Revue neurologique最新文献

{"title":"The pattern of cortical thickness associated with executive dysfunction in MCI and SCC: The MEMENTO cohort","authors":"D. Andriuta ,&nbsp;M. Roussel ,&nbsp;G. Chene ,&nbsp;C. Fischer ,&nbsp;J.-F. Mangin ,&nbsp;B. Dubois ,&nbsp;B. Vellas ,&nbsp;F. Pasquier ,&nbsp;F. Tison ,&nbsp;F. Blanc ,&nbsp;O. Hanon ,&nbsp;C. Paquet ,&nbsp;A. Gabelle ,&nbsp;M. Ceccaldi ,&nbsp;C. Annweiler ,&nbsp;P. Krolak-Salmon ,&nbsp;R. David ,&nbsp;I. Rouch-Leroyer ,&nbsp;A. Benetos ,&nbsp;O. Moreaud ,&nbsp;O. Godefroy","doi":"10.1016/j.neurol.2024.02.394","DOIUrl":"10.1016/j.neurol.2024.02.394","url":null,"abstract":"<div><h3>Background</h3><div><span>The association between the pattern of cortical thickness (CT) and executive dysfunction (ED) in </span>mild cognitive impairment (MCI) and subjective cognitive complaints (SCC) is still poorly understood. We aimed to investigate the association between CT and ED in a large French cohort (MEMENTO) of 2323 participants with MCI or SCC.</div></div><div><h3>Methods</h3><div><span>All participants with available CT and executive function data (verbal fluency and Trail Making Test [TMT]) were selected (</span><em>n</em> <!-->=<!--> <span>1924). Linear regressions<span> were performed to determine relationships between executive performance and the brain parenchymal fraction (BPF) and CT using FreeSurfer.</span></span></div></div><div><h3>Results</h3><div>The global executive function score was related to the BPF (sß: 0.091, <em>P</em> <!-->&lt;<!--> <!-->0.001) and CT in the right supramarginal (sß: 0.060, <em>P</em> <!-->=<!--> <!-->0.041) and right isthmus cingulate (sß: 0.062, <em>P</em> <!-->=<!--> <!-->0.011) regions. Literal verbal fluency was related to the BPF (sß: 0.125, <em>P</em> <!-->&lt;<!--> <!-->0.001) and CT in the left parsorbitalis region (sß: 0.045, <em>P</em> <!-->=<!--> <!-->0.045). Semantic verbal fluency was related to the BPF (sß: 0.101, <em>P</em> <!-->&lt;<!--> <!-->0.001) and CT in the right supramarginal region (sß: 0.061, <em>P</em> <!-->=<!--> <!-->0.042). The time difference between the TMT parts B and A was related to the BPF (sß: 0.048, <em>P</em> <!-->=<!--> <span>0.045) and CT in the right precuneus (sß: 0.073, </span><em>P</em> <!-->=<!--> <!-->0.019) and right isthmus cingulate region (sß: 0.054, <em>P</em> <!-->=<!--> <!-->0.032).</div></div><div><h3>Conclusions</h3><div><span><span>In a large clinically based cohort of participants presenting with either MCI or SCC (a potential early stage of Alzheimer's disease [AD]), ED was related to the BPF and CT in the left </span>pars orbitalis, right </span>precuneus<span><span>, right supramarginal, and right isthmus cingulate regions. This pattern of lesions adds knowledge to the conventional anatomy of ED and could contribute to the early </span>diagnosis of AD.</span></div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1100-1107"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurofilament-light: Impact of chronic stress on brain","authors":"C. Ramdani ,&nbsp;A.-V. Desruelle ,&nbsp;N. Vallée ,&nbsp;M. Ogier","doi":"10.1016/j.neurol.2024.08.001","DOIUrl":"10.1016/j.neurol.2024.08.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1139-1141"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reprint of: Scientific statement from the French neurovascular and cardiac societies for improved detection of atrial fibrillation after ischaemic stroke and transient ischaemic attack","authors":"Nicolas Gaillard ,&nbsp;Jean-Claude Deharo ,&nbsp;Laurent Suissa ,&nbsp;Pascal Defaye ,&nbsp;Igor Sibon ,&nbsp;Christophe Leclercq ,&nbsp;Sonia Alamowitch ,&nbsp;Céline Guidoux ,&nbsp;Ariel Cohen ,&nbsp;French Neurovascular Society,&nbsp;French Society of Cardiology","doi":"10.1016/j.neurol.2024.10.001","DOIUrl":"10.1016/j.neurol.2024.10.001","url":null,"abstract":"<div><div>Atrial fibrillation (AF) is the primary cause of ischaemic stroke and transient ischaemic attack (TIA). AF is associated with a high risk of recurrence, which can be reduced using optimal prevention strategies, mainly anticoagulant therapy. The availability of effective prophylaxis justifies the need for a significant, coordinated and thorough transdisciplinary effort to screen for AF associated with stroke. A recent French national survey, initiated and supported by the Société française neurovasculaire (SFNV) and the Société française de cardiologie (SFC), revealed many shortcomings, such as the absence or inadequacy of telemetry equipment in more than half of stroke units, insufficient and highly variable access to monitoring tools, delays in performing screening tests, heterogeneous access to advanced or connected ambulatory monitoring techniques, and a lack of dedicated human resources. The present scientific document has been prepared on the initiative of the SFNV and the SFC with the aim of helping to address the current shortcomings and gaps, to promote efficient and cost-effective AF detection, and to improve and, where possible, homogenize the quality of practice in AF screening among stroke units and outpatient post-stroke care networks. The working group, composed of cardiologists and vascular neurologists who are experts in the field and are nominated by their peers, reviewed the literature to propose statements, which were discussed in successive cycles, and maintained, either by consensus or by vote, as appropriate. The text was then submitted to the SFNV and SFC board members for review. This scientific statement document argues for the widespread development of patient pathways to enable the most efficient AF screening after stroke. This assessment should be carried out by a multidisciplinary team, including expert cardiologists and vascular neurologists.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1000-1020"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote neurological evaluation reliably identifies patients eligible to endovascular therapy while non-eligible to intravenous thrombolysis","authors":"L. Lucas ,&nbsp;A. Georget ,&nbsp;L. Rouxel ,&nbsp;P. Briau ,&nbsp;M. Couture ,&nbsp;J.-S. Liegey ,&nbsp;S. Debruxelles ,&nbsp;M. Poli ,&nbsp;S. Sagnier ,&nbsp;P. Renou ,&nbsp;S. Olindo ,&nbsp;F. Rouanet ,&nbsp;X. Maurin ,&nbsp;A. Benard ,&nbsp;I. Sibon","doi":"10.1016/j.neurol.2024.05.006","DOIUrl":"10.1016/j.neurol.2024.05.006","url":null,"abstract":"<div><h3>Introduction/background</h3><div>Early identification of suspected stroke patients who might be eligible for a reperfusion strategy is a daily challenge in the management of patient referrals. The aim of this study was to evaluate the performance of a remote medical assessment in identifying patients eligible for endovascular therapy (EVT) while not eligible for intravenous thrombolysis (IVT), compared with a decision based on bedside clinico-radiological data.</div></div><div><h3>Methods</h3><div><span><span>Patients admitted to the emergency department for acute </span>neurological symptoms lasting for less than 24</span> <span>h were prospectively included. Assessment of the clinical severity and medical history<span><span><span> was performed simultaneously by two vascular neurologists (VNs), one remotely using a mobile telemedicine solution (NOMADEEC), the other at the bedside. </span>RACE score was calculated from the </span>NIHSS score. At the end of the evaluation, both VNs quoted their treatment convictions (IVT/EVT). Final therapeutic decision following brain and vascular imaging was recorded and compared to remote and bedside predictions. The performances of three different conditions were evaluated: complete medical evaluation (NIHSS</span></span> <!-->+<!--> <!-->medical history), NIHSS score alone, and RACE score alone. Remote and bedside performances were also compared. Diagnostic accuracy parameters (sensitivity, specificity, positive and negative predictive values) of each condition were estimated, along with their two-sided 95% binomial confidence intervals.</div></div><div><h3>Results</h3><div><span><span>Out of 215 enrolled patients, 186 had a complete evaluation, 91 (54.3%) were diagnosed with an ischemic stroke or </span>transient ischemic attack and 46 (24.7%) had an intracranial occlusion. Considering the three conditions evaluated remotely, RACE score-based decision provided the best sensitivity 54.6% [95% CI 23.4; 83.2]/specificity 80.6% [73.9; 86.2] combination. However, the complete medical evaluation had the best specificity (88.6% [82.9; 92.9] compared to RACE scores alone (</span><em>P</em> <!-->=<!--> <!-->0.038). Remote and bedside performances did not differ (κ<!--> <!-->=<!--> <!-->0.68 [0.59; 0.77]).</div></div><div><h3>Discussion/conclusion</h3><div>This real-life study performed in the setting of emergency demonstrates that remote medical evaluations including recording of extensive medical information and NIHSS examination to address patient's eligibility to revascularization treatment is swiftly feasible and is as effective as bedside prediction to EVT and/or IVT. Remote standardized medical evaluation might improve the decision of patients’ primary orientation and avoid overcrowding of comprehensive stroke centres.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1108-1116"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migraine treatment: Position paper of the French Headache Society","authors":"X. Moisset ,&nbsp;G. Demarquay ,&nbsp;S. de Gaalon ,&nbsp;C. Roos ,&nbsp;A. Donnet ,&nbsp;P. Giraud ,&nbsp;E. Guégan-Massardier ,&nbsp;C. Lucas ,&nbsp;J. Mawet ,&nbsp;D. Valade ,&nbsp;V. Corand ,&nbsp;C. Gollion ,&nbsp;N. Moreau ,&nbsp;L. Grangeon ,&nbsp;M. Lantéri-Minet ,&nbsp;A. Ducros","doi":"10.1016/j.neurol.2024.09.008","DOIUrl":"10.1016/j.neurol.2024.09.008","url":null,"abstract":"<div><div>The French migraine management recommendations were published in 2021. However, in the last three years, new data have come to light and new drugs have been approved (eptinezumab, rimegepant and atogepant) by the European Medicines Agency that require us to take a position on their use and to update certain elements of the recommendations. The first important message concerns the position of the French Headache Society on the use of preventive treatments (monoclonal antibodies and gepants) targeting the calcitonin gene-related peptide (CGRP) pathway. In terms of efficacy and safety, and as suggested by other national headache societies, these treatments can be offered as first-line treatment, although the scope defined by the French national health authority for possible reimbursement is limited to patients with severe migraine, at least eight headache days per month and for whom two previous preventive treatments have failed. Another important change concerns the position of topiramate as a preventive treatment for migraine in women of childbearing age. This treatment has been proposed as a first-line treatment for chronic migraine. However, recent pharmacovigilance data have highlighted a potential adverse effect on neurodevelopment in children exposed in utero. As a result, this treatment is formally contraindicated during pregnancy and must be used with extreme caution in women of childbearing age (effective contraception, no therapeutic alternative available and annual follow-up as with valproate). It can therefore no longer be offered as first-line treatment for women of childbearing age.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1087-1099"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb-girdle muscle weakness and muscle hypertrophy: Do not dismiss spinal muscular atrophy","authors":"T. Nanda ,&nbsp;S. Nanda ,&nbsp;A. Manna ,&nbsp;J. Mukherjee ,&nbsp;M. Mandal ,&nbsp;J. Benito-León","doi":"10.1016/j.neurol.2024.06.001","DOIUrl":"10.1016/j.neurol.2024.06.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1142-1144"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poststroke cognitive outcome is better accounted for by white matter abnormalities automated segmentation than visual analysis","authors":"B. Lawson ,&nbsp;J. Martin ,&nbsp;A. Aarabi ,&nbsp;E. Ouin ,&nbsp;S. Tasseel-Ponche ,&nbsp;M. Barbay ,&nbsp;D. Andriuta ,&nbsp;M. Roussel ,&nbsp;O. Godefroy ,&nbsp;GRECogVASC study group","doi":"10.1016/j.neurol.2024.06.004","DOIUrl":"10.1016/j.neurol.2024.06.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and aims&lt;/h3&gt;&lt;div&gt;The association between white matter abnormalities (WMA) and cognitive decline previously reported in poststroke patients has been mainly documented using visual scales. However, automated segmentation of WMA provides a precise determination of the volume of WMA. Nonetheless, it is rarely used in the stroke population and its potential advantage over visual scales is still unsettled. The objective of this study was to examine whether automated segmentation of WMA provides a better account than the visual Fazekas and Wahlund scales of the decline in executive functions and processing speed in stroke patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The analyses were conducted on the 358 patients of the GRECogVASC cohort with an MRI performed at six months poststroke in the Amiens center. WMA were visually analyzed using the Fazekas (subcortical abnormalities) and Wahlund scales. Segmentation was performed using LST (3.0.3). Following preliminary studies to determine the optimal segmentation threshold, we examined the relationship between cognitive status and WMA volume computed at each threshold using receiver operating characteristic (ROC) curves. Finally, we assessed the ability of both Fazekas and Wahlund visual scores and WMA volume to account for cognitive scores by using a bivariate Pearson correlation analysis, comparing correlation coefficients with the Fisher transformation and repeating correlation analysis after adjustment for the lesion volume.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Increasing the threshold led to an underestimation of WMA (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0001) (significant for a threshold ≥&lt;!--&gt; &lt;!--&gt;0.2) and an improvement in correct rejection of signal changes in the stroke cavity (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.02) (significant for a threshold ≤&lt;!--&gt; &lt;!--&gt;0.5), susceptibility artifacts (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.002) (significant for a threshold ≤&lt;!--&gt; &lt;!--&gt;0.6), and corticospinal degeneration (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.03) (significant for a threshold ≤&lt;!--&gt; &lt;!--&gt;0.5). WMA volume decreased with increasing threshold (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0001). Areas under the curve (AUC) did not differ according to the threshold (processing speed: &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.85, executive cognitive functions: &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.7). Correlation coefficients between cognitive scores and WMA were higher for WMA volume than the Fazekas (processing speed: Z&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;−3.442, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.001; executive functions: Z&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;−2.751, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.006) and Wahlund scores (processing speed: Z&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;−3.615, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0001; executive functions: Z&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;−2.769, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.006). Adjustment for lesion volume did not alter the correlations with WMA volume (processing speed: r&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;−0.327 [95%CI: −0.416; −0.223], &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1117-1127"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of impulse control disorders in Parkinson's disease","authors":"S. Prange ,&nbsp;S. Thobois","doi":"10.1016/j.neurol.2024.09.004","DOIUrl":"10.1016/j.neurol.2024.09.004","url":null,"abstract":"<div><div>Impulse control disorders (ICD) are frequent and cumbersome behavioral disorders in patients with Parkinson's disease (PD). Understanding their pathophysiological underpinnings is crucial. Molecular imaging using positron emission tomography (PET) and single-photon emission computed tomography (SPECT) clearly indicates preexisting vulnerability and abnormal sensitization of the pre- and postsynaptic dopaminergic system. Functional magnetic resonance imaging (fMRI) studies reveal abnormal connectivity within the reward system involving the ventral striatum and orbitofrontal cortex. These alterations pinpoint the dysfunction of reinforcement learning in ICD, which is biased toward the overvaluation of reward and underestimation of risk, and the deficit in inhibitory control mechanisms related to abnormal connectivity within and between the limbic and the associative and motor networks.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1078-1086"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homage to professor Maurice Collard","authors":"J. Reis ,&nbsp;D. Béquet ,&nbsp;P.-M. Preux ,&nbsp;E. Baldauf ,&nbsp;M. Dumas","doi":"10.1016/j.neurol.2024.08.008","DOIUrl":"10.1016/j.neurol.2024.08.008","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 998-999"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-CD20 monoclonal antibodies in multiple sclerosis: Rethinking the current treatment strategy","authors":"S.A. Freeman ,&nbsp;H. Zéphir","doi":"10.1016/j.neurol.2023.12.013","DOIUrl":"10.1016/j.neurol.2023.12.013","url":null,"abstract":"<div><div><span><span>Anti-CD20 monoclonal antibodies are highly-effective B-cell-depleting therapies in multiple sclerosis<span> (MS). These treatments have expanded the arsenal of highly effective disease-modifying therapies, and have changed the landscape in understanding the pathophysiology<span> of MS and the natural course of the disease. Nevertheless, these treatments come at the cost of immunosuppression and risk of serious infections, diminished </span></span></span>vaccination<span> response and treatment-related secondary hypogammaglobulinemia<span>. However, the COVID pandemic has given way to a possibility of readapting these therapies, with most notably extended dosing intervals. While these new strategies show efficacy in maintaining inflammatory MS disease control, and although it is tempting to speculate that tailoring </span></span></span>CD20<span><span> therapies will reduce the negative outcomes of long-term immunosuppression, it is unknown whether they provide meaningful benefit in reducing the risk of treatment-related secondary </span>hypogammaglobulinemia and serious infections. This review highlights the available anti-CD20 therapies that are available for treating MS patients, and sheds light on encouraging data, which propose that tailoring anti-CD20 monoclonal antibodies is the next step in rethinking the current treatment strategy.</span></div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 10","pages":"Pages 1047-1058"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}