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An integrated framework for clinical surveillance in multiple sclerosis: An evidence-informed narrative review.

UNLABELLED: An Integrated Framework for Clinical Surveillance in Multiple Sclerosis: an evidenceinformed narrative review Background: Multiple sclerosis (MS) requires structured lifelong surveillance across clinical, imaging, safety and patient-centred domains. We aimed to integrate relevant recommendations and evidence into a practical framework for longitudinal care. METHODS: We conducted an evidence-informed narrative review of PubMed/MEDLINE, Embase and the Cochrane Library from inception to December 2025, supplemented by society and institutional guidance and reference-list searching. Ev…

Нацеливание на α7-никотиновый ацетилхолиновый рецептор при множественном склерозе: последствия для иммуномодуляции и нейрозащиты.

Множественный склероз (MS) — хроническое иммунное расстройство, характеризующееся демиелинацией, аксонной дегенерацией и прогрессивной неврологической инвалидностью. Текущие методы лечения с целью изменения заболеваний (ДМТ) неадекватно решают проблемы нейродегенерации и отказа от ремиелинирования, особенно в прогрессивных СМ. α7-никотиновый ацетилхолиновый рецептор (α7-nAChR), являющийся ключевым посредником в холинергическом антивоспалительном пути, стал многообещающей терапевтической целью, которая соединяет иммуномодуляцию и нейрозащиту. Этот обзор синтезирует текущие данные о биологии, ра

Совпадение в аннотации оригинала
Multiple sclerosis (MS) is a chronic immune-mediated disorder characterized by demyelination, axonal degeneration, and progressive neurological disability. Current disease-modifying therapies (DMTs) inadequately address neurodegeneration and remyelination failure, particularly in progressive MS. The α7-nicotinic acetylcholine receptor (α7-nAChR), a key media…

Menopause and multiple sclerosis: A scoping review of symptoms, disease course, and lived experience.

Menopause influences disease activity in women with multiple sclerosis. This scoping review mapped current evidence on menopause in women with multiple sclerosis across symptom, disease, biological, and lived experience domains. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was preregistered on Open Science Framework (DOI 10.17605/OSF.IO/H8QBM). PubMed/MEDLINE, Embase, Web of Science, Scopus, CINAHL, and PsycINFO were searched for studies between January 1, 2018, and April 29, 2025. Two reviewers independently screened records with third-party adju…

Association of treatment decision with personality, coping strategies and impulsivity in patients with multiple sclerosis.

INTRODUCTION: Shared decision-making is advocated in treating patients with multiple sclerosis (pwMS), enabled by the wide range of disease-modifying treatments (DMTs). However, the role of psychological characteristics in treatment decisions remains understudied. METHODS: In a prospective study, pwMS completed the Big Five Trait inventory, UPPS Impulsive Behaviour Scale and Brief COPE at treatment initiation. Associations between choosing high-efficacy DMTs (H-DMT; natalizumab, anti-CD20 monoclonal antibodies) versus low/moderate-efficacy DMTs were analysed using logistic regression, for eac…

Association between chronological age and vascular function in adults with and without multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is associated with vascular comorbidity that increases with age. Vascular function (VF) is associated with vascular comorbidity and outcomes such as cognition, fatigue, and disability in MS. Age predicts VF in the general population, yet this relationship is unknown in MS. OBJECTIVES/METHODS: This study compared MS (n=129) and controls (n=51) based on carotid-femoral pulse wave velocity (PWV) and heart rate-corrected augmentation index (AIx75) and examined age as a predictor of PWV and AIx75. RESULTS: The samples did not differ based on age, sex or body ma…

Is MR Imaging of the Cervical Spinal Cord Sufficient for Patients with Suspected Multiple Sclerosis?

PURPOSE: Lesions in the spinal cord (SC) can be found in up to 83% of patients with multiple sclerosis (MS). As they are mainly located in the cervical segment, many centers exclude the thoracic part from SC imaging. The aim of our study was to quantify the decrease in sensitivity resulting from this approach. METHODS: MR images (3T) of 543 consecutive patients with clinically isolated syndrome (CIS) (n: 37) and MS (n: 506) were analyzed retrospectively. Lesions were segmented semi-automatically on axial T2-weighted images of the whole SC using BrainSeg3D. The volume of lesions was related to…

Iron-Rim Lesions in the Optic Chiasm in Multiple Sclerosis: A Neuropathologic Case Series.

OBJECTIVES: The aim of this study was to demonstrate the presence of iron-rim lesions (IRLs) in the anterior visual pathway in multiple sclerosis (MS). METHODS: Postmortem formalin-fixed paraffin-embedded anterior visual pathway tissues (optic chiasms) from 3 donors with MS were examined for iron using Turnbull Blue histochemistry. Demyelinated lesions were identified and staged with immunohistochemistry for myelin proteolipid protein and CD68. RESULTS: A total of 9 lesions were identified, all of which were mixed active/inactive. Iron-positive microglia and macrophages were identified at th…

Does Interrater Variation Influence the Classification According to the Diagnostic Criteria for Multiple Sclerosis?

BACKGROUND: Studies on interrater agreement in MRI analysis for patients experiencing a first clinical episode suggestive of multiple sclerosis (MS) are limited and outdated. This study aimed to evaluate interrater agreement for lesion identification in the brain, optic nerve, and spinal cord, and to assess variability in applying the 2017 and 2024 McDonald criteria. METHODS: Seventy-eight patients underwent a standardized multisequence 3 Tesla MRI of the brain, optic nerves, and spinal cord, analyzed by three readers with varying expertise. Lesions were categorized based on location accordin…

Association between comorbidities and health-related quality of life in patients with multiple sclerosis.

PURPOSE: Multiple sclerosis (MS) is a debilitating disease accompanied by physical and mental comorbidities. Little is known about the relation between different comorbidities and health-related quality of life (HRQOL) in people with MS (pwMS). Therefore, we designed this study to assess the association between comorbidities and HRQOL. METHODS: In this cross-sectional study, of 976 pwMS attending the MS clinic of Kashani Hospital in Isfahan, Iran were assessed. The data on comorbidity were extracted from patients' medical records. The 36-Item Short Form Survey (SF-36) was used to measure HRQO…

Obsessive-compulsive disorder in people with multiple sclerosis: a systematic review and meta-analysis.

BACKGROUND: Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder that is frequently associated with psychiatric comorbidities, particularly obsessive-compulsive disorder (OCD). OCD may increase psychological burden, reduce quality of life, and exacerbate disease activity in people with MS (PwMS). However, the frequency of OCD in PwMS and its association with MS remain mostly uncertain. This review aimed to estimate the overall prevalence of OCD in PwMS and to evaluate the association between MS and OCD. METHODS: A comprehensive search of PubMed, Scopus, Embase, and Web …

Lost in space, lost in time: A clinician's proposed approach to the diagnosis of multiple sclerosis.

Current McDonald criteria for multiple sclerosis (MS) rely on complex statistical metaphors-dissemination in space and time-that are prone to clinical misapplication. This manuscript proposes a clinician-centred approach that simplifies diagnosis by focusing on four fundamental immunobiological pillars: confirming the condition is a chronic, inflammatory, demyelinating disease of the CNS. By reclassifying existing markers-such as the central vein sign, paramagnetic rim lesions, and neurofilaments-into these intuitive categories, the model provides clinicians greater flexibility to triangulate …

Distortion in the Communication of Nonsignificant Primary Outcomes: The Spin Strategy in Multiple Sclerosis Trials.

OBJECTIVE: Spin refers to reporting strategies that highlight the benefits of an experimental treatment or divert attention from nonsignificant primary outcomes. To assess spin in randomized clinic trials (RCTs) on pharmaceutical efficacy in multiple sclerosis (MS) and explore associated factors. METHODS: A systematic literature search was conducted in MedLine (PubMed), EMBASE, and Cochrane using database-specific thesauri ("Multiple Sclerosis" and "Drug Therapy") to identify relevant studies. We included multiple sclerosis phase 3 and 4 randomized controlled trials with parallel, superiority…

Oxylipin Biomarkers of Auto-Oxidation Are Associated with Antioxidant Micronutrients and Multiple Sclerosis Disability.

Purpose: To investigate associations between lipid oxidation biomarkers (oxylipins), antioxidant micronutrients, lipoprotein particles, and apolipoproteins in multiple sclerosis (MS). Methods: Blood and neurological assessments were collected from 30 healthy controls, 68 relapsing remitting MS subjects, and 37 progressive MS subjects. Hydroxy (H) and hydroperoxy lipid peroxidation products of the polyunsaturated fatty acids (PUFAs) arachidonic (20:4, ω-6), linoleic (octadecadienoic acid or ODE, 18:2, ω-6), eicosapentaenoic (20:5, ω-3), and α-linolenic (18:3, ω-3) acids were measured using liqu…

Sexual dysfunction in multiple sclerosis: the role of orexin-A and calpain-2 - a pilot study.

BACKGROUND: Sexual dysfunction (SD) is a common autonomic symptom in patients with multiple sclerosis (pwMS), significantly affecting their quality of life. Alterations in serum levels of calpain-2 (CAPN2) and orexin-A (ORX-A) may contribute to SD development. OBJECTIVE: This study aimed to assess the prevalence of SD in pwMS and investigate its association with serum CAPN2 and ORX-A levels. METHODS: Fifty-seven pwMS diagnosed with relapsing-remitting MS were enrolled. Participants completed the Arizona Sexual Experiences Scale (ASEX), Multiple Sclerosis Quality of Life-54 (MSQoL-54), Beck Dep…

Artificial Intelligence analysis of lesion dynamics and brain volume in patients with multiple sclerosis.

BACKGROUND: Quantitative MRI markers increasingly complement conventional clinical assessment in multiple sclerosis (MS). Artificial intelligence (AI)-based volumetry enables standardized evaluation of lesion burden and brain atrophy in routine care. OBJECTIVE: To examine the association between AI-derived volumetric measures and disability, assess whether annual brain volume loss (ABVL) and lesion dynamics predict atrophy, and descriptively compare proxy radiological phenotype groups with established clinical phenotypes in a real-world MS cohort. MATERIAL AND METHODS: This retrospective stu…

Availability and affordability of therapies and services of multiple sclerosis in Africa: A continent-wide survey.

BACKGROUND: Limited data is available about the availability of multiple sclerosis (MS) therapies and services in Africa. OBJECTIVE: We aimed to investigate the availability, affordability, frequency of usage, and insurance coverage of MS therapies and services across Africa. METHODS: A comprehensive web-based survey was constructed and distributed to neurologists from different African countries. The survey addresses availability, affordability, frequency of use, and insurance coverage of different therapies and services of MS. RESULTS: Respondents represented 27 African countries. Intrave…

Performance of the 2024 McDonald Criteria in Patients Under Evaluation for Suspected Multiple Sclerosis.

BACKGROUND AND OBJECTIVES: The 2024 McDonald criteria provide new recommendations for multiple sclerosis (MS) diagnosis, but validation of the criteria is lacking. We wanted to investigate the application and performance of the 2024 McDonald criteria in patients with suspected MS seen in routine clinical practice. METHODS: We retrospectively identified patients referred with clinical and/or radiologic suspicion for MS between January and December 2024. All patients had a minimum diagnostic evaluation with brain and spinal cord MRI. The 2017 McDonald criteria were applied prospectively, and th…

Accelerated metabolomic aging and its association with social determinants of health in multiple sclerosis.

OBJECTIVES: Biological age may better capture differences in disease course among people with multiple sclerosis (PwMS) of identical chronological age. We investigated biological age acceleration through metabolomic age (mAge) in PwMS and its association with social determinants of health (SDoH) measured by area deprivation index (ADI). METHODS: mAge was calculated for two cohorts: 323 PwMS and 66 healthy controls (HCs); 101 HCs and 71 DMT-naïve PwMS, using an aging clock derived from 11,977 healthy adults. mAge acceleration, the difference between mAge and chronological age, was compared bet…

The pursuit of happiness: Social participation and happiness among minority individuals with multiple sclerosis.

There is a dearth of literature on the dynamics of psychosocial factors and their relation to social participation and happiness among racial and ethnic minorities with multiple sclerosis (MS). A total of 224 racial/ethnic minority participants with MS participated in the study. Using hierarchical regression analysis, the study investigated the extent to which participation in social roles and activities is associated with happiness among minority individuals with MS, controlling for demographic covariates, socioeconomic variables, disability related stress, and positive traits. The final mode…