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

{"title":"A rare but distinct and unique phenotype of MOGAD.","authors":"Kevin Rostásy","doi":"10.1177/13524585221105574","DOIUrl":"https://doi.org/10.1177/13524585221105574","url":null,"abstract":"Myelin oligodendrocyte-immunoglobulin G–associated disorders (MOGADs) are a newly defined entity of acquired demyelinating syndromes (ADSs). The three main clinical phenotypes consist of acute disseminated encephalitis (ADEM), optic neuritis (ON) and transverse myelitis (TM)/longitudinally extensive transverse myelitis (LETM). The clinical presentation is very much influenced by the age of the patient with ADEM occurring more often in children and ON in adults. Depending on the study, a relapsing disease course can occur in up to 40% of patients. In addition to the main phenotypes, other manifestations include myelin oligodendrocyte (MOG)-encephalitis with a unique clinical presentation, typical magnetic resonance imaging (MRI) features and good response to steroid treatment.1 Another unique and even rarer phenotype is described in the teaching case of this month issue of MSJ.2 The authors report a 4-year-old child who initially presented with all the hallmarks of ADEM, remained well until the age of 17 years and then developed progressive neurological decline over several years. MRI of the brain showed changes reminiscent of a progressive leukodystrophy. Despite treatment, the patient’s condition further deteriorated. Several aspects are remarkable. First, the child presented with ADEM. At the time, serum myelin oligodendrocyte-antibodies (MOG-abs) were not measured. One hypothesis is that the child already harboured MOG-abs with a presumed monophasic disease course but then developed another episode 13 years later (!). Second, the further course is reminiscent of a primary-progressive disease course with elements of neuroinflammation and neurodegeneration. The clinical course accompanied by MRI changes with confluent white matter changes and contrast medium enhancement is in stark contrast to the usually observed variants with good response to immunotherapy. The role of MOG-IgG antibodies in this subtype of MOGAD remains unclear. Serum MOG-IgG antibodies are mainly of the IgG1 subtype, induce complement-mediated cytotoxicity and transiently disrupt microtubule organization of oligodendrocyte.3,4 In this subtype of MOGAD, additional host and environmental factors are most likely instrumental in the disease process. As the authors conclude MOG-IgG antibodies should be tested in cases with leukodystrophy of unclear origin in the future.","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1485"},"PeriodicalIF":5.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40240575","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":"Therapy with mesenchymal stem cell transplantation in multiple sclerosis is ready for prime time: No.","authors":"Antonio Uccelli, Mark S Freedman","doi":"10.1177/13524585221095427","DOIUrl":"https://doi.org/10.1177/13524585221095427","url":null,"abstract":"Mark S Freedman Department of Medicine and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada Mesenchymal stromal/stem cells (MSCs) have been extensively studied in the last two decades with the objective to promote tissue repair in many neurological diseases including multiple sclerosis (MS). Seminal studies demonstrated that MSC can promote remyelination,1 slow axonal degeneration, and modulate pathogenic immune response against myelin antigens2 in experimental autoimmune encephalomyelitis (EAE), a model of MS. MSC can be rather easily isolated from the bone marrow (BM) or adipose tissue and expanded in vitro with limited manipulation before intravenous (IV) or local administration in rodents but also in humans, thus providing a strong rationale for their use in MS.3 A consensus conference was held in 20104 to review all available data and concluded that it was time to prove the potential benefit of MSC by outlining the template for a proper randomized trial to examine for an in vivo biological effect of MSC to reduce inflammation and promote repair. Several small human clinical trials ensued and concluded universally that MSC administration to MS patients, regardless the route of administration, was safe and feasible and reported some effect on Expanded Disability Status Scale (EDSS) and magnetic resonance imaging (MRI) metrics and might even reverse long-standing visual deficits.5 Despite these optimistic “hints,” the interpretation of results concerning efficacy of MSC on clinical and radiological parameters is, however, controversial:6 studies were vastly underpowered to generate consistent information on treatment effectiveness due to the limited number of patients and the heterogeneity of MS subtypes; furthermore, they were uncontrolled and unblinded, short-duration studies with limited extension of the clinical and radiological follow-up, rendering most results somewhat anecdotal, particularly for progressive MS patients. Other as yet unresolved issues make it difficult to compare results from these small studies, including the different sources for MSC isolation (e.g. BM, adipose tissue); dose https://doi.org/10.1177/13524585211062173 https://doi.org/10.1177/13524585211062173 Multiple Sclerosis Journal","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1326-1328"},"PeriodicalIF":5.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40470271","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":"SARS-CoV-2 serology after COVID-19 in multiple sclerosis: An international cohort study.","authors":"Maria Pia Sormani,&nbsp;Irene Schiavetti,&nbsp;Doriana Landi,&nbsp;Luca Carmisciano,&nbsp;Nicola De Rossi,&nbsp;Cinzia Cordioli,&nbsp;Lucia Moiola,&nbsp;Marta Radaelli,&nbsp;Paolo Immovilli,&nbsp;Marco Capobianco,&nbsp;Vincenzo Brescia Morra,&nbsp;Maria Trojano,&nbsp;Gioacchino Tedeschi,&nbsp;Giancarlo Comi,&nbsp;Mario Alberto Battaglia,&nbsp;Francesco Patti,&nbsp;Yara Dadalti Fragoso,&nbsp;Sedat Sen,&nbsp;Aksel Siva,&nbsp;Roberto Furlan,&nbsp;Marco Salvetti","doi":"10.1177/13524585211035318","DOIUrl":"https://doi.org/10.1177/13524585211035318","url":null,"abstract":"<p><strong>Background: </strong>The MuSC-19 project is an Italian cohort study open to international partners that collects data on multiple sclerosis (MS) patients with COVID-19. During the second wave of the pandemic, serological tests became routinely available.</p><p><strong>Objective: </strong>To evaluate the seroprevalence of anti-SARS-CoV-2 antibodies according to the use of disease-modifying therapy (DMT) in a subset of patients included in the MuSC-19 data set who had undergone a serological test.</p><p><strong>Methods: </strong>We evaluated the association between positive serological test results and time elapsed since infection onset, age, sex, Expanded Disability Status Scale score, comorbidities and DMT exposure using a multivariable logistic model.</p><p><strong>Results: </strong>Data were collected from 423 patients (345 from Italy, 61 from Turkey and 17 from Brazil) with a serological test performed during follow-up. Overall, 325 out of 423 tested patients (76.8%) had a positive serological test. At multivariate analysis, therapy with anti-CD20 was significantly associated with a reduced probability of developing antibodies after COVID-19 (odds ratio (OR) = 0.20, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>Patients with MS maintain the capacity to develop humoral immune response against SARS-COV-2, although to a lesser extent when treated with anti-CD20 drugs. Overall, our results are reassuring with respect to the possibility to achieve sufficient immunization with vaccination.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1034-1040"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/13524585211035318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39259962","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":"ADEM after ChAdOx1 nCoV-19 vaccine: A case report.","authors":"Virginia Rinaldi,&nbsp;Gianmarco Bellucci,&nbsp;Andrea Romano,&nbsp;Alessandro Bozzao,&nbsp;Marco Salvetti","doi":"10.1177/13524585211040222","DOIUrl":"https://doi.org/10.1177/13524585211040222","url":null,"abstract":"<p><p>Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system (CNS), clinically defined by an acute polyfocal neurological syndrome usually with monophasic course. ADEM often occurs after infections, but 5%-10% of cases are preceded by vaccinations. Several cases of ADEM have been described after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whereas no case has been reported after adenovirus-vectored or mRNA COVID-19 vaccine administration. Here we describe a case of ADEM presenting 2 weeks after receiving the first dose of ChAdOx1 nCoV-19 vaccine. Patient clinical/magnetic resonance imaging (MRI) status spontaneously improved and rapidly resolved with corticosteroids. A 4-month follow-up showed complete recovery and no relapses.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1151-1154"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39471938","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":"Effects of voice rehabilitation in people with MS: A double-blinded long-term randomized controlled trial.","authors":"Valeria Crispiatico,&nbsp;Cinzia Baldanzi,&nbsp;Arianna Napoletano,&nbsp;Laura Tomasoni,&nbsp;Francesca Tedeschi,&nbsp;Elisabetta Groppo,&nbsp;Marco Rovaris,&nbsp;Chiara Vitali,&nbsp;Davide Cattaneo","doi":"10.1177/13524585211051059","DOIUrl":"https://doi.org/10.1177/13524585211051059","url":null,"abstract":"<p><strong>Background: </strong>Hypophonia is a prevailing problem in people with multiple sclerosis (PwMS). However, evidence supporting the effectiveness of voice rehabilitation is lacking.</p><p><strong>Objective: </strong>The aim of this study was to identify the most effective method to reduce hypophonia.</p><p><strong>Methods: </strong>In this randomized controlled trial, 44 PwMS were randomized to intensive and high-effort voice treatment groups, the LSVT-LOUD^®, and conventional treatment group. Subjects received 16 treatments (4 sessions/week) lasting 45 minutes. The primary outcome was voice intensity (dB) in monologue, vocalization, and sentences while voice handicap index (VHI) measured voice self-perception. Outcomes were assessed by a blinded observer at baseline, post-treatment, and 15-month follow-up (FU).</p><p><strong>Results: </strong>Linear models revealed a significant post-intervention between-group mean difference in favor of LSVT-LOUD for monologue: +6.3 dB (95% CI: 2.5 to 10.1); vocalization: +7.4 dB (95% CI: 2.3 to 12.5); and sentences: +9.5 dB (95% CI: 4.7 to 14.3). However, 43.7% PwMS in the LSVT-LOUD and 10% in the conventional treatment group obtained a full recovery of voice intensity (>60 dB) post-treatment, Fisher's test = 13.3, <i>p</i> < 0.01. However, these improvements were not maintained at FU. Between-group differences at VHI were -10.8 (95% CI: -21.2 to -0.4) and -11.3 (95% CI: -24.3 to -1.7) in favor of LSVT-LOUD at post and FU.</p><p><strong>Conclusion: </strong>LSVT-LOUD can be a valid treatment to increase voice intensity in PwMS. However, results suggest the need for FU interventions targeting maintenance.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1081-1090"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39522587","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":"Demyelinating disorders following COVID-19 vaccination.","authors":"Marcello Moccia","doi":"10.1177/13524585211046903","DOIUrl":"https://doi.org/10.1177/13524585211046903","url":null,"abstract":"Introduction: Recent studies suggested that anti-CD20 and fingolimod may be associated with lower anti-spike protein-based immunoglobulin-G response following COVID-19 vaccination. We evaluated if COVID-19 occurred despite vaccination among patients with multiple sclerosis (MS) and neuromyelitis optica (NMO), using the COVISEP registry. Case series: We report 18 cases of COVID-19 after two doses of BNT162b2-vaccination, 13 of which treated with anti-CD20 and four with fingolimod. COVID-19 severity was mild. Discussion: These results reinforce the recommendation for a third COVID-19 vaccine dose among anti-CD20 treated patients and stress the need for a prospective clinical and biological study on COVID-19 vaccine efficacy among MS and NMO patients.","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1154-1155"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39471661","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":"MOG-antibody-associated longitudinal extensive myelitis after ChAdOx1 nCoV-19 vaccination.","authors":"Larissa Dams,&nbsp;Markus Kraemer,&nbsp;Jana Becker","doi":"10.1177/13524585211057512","DOIUrl":"https://doi.org/10.1177/13524585211057512","url":null,"abstract":"<p><p>This case report describes a 59-year-old man with myelin oligodendrocyte glycoprotein (MOG)-positive longitudinal extensive transverse myelitis (LETM) after being vaccinated with the COVID-19 vaccine ChAdOx1 nCoV-19. He presented with urinary retention, gait disturbance, hypoesthesia and brisk reflexes in his lower extremities without paresis. Due to the ineffectiveness of high-dose intravenous methylprednisolone, therapeutic plasma exchange was performed, gradually improving the patient's condition. Vaccination as a trigger for an excessive immunological response seems plausible, though unspecific for the ChAdOx1 nCoV-19 vaccine.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1159-1162"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39606089","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":"MOG antibody-associated longitudinal extensive myelitis after Oxford-Astra Zeneca's COVID-19 vaccination.","authors":"Sarah Wright","doi":"10.1177/13524585211066771","DOIUrl":"https://doi.org/10.1177/13524585211066771","url":null,"abstract":"Sarah Wright MS and Neuroinflammation, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK In this issue of the journal, Dam et al. report a case of myelin oligodendrocyte glycoprotein–associated disorder (MOGAD) myelitis following vaccination with ChAdOx1 nCoV-19. More than 3 billion doses of COVID-19 vaccines have now been administered worldwide, and this case illustrates the rarity of postvaccination-associated MOGAD.","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1163"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39914023","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":"Interpreting change on the Symbol Digit Modalities Test in people with relapsing multiple sclerosis using the reliable change methodology.","authors":"Zachary Weinstock,&nbsp;Sarah Morrow,&nbsp;Devon Conway,&nbsp;Tom Fuchs,&nbsp;Curtis Wojcik,&nbsp;Mahmut Unverdi,&nbsp;Robert Zivadinov,&nbsp;Bianca Weinstock-Guttman,&nbsp;Grant L Iverson,&nbsp;Michael Dwyer,&nbsp;Ralph Hb Benedict","doi":"10.1177/13524585211049397","DOIUrl":"https://doi.org/10.1177/13524585211049397","url":null,"abstract":"<p><strong>Background: </strong>The Symbol Digit Modalities Test (SDMT) is increasingly utilized in clinical trials. A SDMT score change of 4 points is considered clinically important, based on association with employment anchors. Optimal thresholds for statistically reliable SDMT changes, accounting for test reliability and measurement error, are yet to be applied to individual cases.</p><p><strong>Objective: </strong>The aim of this study was to derive a statistically reliable marker of individual change on the SDMT.</p><p><strong>Methods: </strong>This prospective, case-control study enrolled 166 patients with multiple sclerosis (MS). SDMT scores at baseline, relapse, and 3-month follow-up were compared between relapsing and stable patient groups. Using data from the stable group and three previously published studies, candidate thresholds for reliable decline were calculated and validated against other tests and a clinically meaningful anchor-cognitive relapse.</p><p><strong>Results: </strong>Candidate thresholds for reliable decline at the 80% confidence level varied between 6 and 11 points. An SDMT change of 8 or more raw score points was deemed to offer the best balance of discriminatory power and external validity for estimating cognitive decline.</p><p><strong>Conclusion: </strong>This study illustrates the feasibility and usefulness of reliable change methodology for identifying statistically meaningful cognitive decline that could be implemented to identify change in individual patients, for both clinical management and clinical trial outcomes.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1101-1111"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39491111","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 rate of hospitalisation for COVID-19 among rituximab-treated multiple sclerosis patients: A study of the Swedish multiple sclerosis registry.","authors":"Tim Spelman,&nbsp;Lars Forsberg,&nbsp;Kyla McKay,&nbsp;Anna Glaser,&nbsp;Jan Hillert","doi":"10.1177/13524585211026272","DOIUrl":"https://doi.org/10.1177/13524585211026272","url":null,"abstract":"<p><strong>Background: </strong>The primary objective of this study was to analyse the association between multiple sclerosis (MS) disease-modifying therapy (DMT) exposure and hospitalisation in patients infected with COVID-19.</p><p><strong>Methods: </strong>Associations between MS DMT exposure and COVID-19 hospitalisation were analysed using univariable and multi-variable-clustered propensity score weighted logistic regression, where the models were clustered on the individual patients to control for patients contributing multiple COVID-19 episodes.</p><p><strong>Findings: </strong>As of 18 January 2021, a total of 476 reported COVID-19 cases had been recorded in MS patients in the Swedish MS registry. Of these, 292 (61.3%) had confirmed COVID-19. The mean value (standard deviation (SD)) age at infection was 44.0 years (11.6). Of the 292 confirmed infections, 68 (23.2%) required hospitalisation. A total of 49 of the 164 confirmed COVID-19 patients on rituximab at baseline (29.9%) required hospitalisation, compared to a rate of 12.7% for all other DMTs combined. Rituximab in confirmed COVID-19 patients was associated with 2.95 times the odds of hospitalisation relative to any other DMT combined (odds ratio = 2.95; 95% confidence interval (CI) = 1.48-5.87).</p><p><strong>Interpretation: </strong>Rituximab treatment, known to increase the risk of severe infections in general, also confers such a risk for MS patients with COVID-19, in comparison with other MS DMTs.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"1051-1059"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/13524585211026272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39140928","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}