Multiple sclerosis and related disorders最新文献

{"title":"Real-world evidence of clinical outcomes and adherence to ofatumumab in the UK and the impact of a patients support programme: A retrospective, non-interventional cohort study","authors":"David Paling ,&nbsp;David Cottrell ,&nbsp;Ruth Hamlin ,&nbsp;Colin O’Leary ,&nbsp;Owen Pearson ,&nbsp;Agne Straukiene ,&nbsp;Pyry Kivi ,&nbsp;Wendy Rice ,&nbsp;Sarah Al-Azki ,&nbsp;Nazanin Kondori","doi":"10.1016/j.msard.2026.107030","DOIUrl":"10.1016/j.msard.2026.107030","url":null,"abstract":"<div><h3>Background</h3><div>Ofatumumab is the only anti-CD20 monoclonal antibody disease modifying therapy available for self- administration for adults with active relapsing remitting multiple sclerosis (RMS). This study aimed to investigate real-world adherence and clinical outcomes of ofatumumab-treated patients in the UK and looked at the impact of a patient support program called Kesimpta Connect (KC PSP) on these outcomes.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study examined adherence to ofatumumab in 155 RMS patients recruited from six UK MS centres. The primary objective of the study was to describe the medication possession ratio (MPR) adherence of ofatumumab treated patients over a 13-month period. The study also looked at clinical effectiveness measures, including change in annualized relapse rates (ARR). Safety and secondary-care use was also assessed in this study.</div></div><div><h3>Results</h3><div>103 patients had data available to be assessed for adherence and clinical effectiveness. 87 % (n=90) of patients had an MPR adherence of 0.80 or greater and higher proportion of non-KC PSP users reported adherence of greater than 0.80 than KC PSP users (98.4 % vs 69.2 %). The total ARR decreased during the follow-up period from 0.33 (95 % CI 0.23-0.40) prior to ofatumumab initiation to 0.06 (95 % CI 0.01-0.11) 12-months after initiation. In terms of safety, 38.1 % (n=59/155) patients reported experiencing an adverse event during the follow-up period; one was reported to be severe. However, no patients reported discontinuing ofatumumab during the study follow-up period.</div></div><div><h3>Conclusion</h3><div>This study provides evidence of good adherence for RMS patients using ofatumumab. Further, there is evidence of clinical effectiveness based on reduction in ARR post-ofatumumab initiation, as well as tolerability and a favourable safety profile. The results of this study support the continued use of ofatumumab in providing effective RMS disease management in the UK NHS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107030"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078600","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":"Post-infusion observation of patients with multiple sclerosis receiving natalizumab: Is it necessary?","authors":"Melika Arab Bafrani,&nbsp;Negar Sadat Ahmadi,&nbsp;Fateme Zahra Idjadi,&nbsp;Sanaz Bordbar,&nbsp;Shima Jahani,&nbsp;Rayhane Montazeri,&nbsp;Sara Kamali Zonouzi,&nbsp;Mahsa Mohammadi Lapevandani,&nbsp;Zahra Ebadi,&nbsp;Samira Navardi,&nbsp;Hora Heidari,&nbsp;Amirreza Azimi,&nbsp;Abdorreza Naser Moghadasi,&nbsp;Mohammad Ali Sahraian","doi":"10.1016/j.msard.2026.106995","DOIUrl":"10.1016/j.msard.2026.106995","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Natalizumab (Tysabri ®), the first monoclonal antibody approved for treatment of relapsing-remitting Multiple Sclerosis (RRMS), can significantly reduce exacerbations and active brain lesions. Due to concerns on infusion-related reactions (IRRs) patients should be observed during the infusions and one hour after the completion of the infusions for signs and symptoms of hypersensitivity reactions, especially in the first 12 doses. This study was conducted to see if one-hour post-infusion observation is necessary in all patients receiving natalizumab or can be wavied in some stable patients.</div></div><div><h3>Method</h3><div>In this cross-sectional study, one-hour post-infusion observation was not conducted in patients who had previously received three doses of natalizumab without any history of moderate to severe or life-threatening IRRs based on the Common Terminology Criteria for Adverse Events (CTCAE) definition. Patient demographics and clinical characteristics were recorded by a trained physician in a questionnaire coupled with an emergency hotline provided for IRRs. In case of a modere to sever or life-threatening reaction during the ifusion the patient excluded from the study. Phone follow-up was done after an hour by the same medical doctor.</div></div><div><h3>Result</h3><div>424 patients with MS were enrolled in this study. Fatigue (10.8%), headache (4.5%), and cough (2.8%) were the most prevalent symptoms after 1 hour from the infusions. No life-threatening complications happened for the patients. There was no significant relationship between age, gender, the interval between doses, the number of total infusions, and disease duration with the incidence of side effects.</div></div><div><h3>Conclusion</h3><div>Early discharge without one hour post-infusion monitoring can be considered for patients without any moderate to sever adverse reaction in the fisrt three infusion of natalizumab.This sterategy may reduce the costs and save the time of infusion for these patients.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106995"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053064","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":"Incident and prevalent peripartum mental illness in mothers with multiple sclerosis and other chronic diseases in Sweden","authors":"Ruth Ann Marrie ,&nbsp;Colleen J Maxwell ,&nbsp;James M. Bolton ,&nbsp;Jonas Söderling ,&nbsp;Charles N Bernstein ,&nbsp;Kristen M Krysko ,&nbsp;Kyla A McKay ,&nbsp;Dalia Rotstein ,&nbsp;Karma Deakin-Harb ,&nbsp;Neda Razaz","doi":"10.1016/j.msard.2026.107041","DOIUrl":"10.1016/j.msard.2026.107041","url":null,"abstract":"<div><h3>Background</h3><div>Findings conflict regarding the risk of peripartum mental illness in women with multiple sclerosis (MS) and how this compares to the risk among women with other chronic diseases. We compared the incidence and prevalence of peripartum mental illness among women with MS, epilepsy, inflammatory bowel disease (IBD), diabetes, and women without any of these diseases (comparators).</div></div><div><h3>Methods</h3><div>Using population-based Swedish administrative health data we selected women with MS, epilepsy, IBD, diabetes, and comparators who had deliveries between 2002 and 2019. Using validated case definitions for peripartum mental illness we estimated the incidence and prevalence of mental illness during the period encompassing pregnancy and the first post-partum year. We compared incidence and prevalence between cohorts using crude estimates and unadjusted Poisson regression.</div></div><div><h3>Results</h3><div>We included 1096,814 women (1936 MS; 7709 epilepsy; 7731 IBD; 7182 diabetes; 1072,256 comparators). Mean (SD) age at conception was 30.1 (5.1) years. Compared to comparators, mothers with MS had a higher incidence of any mental illness (incidence rate ratio [IRR] 1.36; 1.04–1.78), as did mothers with epilepsy (1.78; 1.58–2.00), IBD (1.46; 1.28–1.66) and diabetes (1.61; 1.41–1.83). Mothers with MS, epilepsy, IBD and diabetes also had a higher incidence and prevalence of depression and bipolar disorder than comparators. Mothers with epilepsy had higher incidence rates of anxiety, and higher prevalence ratios of any mental illness and anxiety than mothers with MS.</div></div><div><h3>Conclusions</h3><div>Women with MS, epilepsy, IBD and diabetes have a similarly elevated incidence and prevalence of peripartum mental illness as compared to mothers without these conditions.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107041"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119526","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":"Baseline severe disability as a predictor of treatment escalation to rituximab in AQP4-IgG–positive NMOSD patients: A retrospective cohort study","authors":"Chayangkoon Siripornmongkol,&nbsp;Metha Apiwattanakul,&nbsp;Saharat Aungsumart","doi":"10.1016/j.msard.2026.107022","DOIUrl":"10.1016/j.msard.2026.107022","url":null,"abstract":"<div><h3>Introduction</h3><div>Azathioprine and mycophenolate mofetil remain widely used as first-line immunosuppressive therapies for neuromyelitis optica spectrum disorder (NMOSD) in resource-limited settings. However, a subset of patients experience ongoing disease activity or treatment intolerance requiring escalation to rituximab. Identification of clinical factors associated with treatment escalation may improve treatment strategies.</div></div><div><h3>Objectives</h3><div>To identify clinical factors associated with escalation from azathioprine and mycophenolate mofetil to rituximab in AQP4-IgG–positive NMOSD patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of AQP4-IgG–positive NMOSD patients treated at the Neurological Institute of Thailand between 2019 and 2024. Patients initially treated with azathioprine or mycophenolate mofetil were followed until escalation to rituximab or last follow-up. Baseline demographic, clinical, and laboratory variables were analyzed using logistic regression to identify factors associated with treatment escalation.</div></div><div><h3>Results</h3><div>Among 173 patients, 35 (20.23%) required escalation to rituximab. In multivariable analysis, baseline severe disability (EDSS ≥6 prior to first-line therapy) was independently strongly associated with treatment escalation to rituximab (OR 18.19, 95% CI 2.22–148.95; p=0.007). Other demographic and laboratory variables were not independently associated.</div></div><div><h3>Conclusion</h3><div>Baseline severe disability was strongly associated with subsequent escalation to rituximab. Early identification of high-risk patients may support more individualized treatment strategies and inform future policy decisions in resource-limited healthcare systems.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107022"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034515","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":"AQP4-IgG positive and AQP4-IgG–negative NMOSD: A Multicenter Latin-American Cohort vs. a Single-Center Argentine Cohort","authors":"Andrés M. Villa","doi":"10.1016/j.msard.2025.106933","DOIUrl":"10.1016/j.msard.2025.106933","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106933"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878842","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":"Self-harm-related mortality among U.S. decedents with multiple sclerosis: A nationwide analysis (1999–2020)","authors":"Moaz Elsayed Abouelmagd ,&nbsp;Belal Mohamed Hamed ,&nbsp;Mostafa Meshref ,&nbsp;Devon S Conway","doi":"10.1016/j.msard.2025.106934","DOIUrl":"10.1016/j.msard.2025.106934","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide risk in persons with multiple sclerosis (PwMS) exceeds that of the general population, yet national data on temporal change and demographic gradients remain limited. We conducted this study to quantify long-term trends and demographic disparities in fatal self-harm among U.S. decedents with MS.</div></div><div><h3>Methods</h3><div>We extracted Multiple Cause-of-Death records between 1999–2020 from the freely available CDC WONDER database, identifying cases in which intentional self-injury was the underlying manner of death and MS was a contributing cause. Crude mortality rates (per 100,000) overall and by sex, ten-year age group, race, and 2013 urbanization level were calculated. Log-linear and segmented regressions were used to estimate annual-percent change (APC) and join-points; rate ratios (RRs) contrasted 2020 with 1999 and each stratum with prespecified anchors.</div></div><div><h3>Results</h3><div>A total of 453 MS-related self-harm deaths yielded an overall crude rate of 0.0067 (95 % CI 0.0061–0.0073) per 100,000 per year. The APC was 0.88 % (-0.49 % to 2.27 %); a single join-point was detected in 2013. Self-harm mortality was 2.7-fold higher in non-core rural counties than large central metros, and highest in adults older than 35 years; no sex difference emerged.</div></div><div><h3>Conclusions</h3><div>Despite therapeutic advances, self-harm mortality in MS has edged upward since 2013, with pronounced rural. Tailored mental-health surveillance, particularly in remote areas, remains a critical, unmet need.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106934"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885832","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":"Is newly diagnosed multiple sclerosis a medical emergency?","authors":"H El Mouhajir ,&nbsp;A Alrashed ,&nbsp;B Mohamed ,&nbsp;K Schmierer","doi":"10.1016/j.msard.2025.106939","DOIUrl":"10.1016/j.msard.2025.106939","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106939"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842628","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":"Perceived pain during isometric exercise and neuromuscular fatigability in individuals with multiple sclerosis","authors":"Mitra Rouhani ,&nbsp;Marie K. Hoeger Bement ,&nbsp;Sandra K. Hunter ,&nbsp;Kathleen M. Zackowski ,&nbsp;Ahmed Z. Obeidat ,&nbsp;Alexander V. Ng","doi":"10.1016/j.msard.2025.106943","DOIUrl":"10.1016/j.msard.2025.106943","url":null,"abstract":"<div><div>Among people with multiple sclerosis (PwMS), pain is a common symptom, and neuromuscular fatigability is widely reported. However, the association between pain during exercise and neuromuscular fatigability remains unclear. This study aimed to identify the association between perceived pain and neuromuscular fatigability during an exercise task in PwMS. Thirty-two PwMS (age=56.4, females=15) and 15 age- and sex-matched non-MS controls (age=57.9, females=7) participated. Disease severity was evaluated using the Expanded Disability Status Scale (median EDSS=4.0). The experimental protocol involved maximal voluntary contractions (MVCs) of the dorsiflexors, time-to-task failure (TTF) of an isometric fatiguing exercise sustained at maximal strength (neuromuscular fatigability), and a post-exercise MVC. Central and peripheral fatigability were assessed using electrical stimulation. The twitch interpolation technique quantified voluntary activation (VA), with pre-to-post exercise reductions in VA indicating central fatigability. Pre-to-post exercise reductions in resting twitch amplitude indicated peripheral fatigability. Perceived pain (0–10) was assessed at rest prior to exercise, during, and immediately post-exercise. Associations of changes in pain perception were identified using Spearman’s correlation coefficient (rho). Despite no significant differences between PwMS and controls across all outcome measures (<em>p</em> &gt; 0.2), compared to controls, PwMS with higher disease severity (<em>n</em> = 12, EDSS≥4.5) had a significantly shorter TTF (mean difference=-38.5 s, <em>p</em> = 0.04), higher central fatigability (11 percentage points, <em>p</em> = 0.01), and lower peripheral fatigability (-20.8%, <em>p</em> = 0.01). Among PwMS, smaller changes in pain perception correlated with increased neuromuscular fatigability (rho=0.5, <em>p</em> = 0.003), higher central fatigability (rho=-0.4, <em>p</em> = 0.05), and lower peripheral fatigability (rho=0.4, <em>p</em> = 0.03). These findings suggest that perceived pain during the exercise task may be an overlooked mechanism contributing to neuromuscular fatigability in PwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106943"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842627","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 brainstem signature of multiple sclerosis: predictable lesions, consistent syndromes","authors":"Mohammad Wafa ,&nbsp;Khalid Nuh ,&nbsp;Gavin Giovannoni ,&nbsp;Klaus Schmierer ,&nbsp;Sharmilee Gnanapavan ,&nbsp;Ruth Dobson ,&nbsp;Monical Marta ,&nbsp;Maria Papachatzaki ,&nbsp;Benjamin Turner ,&nbsp;Thomas Campion ,&nbsp;Ashok Adams ,&nbsp;Anant Krishnan ,&nbsp;Alexandros Chatzistefanou ,&nbsp;Bader Mohamed ,&nbsp;Ahmed Hashish","doi":"10.1016/j.msard.2025.106894","DOIUrl":"10.1016/j.msard.2025.106894","url":null,"abstract":"<div><h3>Background</h3><div>Integrating clinical findings with neuroradiological changes is a crucial skill in neurology, particularly for diagnosis. Multiple Sclerosis (MS) lesions in the brainstem are rarely asymptomatic, leading to unique and often localised clinical syndromes. MS lesions exhibit a characteristic perivenular distribution, which in the brainstem is imprinted by the consistent topography of the penetrating veins.</div></div><div><h3>Objective</h3><div>This review provides an integrative perspective on the anatomical patterns of MS lesions in the brainstem (midbrain, pons, and medulla). It correlates specific clinical syndromes with radiological appearances, aiding in both diagnosis and functional localisation.</div></div><div><h3>Methods</h3><div>We searched the available literature using keywords related to the three brainstem sections (midbrain, pons, medulla) and eloquent anatomical locations (<em>medial longitudinal fasciculus, cerebellar peduncle, nerve fascicle, aqueduct, area postrema</em>), aiming to correlate specific radiological patterns of MS lesions with their consistent clinical syndromes as reported in the literature.</div></div><div><h3>Summary of Key Findings</h3><div>Brainstem MS lesions often cause irritative symptoms rather than full functional loss. Unlike other conditions, visible MS lesions on MRI rarely disappear and usually remain as silent lesions following an acute event. The consistent venous architecture creates specific radiological patterns that link to distinct clinical presentations. In contrast, inflammatory disorders like NMOSD and MOGAD cause more aggressive and extensive dysfunction.</div></div><div><h3>Conclusion</h3><div>The visual details of MS brainstem lesions reflect their close relationship to venous anatomy, which can be anticipated even when the central vein sign is not directly visualised. Recognising these specific clinical-radiological syndromes provides a unique and insightful diagnostic tool for MS, underscoring the value of strong functional and radiological-anatomical interpretation skills in clinical neurology.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106894"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834171","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":"Impact of a short-term stress management protocol on physiologic biofeedback measures of stress and mood in people with multiple sclerosis","authors":"A.B. Sullivan ,&nbsp;G. Tworek ,&nbsp;A. Kane ,&nbsp;J. Fredieu ,&nbsp;T. Harvey","doi":"10.1016/j.msard.2026.106967","DOIUrl":"10.1016/j.msard.2026.106967","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Stress exacerbates multiple sclerosis (MS) symptoms. We report a 10-year study examining objective and subjective measures of stress and mood in people with MS (PwMS) using a shortened and more practical form of the Stress Management Therapy for MS (SMT-MS), the Stress Management Protocol (SMP).</div></div><div><h3>Methods</h3><div>We analyzed data from PwMS who underwent a 4-session SMP at Cleveland Clinic between 2012 and 2022 (<em>N</em> = 195; 90.5 % female; 68.2 % White; average age, 44.4 years; average disease duration, 12.1 years). Subjective data were collected pre-session using the Patient Health Questionaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD). Objective data, including breathing rate (breaths per minute, BPM), pulse (beats per minute, bpm), and blood oxygen saturation (%Sp02), were collected pre- and post-SMP. Statistical models assessed data differences and within-session improvement by session, as well as differences in pre- and post-session measurements .</div></div><div><h3>Results</h3><div>Subjective and objective scores improved significantly after Session 1. Significant intrasession improvements were observed, especially during the initial sessions. Significant overall improvements were observed in PHQ-9, GAD-7, and pre-session BPM and %SpO₂. Greatest improvements in PHQ-9 and BPM were observed in patients completing 3 sessions and that %Sp0₂ were observed in patients completing 4 sessions.</div></div><div><h3>Discussion</h3><div>PwMS who participated in the SMP showed considerable improvement in outcomes within and across sessions. Our results show that a brief, 4-session SMP can improve both subjective and objective measures of stress and mood in PwMS and that PwMS are able to utilize the SMP/biofeedback tools outside of therapy, in a real-world environment.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106967"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939931","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}