; <em>P</em> = 0.01 were observed. Physical activity was also effective at reducing traditional cardiovascular disease (CVD) risk factors of triglycerides [MD] = -13.64; 95 % CI:9.36 to -17.92; <em>P</em> &lt; 0.00001 and LDL-cholesterol [MD] = -6.61; 95 % CI:8.82 to -4.40; P &lt; 0.00001 and total cholesterol [MD] = -8.35; 95 % CI:15.26 to -1.45; <em>P</em> = 0.02 and resulted in a significant decrease in body fat percentage [MD] = -1.56; 95 % CI:2.36 to -0.76; <em>P</em> = 0.0001.</div></div><div><h3>Conclusions</h3><div>Physical activity appears beneficial in improving cardiovascular fitness and managing some traditional CVD risk factors in adults with MS. Tailored interventions such as Pilates, aerobic exercise, and combined aerobic and resistance training warrant further investigation due to their positive outcomes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106170"},"PeriodicalIF":2.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693310","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":"Neurofilament light in serum: Reference values and effect of risk factors for multiple sclerosis","authors":"Helle Bach Søndergaard ,&nbsp;Anna Olsson ,&nbsp;Stefan Gustavsen ,&nbsp;Cecilie Ammitzbøll ,&nbsp;Lise Wegner Thørner ,&nbsp;Erik Sørensen ,&nbsp;Marie Krogh Nielsen ,&nbsp;Josefine Britze ,&nbsp;Signe Modvig ,&nbsp;Poul Erik Hyldgaard Jensen ,&nbsp;Torben Lykke Sørensen ,&nbsp;Annette Bang Oturai ,&nbsp;Finn Sellebjerg","doi":"10.1016/j.msard.2024.106166","DOIUrl":"10.1016/j.msard.2024.106166","url":null,"abstract":"<div><h3>Background</h3><div>The measurement of neurofilament light (NFL) in blood samples has been established as a sensitive measure of neuroaxonal damage in a wide range of diseases in the peripheral and central nervous system, including multiple sclerosis (MS). Previous studies have identified confounding factors that may influence the serum concentration of NFL.</div></div><div><h3>Aim</h3><div>We aimed at investigating the relationship between known confounders (age, body mass index, blood volume) and risk factors for MS (smoking and human leukocyte antigen (HLA)) on serum concentrations of NFL in control subjects. In addition, we compared different methods for correction for confounders when applied to newly diagnosed patients with MS.</div></div><div><h3>Methods</h3><div>We measured serum concentrations of NFL by single molecule array analysis in 1.101 control subjects without neurological disease from 4 different cohorts (including 906 healthy blood donors) and 72 patients with newly diagnosed relapsing-remitting MS. A questionnaire on smoking habits was distributed to the 906 healthy blood donors, and the HLA risk alleles <em>HLA-DRB1*15:01</em> and <em>HLA-A*02:01</em> were genotyped by TaqMan allelic-discrimination PCR analysis in these subjects.</div></div><div><h3>Results</h3><div>We confirmed that serum concentrations of NFL increase with age, but we also found that sample storage conditions for the different cohorts of control subjects had a substantial effect. Prolonged storage time and storage at -20° were independently associated with lower serum concentrations of NFL than shorter storage time and storage at -80° In samples from the large cohort of blood donors, we confirmed an association between high BMI and high blood volume with lower serum concentrations of NFL and found that this association was marginally stronger for BMI than for blood volume. We found no association between smoking and HLA risk factors for MS with serum concentrations of NFL in the blood donor cohort. Finally, we found that a simple method for correcting for the effect of age on NFL performed as well as Z-scores, which consider the effect of both age and BMI. This was shown when discriminating between patients with MS and control subjects and between MS patients with and without Gd-enhancing MRI lesions.</div></div><div><h3>Conclusions</h3><div>We confirm an association between serum concentrations of NFL, age, and BMI, but we also find that it may often be sufficient to correct for the effect of age alone. The effect of BMI should, however, be considered along with the effect of other confounding factors, including various comorbidities.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106166"},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693300","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":"Aberrant hippocampal intrinsic morphological connectivity patterns in Neuromyelitis optica spectrum disorder with cognitive impairment: Insights from an individual-based morphological brain network","authors":"Xin Wang ,&nbsp;Yang Yang ,&nbsp;Qianyun Rui ,&nbsp;Yunshu Zhao ,&nbsp;Hui Dai ,&nbsp;Qun Xue ,&nbsp;Yonggang Li","doi":"10.1016/j.msard.2024.106174","DOIUrl":"10.1016/j.msard.2024.106174","url":null,"abstract":"<div><h3>Background</h3><div>Although several clinical studies have demonstrated that hippocampus volume loss in neuromyelitis optica spectrum disorder (NMOSD) may be a significant predictor of cognition, no consensus has been reached. To investigate the alterations of the intrinsic ,hippocampal morphological networks in cognitively impaired NMOSD patients and their correlations with cognitive performance.</div></div><div><h3>Methods</h3><div>38 NMOSD patients and 39 healthy controls (HC) were enrolled. NMOSD patients were categorized into two groups based on neuropsychological assessment, including the cognitively impaired (CI) group (<em>n</em> = 21) and the cognitively preserved (CP) group (<em>n</em> = 17). Brain high-resolution 3D-T1WI MR images were evaluated, and individual-based intrinsic hippocampus morphological networks were constructed. The between-group differences in global and nodal network topology profiles were estimated, and correlations between the nodal network metrics and cognitive scores were further analyzed.</div></div><div><h3>Results</h3><div>Compared to the HC and CP groups, the CI group shows significant differences in nodal network metrics of the left hippocampal tail and left hippocampal cornu ammonis (CA) 1-body. Nodal network metrics of the left hippocampal tail were significantly correlated with neurocognitive scores across the entire NMOSD group.</div></div><div><h3>Conclusions</h3><div>NMOSD patients with cognitive impairment exhibit abnormal intrinsic hippocampal morphological networks. Nodal network property measurements can help identify those with cognitive impairment.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106174"},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655634","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":"Etiology and characteristics of pseudotumoral lesions and tumefactive demyelination in multiple sclerosis","authors":"Olivera Tamas ,&nbsp;Marija Kovacevic ,&nbsp;Nikola Veselinovic ,&nbsp;Maja Budimkic ,&nbsp;Vanja Jovicevic ,&nbsp;Nikola Momcilovic ,&nbsp;Jelena Drulovic ,&nbsp;Sarlota Mesaros","doi":"10.1016/j.msard.2024.106168","DOIUrl":"10.1016/j.msard.2024.106168","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral pseudotumoral lesions (CPTL) (&gt;2cm) on magnetic resonance imaging (MRI) may pose a clinical challenge. A majority will occur in the context of multiple sclerosis (MS) – also referred to as tumefactive demyelinating lesions (TDL). The aim of this study was to define and analyze clinical, MRI, and paraclinical data for MS and non-MS patients.</div></div><div><h3>Methods</h3><div>This prospective study included adult patients with CPTL on brain MRI referred to the Neurology Clinic, Belgrade as a tertiary University Center (2019–2023) for clinical workup and treatment. Demographic, clinical, MRI, and paraclinical data were reviewed.</div></div><div><h3>Results</h3><div>This study included 75 patients, of which 58.7 % had MS. Fourteen patients had previously been diagnosed with MS, while 30 (68.2 %) received the diagnosis of MS in the later course. The concordance of initial and final diagnoses was 52 %. Relapsing disease (<em>p</em> &lt; 0.001) and brainstem presentation (<em>p</em> = 0.039) were significantly more common in MS patients. Headache (<em>p</em> = 0.008) and lethal outcome (<em>p</em> = 0.014) were significantly more common in the non-MS group. Lesions were ring-like more frequently in the MS group (<em>p</em> &lt; 0.001), while patients in the non-MS group frequently displayed infiltrative (<em>p</em> = 0.001) and nonspecific lesions (<em>p</em> = 0.002). The presence of headache and megacystic morphology was associated with the presence of pathology other than MS while the relapsing disease was in favor of MS.</div></div><div><h3>Conclusion</h3><div>Multiple sclerosis was the most common cause of CPTL. Headache, relapsing course of disease, and megacystic morphology may help discern MS from non-MS pathology. These findings should be challenged in future studies examining larger cohorts.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106168"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687496","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}