Multiple sclerosis (Houndmills, Basingstoke, England)最新文献

{"title":"Author response-Rituximab versus ocrelizumab: When inference exceeds the evidence.","authors":"Nathan Y Chu, Jodie I Roberts, Alice J Schabas","doi":"10.1177/13524585261496131","DOIUrl":"https://doi.org/10.1177/13524585261496131","url":null,"abstract":"","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261496131"},"PeriodicalIF":5.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab versus ocrelizumab: When inference exceeds the evidence.","authors":"Fredrik Piehl, Thomas Frisell, Kjell-Morten Myhr, Øivind Torkildsen","doi":"10.1177/13524585261496111","DOIUrl":"https://doi.org/10.1177/13524585261496111","url":null,"abstract":"","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261496111"},"PeriodicalIF":5.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased autoimmune disease burden before multiple sclerosis and neuromyelitis optica spectrum disorder diagnosis: A nationwide Korean cohort study.","authors":"Soonwook Kwon, Jinhee Kim, Yeon Hak Chung, Bongseong Kim, Kyungdo Han, Dong Wook Shin, Ju-Hong Min","doi":"10.1177/13524585261494379","DOIUrl":"https://doi.org/10.1177/13524585261494379","url":null,"abstract":"<p><strong>Background: </strong>A prodromal phase is increasingly recognized in multiple sclerosis and neuromyelitis optica spectrum disorder, but the temporal patterns of autoimmune diseases remain poorly characterized.</p><p><strong>Objectives: </strong>To evaluate the risk and timing of autoimmune diseases before multiple sclerosis and neuromyelitis optica spectrum disorder diagnosis.</p><p><strong>Methods: </strong>Using the Korean National Health Insurance Service database (2011-2021), we identified incident multiple sclerosis (<i>n</i> = 3079) and neuromyelitis optica spectrum disorder (<i>n</i> = 1407) cases, each matched with 10 controls by age, sex, and index year. Autoimmune diseases were assessed during the 10 years preceding the index year and categorized into early (5-10 years), intermediate (2-5 years), and late (0-2 years). Adjusted rate ratios were estimated using Poisson regression.</p><p><strong>Results: </strong>Autoimmune diseases occurred more frequently before the index year in multiple sclerosis (adjusted rate ratio = 1.58, 95% confidence interval = 1.46-1.71) and neuromyelitis optica spectrum disorder (adjusted rate ratio = 1.28, 95% confidence interval = 1.14-1.45) than controls, with the greatest differences in the late period. The adjusted rate ratio of autoimmune diseases in multiple sclerosis persisted across all periods, whereas the adjusted rate ratio was increased only in the intermediate and late periods in neuromyelitis optica spectrum disorder. Systemic autoimmune diseases, including systemic lupus erythematosus, Sjögren's syndrome, and rheumatoid arthritis, were more frequent in both conditions.</p><p><strong>Conclusions: </strong>The burden of autoimmune disease is increased before multiple sclerosis and neuromyelitis optica spectrum disorder diagnosis.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261494379"},"PeriodicalIF":5.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who declines neurocognitive testing? A cross-sectional study in people with multiple sclerosis.","authors":"David E Freedman, Jiwon Oh, Anthony Feinstein","doi":"10.1177/13524585261491122","DOIUrl":"https://doi.org/10.1177/13524585261491122","url":null,"abstract":"<p><p>In 334 people with multiple sclerosis, a backward stepwise regression analysis was conducted to identify clinical characteristics that predict who declines neurocognitive testing (<i>p</i> < 0.05), from demographics, disease-related variables, psychiatric diagnoses, and self-reported cognitive concerns. The mean age was 44.1 years (standard deviation = 11.4), the median Expanded Disability Status Scale was 2.5 (1.5-4.0), 79.8% had relapsing-remitting MS, and 14.7% declined testing. Independent correlates of declining neurocognitive testing included progressive MS (odds ratio = 2.1, 95% confidence interval = [1.0, 4.4], <i>p</i> = 0.046), anxiety-related disorders (odds ratio = 2.5, 95% confidence interval = [1.3, 4.9], <i>p</i> = 0.007), and the absence of self-reported cognitive concerns (odds ratio = 0.3, 95% confidence interval = [0.2, 0.7], <i>p</i> = 0.004). People with multiple sclerosis with these clinical characteristics are more likely to decline neurocognitive testing.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261491122"},"PeriodicalIF":5.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocytosis as a biomarker for natalizumab treatment response in multiple sclerosis: The link with anti-drug antibodies.","authors":"Ester Valero-Hernandez, Jai Mathur, David Baker, Iris Y H Liu, Sarah L Morgan, Emma C Tallantyre, Klaus Schmierer, Angray S Kang","doi":"10.1177/13524585261495351","DOIUrl":"https://doi.org/10.1177/13524585261495351","url":null,"abstract":"<p><strong>Background: </strong>Natalizumab is a high-efficacy therapy drug for multiple sclerosis that inhibits lymphocyte migration into the central nervous system, increasing lymphocyte counts in the peripheral blood. Anti-drug antibody responses may limit drug efficacy, but current guidance recommends anti-drug antibody testing only after evidence of 'reduced efficacy'.</p><p><strong>Objective: </strong>To assess the lack of relative lymphocytosis as a biomarker of anti-drug antibody responses.</p><p><strong>Methods: </strong>Lymphocyte counts and immunogenicity data from the pivotal AFFIRM clinical trial (<i>n</i> = 627 natalizumab vs <i>n</i> = 315 placebo) and real-world data from the Cardiff MS register (<i>n</i> = 185) were analysed to assess the relationship between lymphocyte counts, anti-drug antibody responses, drug levels and disease activity.</p><p><strong>Results: </strong>Natalizumab treatment induced an absolute change in lymphocyte counts by week 12 (1.40 ± 0.92 vs -0.05 ± 0.62 × 10⁹ cells/L in natalizumab vs placebo; <i>p</i> < 0.0001) that was absent in the persistent anti-drug antibody group (-0.12 ± 0.60 × 10⁹ cells/L). Increases in lymphocyte counts by ⩾ 0.8 × 10⁹ cells/L from the baseline discriminated individuals without anti-drug antibody responses with high sensitivity (≥ 84%) and specificity (≥ 91%).</p><p><strong>Conclusion: </strong>The absence of relative lymphocytosis is associated with anti-drug antibody responses and may provide a simple biomarker to prompt anti-drug antibody testing before disease breakthrough occurs.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261495351"},"PeriodicalIF":5.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survivor bias and disease progression in observational cohorts in multiple sclerosis.","authors":"Mark H J Wessels, Daan J de Jong, Mar Barrantes-Cepas, Julia R Jelgerhuis, Zoë van Lierop, Eline van Daele, Anna L Wojdała, Tom A N Fuchs, Marloes M D A Bet, David R van Nederpelt, Ismail Koubiyr, Martijn D Steenwijk, Hugo Vrenken, Bastiaan Moraal, Frederik Barkhof, Bernard M J Uitdehaag, Charlotte E Teunissen, Joep Killestein, Menno M Schoonheim, Eva M M Strijbis","doi":"10.1177/13524585261490350","DOIUrl":"https://doi.org/10.1177/13524585261490350","url":null,"abstract":"<p><strong>Background: </strong>Long-term studies on multiple sclerosis progression often face dropout, possibly among those with more aggressive disease, biasing the cohort.</p><p><strong>Objectives: </strong>We assessed potential survivorship bias in a long-term observational multiple sclerosis cohort.</p><p><strong>Methods: </strong>Three hundred sixty-one patients with multiple sclerosis were followed for 10 years, with clinical assessments, blood biomarkers and magnetic resonance imaging at baseline, follow-up 1 and follow-up 2. Progression was defined as an Expanded Disability Status Scale increase. Dropout was analysed and predicted; estimated Expanded Disability Status Scale was calculated for dropouts to assess bias. Brain volumes were normalized.</p><p><strong>Results: </strong>One hundred and sixty-two patients with multiple sclerosis completed all follow-ups; 81 showed progression. Dropout rates were 97/361 at follow-up 1 and 102/264 at follow-up 2. Dropouts had worse Expanded Disability Status Scale, Nine-Hole Peg test, Timed 25-Foot Walk, lower brain volume and higher lesion volume before dropping out. Blood biomarkers did not differ. Main dropout predictors were higher baseline Expanded Disability Status Scale, lesion volume, worse Nine-Hole Peg test and shorter disease duration. Median estimated Expanded Disability Status Scale at follow-up 2 for dropouts was 5.5 versus 3.5 for non-dropouts.</p><p><strong>Discussion: </strong>Fewer than half completed the study. High lesion load and worse clinical status predicted dropout. This may cause underestimation of progression and reduced statistical power. Similar bias may affect other long-term studies in chronic diseases.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261490350"},"PeriodicalIF":5.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of generative artificial intelligence techniques for synthetic data generation in multiple sclerosis research: A comparison with real-world evidence from the Italian multiple sclerosis registry.","authors":"Pietro Iaffaldano, Saverio D'Amico, Giuseppe Lucisano, Massimiliano Copetti, Tommaso Guerra, Maria A Rocca, Francesco Patti, Giovanna De Luca, Diana Ferraro, Rocco Totaro, Vincenzo Brescia Morra, Giuseppe Salemi, Emilio Portaccio, Matteo Foschi, Matilde Inglese, Maria G Coniglio, Clara G Chisari, Francesca Caputo, Damiano Paolicelli, Mario A Battaglia, Matteo G Della Porta, Victor Savevski, Mattia Delleani, Filippo E Colella, Elisabetta Sauta, Maria P Amato, Massimo Filippi, Maria Trojano","doi":"10.1177/13524585261492525","DOIUrl":"https://doi.org/10.1177/13524585261492525","url":null,"abstract":"<p><strong>Background: </strong>The use of generative artificial intelligence to create synthetic data is an emerging strategy to enhance real-world evidence.</p><p><strong>Objective: </strong>To assess the validity of artificial intelligence-generated synthetic data in replicating data collected in the Italian Multiple Sclerosis and Related Disorders Register for the evaluation of progression independent of relapse activity risk under early intensive treatment and escalation treatment strategies.</p><p><strong>Methods: </strong>Artificial intelligence generative models were trained on a sub-cohort of 1666 Italian Multiple Sclerosis and Related Disorders Register patients to generate a synthetic dataset of 4878 patients. Synthetic vAlidation FramEwork, Clinical Synthetic Fidelity, and Nearest Neighbor Distance Ratio were applied. Comparisons between treatment strategies were conducted using both real and synthetic data, focusing on progression independent of relapse activity risk.</p><p><strong>Results: </strong>The synthetic data demonstrated fidelity and privacy preservation. Treatment-effect estimates for escalation treatment versus early intensive treatment were similar across the real and synthetic datasets. Cox proportional hazards models showed that synthetic data preserved the robustness of the estimates for the risk of a first progression independent of relapse activity event. Associations with radiological risk factors were broadly similar across the real and synthetic datasets.</p><p><strong>Conclusion: </strong>Artificial intelligence-generated synthetic data reliably replicated treatment-effect outcomes of Italian Multiple Sclerosis and Related Disorders Register data, supporting their potential use in clinically defined research settings.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261492525"},"PeriodicalIF":5.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How well do junior neurology residents recognize multiple sclerosis? Analysis of the \"Close the Loop\" resident clinical acumen project.","authors":"Claudia Zbrzeski, Emily M Schorr, Sai P Polineni, Rachel Brandstadter, Michelle T Fabian, Stephen C Krieger","doi":"10.1177/13524585261492141","DOIUrl":"https://doi.org/10.1177/13524585261492141","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate diagnostic accuracy and patterns of errors among junior neurology residents evaluating acute presentations of multiple sclerosis and other demyelinating diseases.</p><p><strong>Methods: </strong>We retrospectively reviewed a morning-report case log of overnight neurology consultations presented by postgraduate year-2 residents at a New York academic center over 6 years. Cases with an initial resident impression of multiple sclerosis/demyelinating disease or a final diagnosis of multiple sclerosis/demyelinating disease were analyzed using a predefined localization-etiology schema.</p><p><strong>Results: </strong>Among 1301 cases with uncertain initial diagnoses, 66 (5.1%) had an initial resident impression of multiple sclerosis/demyelinating disease and 57 (4.4%) had a final multiple sclerosis/demyelinating disease diagnosis. Overall diagnostic accuracy for multiple sclerosis/demyelinating disease presentations was 66.7%. Of initial multiple sclerosis/demyelinating disease impressions, 33.3% were incorrect (over-called); most errors occurred at the level of neurologic versus non-neurologic (40.9%) and central nervous system etiologies (40.9%). Among confirmed multiple sclerosis/demyelinating disease cases, 22.8% were under-called, predominantly due to errors in central nervous system etiology (69.2%).</p><p><strong>Conclusions: </strong>Acute multiple sclerosis/demyelinating disease presentations pose educational challenges for neurology residents, with errors primarily arising from misclassification of central nervous system etiologies. Diagnostic accuracy was influenced by prior disease history and patient age, highlighting cognitive biases such as framing and anchoring. Structured feedback models like \"close the loop\" may help improve multiple sclerosis diagnostic acumen in residency training and clinical practice.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261492141"},"PeriodicalIF":5.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple sclerosis and housing insecurity or forcible displacement: A scoping review.","authors":"Nathanael J Lee, Andreea M Beu, Lilyana Amezcua, Farrah J Mateen","doi":"10.1177/13524585261492505","DOIUrl":"10.1177/13524585261492505","url":null,"abstract":"<p><p>There is an increasing number of people experiencing housing insecurity and forcible displacement globally. We perform a scoping review, searching PubMed (1 January 1990-30 June 2026) for the key terms \"housing insecurity,\" \"inadequate housing,\" \"houselessness,\" \"homelessness,\" \"housing,\" \"forcible displacement,\" \"refugee,\" \"asylum seeker,\" and \"internal displacement,\" focusing on the outcomes of persons with multiple sclerosis. We estimate the approximate number of persons with multiple sclerosis in these situations. The number of reports from persons with multiple sclerosis who experience housing insecurity, homelessness, or forcible displacement remains very limited compared to the high number of estimated persons with multiple sclerosis living in these circumstances. Among US veterans, homelessness was not significantly more common among those with multiple sclerosis than matched veterans without multiple sclerosis. Refugees with multiple sclerosis experience inaffordability of care. A larger, but distinct, literature examining exposure to armed conflict (war) finds increased relapse and magnetic resonance imaging disease activity in subsets of persons with multiple sclerosis during conflict as well as disruptions in access to multiple sclerosis care and treatment. Global geographic representation of these reports is limited. We recommend health systems-based and clinical approaches for persons with multiple sclerosis in times of vulnerability. More data are needed to understand the defined risks to persons with multiple sclerosis as well as inform and monitor a durable humanitarian approach to their care.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261492505"},"PeriodicalIF":5.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monogenic disorders of immune regulation presenting with neurological autoimmunity.","authors":"Shilpan G Patel, Wallace J Brownlee","doi":"10.1177/13524585261490254","DOIUrl":"https://doi.org/10.1177/13524585261490254","url":null,"abstract":"","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585261490254"},"PeriodicalIF":5.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}