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[Antioxidant use as dietary therapy in patients with multiple sclerosis].

INTRODUCTION: Multiple sclerosis is an immune-mediated disease that produces chronic inflammation and neural degeneration. The disease progresses with acute attacks that result in myelin inflammation. This in turn increases oxidative stress and favors the appearance of reactive oxygen species. Reactive oxygen species damage neural cells causing apoptosis. The etiology of multiple sclerosis remains unknown and current therapy is aggressive and expensive. Recently, complementary and alternative medicine therapies have been proposed to control pathogenesis and symptoms of this disease. It is beli…

Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity.

BACKGROUND AND OBJECTIVES: Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed. METHODS: Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5,648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to …

Functional Connectivity Alterations of the Central Autonomic Network in Multiple Sclerosis: Links to Fatigue and Aerobic Training Effects.

BACKGROUND AND OBJECTIVES: Autonomic dysfunction is common in multiple sclerosis (MS), and autonomic symptoms are independent contributors to MS fatigue. Aerobic training (AT) has been shown to reduce fatigue severity and to promote functional network reorganization in MS. We explored resting-state (RS) functional connectivity (FC) of the central autonomic network (CAN) in MS, its relationship with fatigue severity, and its modifications after AT vs non-AT. METHODS: Seventy-five patients with MS (38 with relapsing-remitting [RR] and 37 with progressive [P]) underwent 3T RS functional MRI at b…

Longitudinal changes in serum immunoglobulin levels and peripheral immune cell counts during ocrelizumab treatment in people with multiple sclerosis.

Ocrelizumab is a humanized monoclonal antibody targeting the CD20 antigen on B cells, approved for the treatment of multiple sclerosis (MS). This retrospective observational study investigated the longitudinal immunological effects of ocrelizumab in a real-world cohort of patients with relapsing and progressive MS. Distinct and time-dependent immunological changes emerged, with a marked and early decline in IgM levels, a slower reduction in IgG and IgA levels. As expected with ocrelizumab therapy, CD20+ and CD19+ B-cell counts showed marked and persistent depletion from the first post-treatmen…

Subcutaneous Ocrelizumab in Patients With Multiple Sclerosis: Results of the Phase 3 OCARINA II Study.

BACKGROUND AND OBJECTIVES: IV-administered ocrelizumab (OCR) is approved for the treatment of relapsing and primary progressive multiple sclerosis (RMS/PPMS). OCARINA II (NCT05232825) was designed to demonstrate noninferiority in drug exposure of OCR subcutaneous (SC) vs IV administration. METHODS: This phase 3, randomized, open-label study enrolled OCR-naive patients aged 18-65 years with RMS/PPMS and an Expanded Disability Status Scale score of 0-6.5. Patients received OCR IV 600 mg or OCR SC 920 mg (controlled period), followed by OCR SC 920 mg every 24 weeks, up to week 96 (OCR IV/SC and …

Reappraisal of brain MRI features in patients with multiple sclerosis and neuromyelitis optica according to anti-aquaporin-4 antibody status.

Brain lesions are not uncommon in neuromyelitis optica (NMO) patients with anti-aquaporin-4 (AQP4) antibody; however, the appearance of these lesions is said to be different from that of those in Western patients with multiple sclerosis (MS). To clarify the similarities and dissimilarities of brain lesions in anti-AQP4 antibody-positive and -negative MS and NMO patients, we examined the presence of anti-AQP4 antibody in the sera of 148 consecutive patients fulfilling Poser's criteria for clinically definite MS, of whom 38 also met the revised NMO criteria, using an immunofluorescence method, a…

Adapting standard care to support self-management for a patient with lymphoedema and neurological co-morbidities: a case report.

This case report discusses the role of a practitioner managing a patient with secondary lymphoedema as part of a self-management regime. The patient was diagnosed with multiple sclerosis and lumbar spinal stenosis. The focus is on compression therapy, which is used as part of complete decongestive therapy to reduce and control lymphoedema. The case report illustrates how a patient-centred plan can help people with lymphoedema and co-morbidities to achieve their personal goals. The evidence behind treatment decisions is considered, and modifications made to the care plan to accommodate the need…

Headache and Other Pain Syndromes in Multiple Sclerosis: A Narrative Review.

Multiple sclerosis is a chronic and progressive neurological disease, with an important socio-economic burden. Over time, an increased incidence of headaches like migraines and tension headaches has been observed among these patients. Headaches have not been considered as multiple sclerosis-related symptoms, even representing a red flag for multiple sclerosis diagnosis. It is uncertain whether the headache-multiple sclerosis association could be explained by the presence of common triggers or a common physiopathological mechanism (involvement of tertiary B-cell follicles). An important differe…

Изучение факторов, определяющих эволюцию хронических повреждений в множестве склерозов с помощью машинного обучения.

ЦЕЛИ: Исследование было направлено на выявление факторов, влияющих на эволюцию хронических повреждений при множественном склерозе (МС) с использованием метода машинного обучения. МАТЕРИАЛЫ И МЕТОДЫ: Продольные данные собирались у лиц с множественным склерозом (RRMS). Знак "железного обода" был определен с использованием количественного картографирования уязвимости (QSM), а микроструктурные повреждения были оценены с помощью коэффициентов восстановления потока (FLEAIR) с использованием T1/fluid. Дополнительные данные включали базовый объем повреждений, объем церебрального повреждения Т2-гиперин

Совпадение в аннотации оригинала
OBJECTIVES: The study aimed to identify factors influencing the evolution of chronic lesions in multiple sclerosis (MS) using a machine learning approach. MATERIALS AND METHODS: Longitudinal data were collected from individuals with relapsing-remitting multiple sclerosis (RRMS). The "iron rim" sign was identified using quantitative susceptibility mapping (Q…

Cost Effectiveness and Budget Impact of Siponimod Compared to Interferon Beta-1a in the Treatment of Adult Patients with Secondary Progressive Multiple Sclerosis with Active Disease in Switzerland.

OBJECTIVE: The study aim was to evaluate the cost effectiveness and budget impact of siponimod compared to interferon beta-1a for adult patients with secondary progressive multiple sclerosis (SPMS) with active disease, from a Swiss health insurance perspective. METHODS: We conducted an analysis using a Markov cohort model with a cycle length of 1 year, life-long time horizon, and discount rate of 3% for cost and health outcomes. We used a matching-adjusted indirect comparison to estimate clinical outcomes using data from the EXPAND randomised controlled trial of siponimod vs placebo and the N…

An Autopsy Confirmed Neuromyelitis Optica Spectrum Disorder with Extensive Brain White Matter Lesion and Optic Neuritis but Intact Spinal Cord, Clinically Mimicking a Secondary Progressive Multiple Sclerosis-like Course.

A 57-year-old woman presented with optic neuritis with repeated clinical symptoms of focal demyelination of the cerebral white matter and brain stem for 14 years. At the end of the patient's course, the clinical signs mimicked secondary progressive multiple sclerosis, but whether it was caused by interferon administration or neuromyelitis optica spectrum disorders (NMOSD) - or a combination of both or others - was unclear. Histopathological findings indicated the etiology to be NMOSD, with no apparent plaque in spinal cord specimens. This case suggests that an accurate clinical diagnosis requi…

Differential cerebellar activation on functional magnetic resonance imaging during working memory performance in persons with multiple sclerosis.

OBJECTIVE: To explore the potential role of the cerebellum in working memory dysfunction in multiple sclerosis (MS). DESIGN: Blood oxygen level dependent functional magnetic resonance imaging (fMRI) was used to examine cerebellar activation during a working memory task. SETTING: University-affiliated medical rehabilitation facility. PARTICIPANTS: Eight persons with MS and 5 healthy controls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Change in hemodynamic response. fMRI data were acquired and subsequently analyzed by using Statistical Parametric Mapping. RESULTS: Both the cont…

Spinal cord herniation: a missing piece in the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis?

BACKGROUND: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal c … comitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis. The third patient underwent surgery and gradually recovered over 6 months. CONCLUSIONS: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and mul …

Longitudinal changes in serum protein levels are associated with disability progression in multiple sclerosis.

BACKGROUND: Early identification of patients with multiple sclerosis (MS) at risk of transitioning from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS) remains a major clinical challenge. Although magnetic resonance imaging (MRI) is widely used to monitor disease activity, imaging markers alone may not adequately predict progression. The identification of accessible biochemical markers associated with disability progression could improve long-term monitoring. METHODS: This retrospective observational study evaluated clinical, radiological, and …

Long-term effectiveness and safety of ocrelizumab: a single-centre real-world study.

BACKGROUND: This retrospective single-centre study evaluated the effectiveness and safety of ocrelizumab (OCR) in relapse-onset multiple sclerosis (RMS) and primary progressive MS (PPMS) and identified predictors of treatment response. METHODS: We included 260 RMS and 73 PPMS patients treated with ocrelizumab for ≥ 1 year at our MS Centre until May 2024. RESULTS: Median follow-up was 3.90 years for RMS and 4.23 years for PPMS. Within 2 years from treatment initiation, annualized relapse rate (ARR) decreased from 0.412 to 0.014 and was maintained low throughout follow-up in RMS, with no relap…

Early reduction of retinal thickness predicts physical and cognitive disability in newly diagnosed multiple sclerosis patients: results from a cross-sectional study.

INTRODUCTION: Retinal nerve fiber layer (RNFL) thickness is a promising biomarker of axonal loss and a potential outcome predictor in Multiple Sclerosis (MS). Cognitive impairment (CoI) exhibits a high prevalence in patients with MS (pwMS), even in the early phases of the disease. Our aim was to explore the role of RNFL thickness as a predictor of physical and cognitive disability in pwMS. METHODS: All newly diagnosed pwMS referred to the MS centre of the University-Hospital "Policlinico-San Marco" between 2015-2019 were evaluated at baseline and at 3 years. RNFL and ganglion cell layer (GCL)…

Progressive multiple sclerosis: Six trials to watch.

Emerging therapies for progressive multiple sclerosis (PMS) increasingly target CNS-compartmentalized inflammation driving progression independent of relapse activity. Six pivotal trials are evaluating Bruton's tyrosine kinase inhibitors, CD40-CD40L blockade, and CD19-directed CAR-T cells. Together, these studies may establish mechanism-based strategies to modulate microglia and B cell pathology, redefining treatment of progression and addressing a major unmet clinical need.

Disease-modifying treatment and disability progression in subclasses of patients with primary progressive MS: results from the Big MS Data Network.

BACKGROUND: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories. METHODS: Within the framework of the Big MS Data network, we merged data from the Observatoire Français de la Sclérose en Plaques, the Swedish and Italian MS registries, and MSBase. We identified patients with…

Interthalamic adhesion alterations in multiple sclerosis: associations with thalamic damage and cognition.

BACKGROUND/OBJECTIVES: We investigated whether the interthalamic adhesion (IA), a midline structure connecting the thalami, is altered in multiple sclerosis (MS) and associated with thalamic damages and cognition. METHODS: We prospectively included 32 clinically isolated syndrome/early MS, 31 relapsing-remitting MS, 31 primary-progressive MS patients, and 103 matched controls. All underwent anatomical 3 T MRI and completed a comprehensive cognitive battery. IA presence, subtype, and volume were assessed by two blinded readers. Thalamic nuclei and other brain structures were segmented automati…

Изучение явления износа методов лечения против CD20 при множественном склерозе.

ВВЕДЕНИЕ: явление износа, характеризующееся возобновлением или ухудшением симптомов до следующей плановой дозы, может затрагивать людей с множественным склерозом (pwMS), получающих антиCD20 моноклональную антителную терапию. Это явление может негативно сказаться на функциональном статусе пациентов и их восприятии мер по борьбе с заболеваниями. ЦЕЛИ: Оценить распространенность, клинические характеристики и потенциальные факторы риска, связанные с износом в ПТМС, обработанных окролизумабами, атумумабами или ритуксимабами. МЕТОДЫ: Мы провели когортное исследование по всему спектру, в котором прин

Совпадение в аннотации оригинала
INTRODUCTION: The wearing-off phenomenon, characterized by the re-emergence or worsening of symptoms prior to the next scheduled dose, may affect people with Multiple Sclerosis (pwMS) receiving anti-CD20 monoclonal antibody therapies. This phenomenon can negatively influence patients' functional status and perception of disease control. OBJECTIVES: To asses…