首页 > 最新文献

Annals of Clinical and Translational Neurology最新文献

英文 中文
Real-world clinical experience with serum MOG and AQP4 antibody testing by live versus fixed cell-based assay
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1002/acn3.52310
Yana Said, Angeliki Filippatou, Conlan Tran, LuAnn Rezavi, Kai Guo, Matthew D. Smith, Yasmin Resto, John J. Chen, Peter A. Calabresi, Patrizio Caturegli, Sean J. Pittock, Eoin P. Flanagan, Elias S. Sotirchos

Objective

To assess the real-world performance of a live (LCBA) versus a fixed (FCBA) cell-based assay for the detection of serum antibodies directed against myelin oligodendrocyte glycoprotein (MOG-IgG) and aquaporin-4 (AQP4-IgG).

Methods

This was a retrospective study of patients evaluated at a single tertiary academic referral center, with serum testing performed clinically for AQP4-IgG and/or MOG-IgG by FCBA and LCBA on the same day. Additionally, frozen banked sera from the same day for patients tested only by one assay were retrieved and tested by the other assay. FCBA was performed by the Johns Hopkins Immunology Laboratory using Euroimmun kits with detection by indirect immunofluorescence (FCBA-IF), whereas LCBA was performed by the Mayo Clinic Neuroimmunology Laboratory with detection by flow cytometry (LCBA-FACS).

Results

Of 594 specimens with paired MOG-IgG testing, 500 were negative by both assays, 33 were positive by both assays, 56 were positive exclusively by LCBA-FACS, and 5 were only positive by FCBA-IF. Overall, MOG-IgG LCBA-FACS exhibited 95.1% sensitivity and 97.7% specificity, whereas MOG-IgG FCBA-IF had 45.7% sensitivity and 99.8% specificity. Of 577 specimens with paired AQP4-IgG testing, 503 were negative by both assays, 51 were positive by both assays, 21 were positive exclusively by LCBA-FACS, and 2 were only positive by FCBA-IF. Overall, AQP4-IgG LCBA-FACS exhibited 97.3% sensitivity and 100% specificity, whereas AQP4-IgG FCBA-IF had 71.6% sensitivity and 100% specificity.

Interpretation

LCBA-FACS for both MOG-IgG and AQP4-IgG had markedly better sensitivity than FCBA-IF, with similar specificity. The use of FCBA-IF may result in underrecognition of both MOG antibody-associated disease (MOGAD) and AQP4-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD).

{"title":"Real-world clinical experience with serum MOG and AQP4 antibody testing by live versus fixed cell-based assay","authors":"Yana Said,&nbsp;Angeliki Filippatou,&nbsp;Conlan Tran,&nbsp;LuAnn Rezavi,&nbsp;Kai Guo,&nbsp;Matthew D. Smith,&nbsp;Yasmin Resto,&nbsp;John J. Chen,&nbsp;Peter A. Calabresi,&nbsp;Patrizio Caturegli,&nbsp;Sean J. Pittock,&nbsp;Eoin P. Flanagan,&nbsp;Elias S. Sotirchos","doi":"10.1002/acn3.52310","DOIUrl":"10.1002/acn3.52310","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the real-world performance of a live (LCBA) versus a fixed (FCBA) cell-based assay for the detection of serum antibodies directed against myelin oligodendrocyte glycoprotein (MOG-IgG) and aquaporin-4 (AQP4-IgG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective study of patients evaluated at a single tertiary academic referral center, with serum testing performed clinically for AQP4-IgG and/or MOG-IgG by FCBA and LCBA on the same day. Additionally, frozen banked sera from the same day for patients tested only by one assay were retrieved and tested by the other assay. FCBA was performed by the Johns Hopkins Immunology Laboratory using Euroimmun kits with detection by indirect immunofluorescence (FCBA-IF), whereas LCBA was performed by the Mayo Clinic Neuroimmunology Laboratory with detection by flow cytometry (LCBA-FACS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 594 specimens with paired MOG-IgG testing, 500 were negative by both assays, 33 were positive by both assays, 56 were positive exclusively by LCBA-FACS, and 5 were only positive by FCBA-IF. Overall, MOG-IgG LCBA-FACS exhibited 95.1% sensitivity and 97.7% specificity, whereas MOG-IgG FCBA-IF had 45.7% sensitivity and 99.8% specificity. Of 577 specimens with paired AQP4-IgG testing, 503 were negative by both assays, 51 were positive by both assays, 21 were positive exclusively by LCBA-FACS, and 2 were only positive by FCBA-IF. Overall, AQP4-IgG LCBA-FACS exhibited 97.3% sensitivity and 100% specificity, whereas AQP4-IgG FCBA-IF had 71.6% sensitivity and 100% specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>LCBA-FACS for both MOG-IgG and AQP4-IgG had markedly better sensitivity than FCBA-IF, with similar specificity. The use of FCBA-IF may result in underrecognition of both MOG antibody-associated disease (MOGAD) and AQP4-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD).</p>\u0000 </section>\u0000 </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 3","pages":"556-564"},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Blood exosome connexins and small RNAs related to demyelinating disease activity
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1002/acn3.52307
Guzailiayi Maimaitijiang, Jun-ichi Kira, Yuri Nakamura, Mitsuru Watanabe, Ezgi Ozdemir Takase, Satoshi Nagata, Ayako Sakoda, Xu Zhang, Katsuhisa Masaki, Ryo Yamasaki, Noriko Isobe, Hiroo Yamaguchi, Tomohiro Imamura

Objectives

To assess blood exosome (Ex)-connexin (Cx)43 (encoded by GJA1) and its truncated isoforms in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which show distinct alterations in astroglial Cx43.

Methods

Serum Exs from 48 patients with MS (34 relapsing–remitting, 14 secondary-progressive), 35 with NMOSD, 20 with other inflammatory neurologic diseases (OIND), and 17 healthy controls (HC) were subjected to quantitative Western blotting for Cx43, single-molecule array for neurofilament-L, and quantitative polymerase chain reaction for non-coding RNAs detected by RNA sequencing. Sera from control and astroglia-specific Cx43 inducible conditional knockout (Cx43-icKO) mice with experimental autoimmune encephalomyelitis (EAE) were also tested.

Results

Ex-GJA1-29k was markedly higher in MS than in NMOSD, OIND, and HC; it successively increased at relapse, remission, and secondary progression, and positively correlated with disability scores. Ex-hsa-miR-133b and other hsa-miRs that bind to full-length Cx43 were significantly lower in secondary-progressive MS than in HC, and Ex-hsa-miR-133b was negatively correlated with disability scores. Ex-GJA1-11k expression was lower in NMOSD at relapse than in HC and OIND, and was negatively correlated with disability score worsening and Ex-neurofilament-L levels. NMOSD at relapse had significantly higher expression of small nucleolar RNA (SNORD37, SNORD95, and SNORD97) than HC, and SNORD37 and SNORD95 showed strong negative correlations with disability scores. Control mice showed increased Ex-GJA1-43k and -29k during EAE; this effect was markedly reduced in Cx43-icKO mice with attenuated EAE.

Interpretation

Blood Ex-Cx43-truncated isoforms and small non-coding RNAs, which partially come from brain astroglia, are distinctly dysregulated in MS and NMSOD.

{"title":"Blood exosome connexins and small RNAs related to demyelinating disease activity","authors":"Guzailiayi Maimaitijiang,&nbsp;Jun-ichi Kira,&nbsp;Yuri Nakamura,&nbsp;Mitsuru Watanabe,&nbsp;Ezgi Ozdemir Takase,&nbsp;Satoshi Nagata,&nbsp;Ayako Sakoda,&nbsp;Xu Zhang,&nbsp;Katsuhisa Masaki,&nbsp;Ryo Yamasaki,&nbsp;Noriko Isobe,&nbsp;Hiroo Yamaguchi,&nbsp;Tomohiro Imamura","doi":"10.1002/acn3.52307","DOIUrl":"10.1002/acn3.52307","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess blood exosome (Ex)-connexin (Cx)43 (encoded by <i>GJA1</i>) and its truncated isoforms in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which show distinct alterations in astroglial Cx43.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Serum Exs from 48 patients with MS (34 relapsing–remitting, 14 secondary-progressive), 35 with NMOSD, 20 with other inflammatory neurologic diseases (OIND), and 17 healthy controls (HC) were subjected to quantitative Western blotting for Cx43, single-molecule array for neurofilament-L, and quantitative polymerase chain reaction for non-coding RNAs detected by RNA sequencing. Sera from control and astroglia-specific Cx43 inducible conditional knockout (<i>Cx43-icKO</i>) mice with experimental autoimmune encephalomyelitis (EAE) were also tested.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ex-GJA1-29k was markedly higher in MS than in NMOSD, OIND, and HC; it successively increased at relapse, remission, and secondary progression, and positively correlated with disability scores. Ex-hsa-miR-133b and other hsa-miRs that bind to full-length Cx43 were significantly lower in secondary-progressive MS than in HC, and Ex-hsa-miR-133b was negatively correlated with disability scores. Ex-GJA1-11k expression was lower in NMOSD at relapse than in HC and OIND, and was negatively correlated with disability score worsening and Ex-neurofilament-L levels. NMOSD at relapse had significantly higher expression of small nucleolar RNA (SNORD37, SNORD95, and SNORD97) than HC, and SNORD37 and SNORD95 showed strong negative correlations with disability scores. Control mice showed increased Ex-GJA1-43k and -29k during EAE; this effect was markedly reduced in <i>Cx43-icKO</i> mice with attenuated EAE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Blood Ex-Cx43-truncated isoforms and small non-coding RNAs, which partially come from brain astroglia, are distinctly dysregulated in MS and NMSOD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 3","pages":"538-555"},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Right-sided vagus nerve stimulation: Worldwide collection and perspectives
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1002/acn3.52312
Marc Zanello, Berthold Voges, Ramesh Chelvarajah, Arjune Sen, Željka Petelin Gadže, Guillaume Penchet, Alessandro De Benedictis, Riccardo Fornaro, Masaki Iwasaki, Keiya Iijima, Elena Jiltsova, Goran Mrak, Sami Barrit, Alessandro Moiraghi, Andrea Landi, Marcus Neale, Shailendra Magdum, François Caire, Bertrand Godet, Philippe Domenech, Raphael Gaillard, Marc Guenot, Jason Labuschagne, Alexandre Rainha Campos, Herbert Rooijakkers, Riëm El Tahry, Tatiana Von Hertwig Fernandes De Oliveira, Amelia Alvarez-Sala, Cristina V. Torres, Fernando Vale, Johan Pallud, Romain Carron

Objective

Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy (DRE) and is indicated for implantation on the left vagus nerve-only. In rare cases right-sided VNS may be the only option. With only seven published cases in the literature, data on safety and effectiveness of right-sided VNS is very limited.

Methods

An anonymous 38-item questionnaire was sent to expert surgeons implanting VNS for DRE. The questions covered demographics and clinical characteristics, the reason for right-sided implantation and both neurological and surgical outcomes of right-sided VNS.

Results

The survey captured 38 cases of right-sided VNS (18 females, mean age at surgery of 28.0 ± 16.3 years). Right-sided VNS was performed because of VNS lead deficiency (n = 20), anatomical constraints (n = 8), infection of a left-sided VNS site (n = 9), and presence of a left ventricular shunt (n = 1). Thirty-two patients (84%) had a preoperative cardiac assessment. Three patients presented postoperative cardiac side-effects. Right-sided VNS was stopped at last follow-up in three patients: due to deep infection (n = 1), due to dyspnea (n = 1), and due to sleep apnea syndrome (n = 1). Twenty-one patients (55%) were responders to right-sided VNS and the mean reduction of seizure frequency under right-sided VNS was 56.2 ± 18.8%. Focusing on seizure frequency reduction between right-sided VNS and left-sided VNS: 20 patients experienced similar effectiveness, 1 experienced lesser effectiveness, and 2 patients experienced greater effectiveness with right-sided VNS.

Interpretation

This multicenter case series significantly augments the available literature on right-sided VNS. This suggests comparable effectiveness to left-sided VNS but potentially lower tolerability. Further studies are warranted to better evaluate safety and efficacy of right-sided VNS.

{"title":"Right-sided vagus nerve stimulation: Worldwide collection and perspectives","authors":"Marc Zanello,&nbsp;Berthold Voges,&nbsp;Ramesh Chelvarajah,&nbsp;Arjune Sen,&nbsp;Željka Petelin Gadže,&nbsp;Guillaume Penchet,&nbsp;Alessandro De Benedictis,&nbsp;Riccardo Fornaro,&nbsp;Masaki Iwasaki,&nbsp;Keiya Iijima,&nbsp;Elena Jiltsova,&nbsp;Goran Mrak,&nbsp;Sami Barrit,&nbsp;Alessandro Moiraghi,&nbsp;Andrea Landi,&nbsp;Marcus Neale,&nbsp;Shailendra Magdum,&nbsp;François Caire,&nbsp;Bertrand Godet,&nbsp;Philippe Domenech,&nbsp;Raphael Gaillard,&nbsp;Marc Guenot,&nbsp;Jason Labuschagne,&nbsp;Alexandre Rainha Campos,&nbsp;Herbert Rooijakkers,&nbsp;Riëm El Tahry,&nbsp;Tatiana Von Hertwig Fernandes De Oliveira,&nbsp;Amelia Alvarez-Sala,&nbsp;Cristina V. Torres,&nbsp;Fernando Vale,&nbsp;Johan Pallud,&nbsp;Romain Carron","doi":"10.1002/acn3.52312","DOIUrl":"10.1002/acn3.52312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy (DRE) and is indicated for implantation on the left vagus nerve-only. In rare cases right-sided VNS may be the only option. With only seven published cases in the literature, data on safety and effectiveness of right-sided VNS is very limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An anonymous 38-item questionnaire was sent to expert surgeons implanting VNS for DRE. The questions covered demographics and clinical characteristics, the reason for right-sided implantation and both neurological and surgical outcomes of right-sided VNS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survey captured 38 cases of right-sided VNS (18 females, mean age at surgery of 28.0 ± 16.3 years). Right-sided VNS was performed because of VNS lead deficiency (<i>n</i> = 20), anatomical constraints (<i>n</i> = 8), infection of a left-sided VNS site (<i>n</i> = 9), and presence of a left ventricular shunt (<i>n</i> = 1). Thirty-two patients (84%) had a preoperative cardiac assessment. Three patients presented postoperative cardiac side-effects. Right-sided VNS was stopped at last follow-up in three patients: due to deep infection (<i>n</i> = 1), due to dyspnea (<i>n</i> = 1), and due to sleep apnea syndrome (<i>n</i> = 1). Twenty-one patients (55%) were responders to right-sided VNS and the mean reduction of seizure frequency under right-sided VNS was 56.2 ± 18.8%. Focusing on seizure frequency reduction between right-sided VNS and left-sided VNS: 20 patients experienced similar effectiveness, 1 experienced lesser effectiveness, and 2 patients experienced greater effectiveness with right-sided VNS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>This multicenter case series significantly augments the available literature on right-sided VNS. This suggests comparable effectiveness to left-sided VNS but potentially lower tolerability. Further studies are warranted to better evaluate safety and efficacy of right-sided VNS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 3","pages":"565-576"},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Healthcare use is elevated two decades before a first demyelinating event and differs by age and sex
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-29 DOI: 10.1002/acn3.52267
Helen Tremlett, Feng Zhu, Karl Everett, Ayesha Asaf, Ali Manouchehrinia, Ping Li, Kyla A. McKay, Jan Hillert, Yinshan Zhao, Colleen Maxwell, Ruth Ann Marrie

Objective

Elevated healthcare use before multiple sclerosis (MS) onset suggests earlier opportunity to identify MS. Yet their timing and sociodemographic effects are unclear. We examined rates of healthcare use (and by age/sex) for >two decades pre-MS onset.

Methods

We identified people with MS (PwMS) using administrative data from Canada (Ontario) and Sweden (1991–2020) (“administrative” cohort), and the Swedish MS Registry (“clinical” cohort). The first MS/demyelinating diagnostic code (administrative) or symptom onset (clinical) defined MS onset. We compared annual rates of healthcare use (hospital, physician, and emergency-room [ED]) pre-onset between PwMS and up to five matched population controls using negative binomial regression, and by age/sex.

Results

The administrative cohort = 35,018/136,007 PwMS/controls (Ontario), and 10,269/51,297 (Sweden). Rates of healthcare use were higher for PwMS than controls up to 28 (of 29) years (Ontario) and up to 15 (of 19) years (Sweden) pre-onset. Annual healthcare use rose steadily as onset approached, particularly escalating 7 years pre-onset in Ontario (e.g., hospital visit rate ratios [RRs] exceeded 1.30), and 6 years in Sweden (physician visit RRs > 1.10). RRs peaked the year pre-onset (ED visits [Ontario] = 3.04; 95% CI: 2.94–3.13, physician visits [Sweden] = 2.51; 95% CI: 2.44–2.59). In the year pre-onset, RRs were disproportionately higher for males (ED RRs [Ontario] = 3.30; 95% CI: 3.13–3.48 vs. females = 2.90; 95% CI: 2.79–3.02), and dropped steadily by age (physician visit RRs [Sweden] = 2.61/2.27/1.97/1.72 for 50/40/30/20-year-olds). The smaller clinical cohort (7604/37,974 PwMS/controls) exhibited similar patterns, albeit more modest, with RRs elevated up to 5 years pre-onset (physician visit RR [year-5] = 1.08; 95% CI: 1.02–1.14; RR [year-1] = 1.39;1.33–1.46).

Interpretation

Higher healthcare use was evident decades before MS onset, escalating 6–7 years pre-onset, peaking the year before, being disproportionately higher for males and older PwMS.

{"title":"Healthcare use is elevated two decades before a first demyelinating event and differs by age and sex","authors":"Helen Tremlett,&nbsp;Feng Zhu,&nbsp;Karl Everett,&nbsp;Ayesha Asaf,&nbsp;Ali Manouchehrinia,&nbsp;Ping Li,&nbsp;Kyla A. McKay,&nbsp;Jan Hillert,&nbsp;Yinshan Zhao,&nbsp;Colleen Maxwell,&nbsp;Ruth Ann Marrie","doi":"10.1002/acn3.52267","DOIUrl":"10.1002/acn3.52267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Elevated healthcare use before multiple sclerosis (MS) onset suggests earlier opportunity to identify MS. Yet their timing and sociodemographic effects are unclear. We examined rates of healthcare use (and by age/sex) for &gt;two decades pre-MS onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified people with MS (PwMS) using administrative data from Canada (Ontario) and Sweden (1991–2020) (“administrative” cohort), and the Swedish MS Registry (“clinical” cohort). The first MS/demyelinating diagnostic code (administrative) or symptom onset (clinical) defined MS onset. We compared annual rates of healthcare use (hospital, physician, and emergency-room [ED]) pre-onset between PwMS and up to five matched population controls using negative binomial regression, and by age/sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The administrative cohort = 35,018/136,007 PwMS/controls (Ontario), and 10,269/51,297 (Sweden). Rates of healthcare use were higher for PwMS than controls up to 28 (of 29) years (Ontario) and up to 15 (of 19) years (Sweden) pre-onset. Annual healthcare use rose steadily as onset approached, particularly escalating 7 years pre-onset in Ontario (e.g., hospital visit rate ratios [RRs] exceeded 1.30), and 6 years in Sweden (physician visit RRs &gt; 1.10). RRs peaked the year pre-onset (ED visits [Ontario] = 3.04; 95% CI: 2.94–3.13, physician visits [Sweden] = 2.51; 95% CI: 2.44–2.59). In the year pre-onset, RRs were disproportionately higher for males (ED RRs [Ontario] = 3.30; 95% CI: 3.13–3.48 vs. females = 2.90; 95% CI: 2.79–3.02), and dropped steadily by age (physician visit RRs [Sweden] = 2.61/2.27/1.97/1.72 for 50/40/30/20-year-olds). The smaller clinical cohort (7604/37,974 PwMS/controls) exhibited similar patterns, albeit more modest, with RRs elevated up to 5 years pre-onset (physician visit RR [year-5] = 1.08; 95% CI: 1.02–1.14; RR [year-1] = 1.39;1.33–1.46).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Higher healthcare use was evident decades before MS onset, escalating 6–7 years pre-onset, peaking the year before, being disproportionately higher for males and older PwMS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 2","pages":"415-432"},"PeriodicalIF":4.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An MRI assessment of mechanisms underlying lesion growth and shrinkage in multiple sclerosis.
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-27 DOI: 10.1002/acn3.52308
Ermelinda De Meo, Ferran Prados Carrasco, J William L Brown, Alasdair J Coles, Nick G Cunniffe, Amy E Jolly, Baris Kanber, Rebecca Samson, Frederik Barkhof, Declan Chard

Objective: To assess the pathological mechanisms contributing to white matter (WM) lesion expansion or contraction and remyelination in multiple sclerosis (MS).

Methods: We assessed 1,613 lesions in 49 people with relapsing-remitting MS in the CCMR-One bexarotene trial (EudraCT 2014-003145-99). We measured lesion orientation relative to WM tracts, surface-in gradients and veins. Jacobian deformation was used to assess lesion expansion over 6 months, while magnetization transfer ratio (MTR) imaging was used to assess remyelination.

Results: At baseline, 33% of lesions were aligned with veins, 2% along WM tracts, 0% with surface-in gradients, and 4% orthogonal to veins. No significant differences were observed in lesion shape, while lesions aligned with surface-in gradients and with veins had lower volume compared to all remaining orientations. At follow-up, 13% of lesions expanded and 7% contracted. The directions for both expansion and contraction were 18% and 8%, respectively, along WM tracts, 20% and 15% parallel to veins, 22% and 23% orthogonal to veins and 0% and 1% along surface-in gradients. Bexarotene had no effect on lesion expansion or contraction, but MTR significantly increased in lesions aligned with surface-in gradients and veins.

Interpretation: Lesion expansion and shrinkage are affected by venous and WM tract factors, but these do not influence bexarotene's capacity to promote remyelination. This, instead, appears to be affected by surface-in factors. To limit lesion expansion and maximize tissue repair, multiple processes may need to be targeted.

{"title":"An MRI assessment of mechanisms underlying lesion growth and shrinkage in multiple sclerosis.","authors":"Ermelinda De Meo, Ferran Prados Carrasco, J William L Brown, Alasdair J Coles, Nick G Cunniffe, Amy E Jolly, Baris Kanber, Rebecca Samson, Frederik Barkhof, Declan Chard","doi":"10.1002/acn3.52308","DOIUrl":"https://doi.org/10.1002/acn3.52308","url":null,"abstract":"<p><strong>Objective: </strong>To assess the pathological mechanisms contributing to white matter (WM) lesion expansion or contraction and remyelination in multiple sclerosis (MS).</p><p><strong>Methods: </strong>We assessed 1,613 lesions in 49 people with relapsing-remitting MS in the CCMR-One bexarotene trial (EudraCT 2014-003145-99). We measured lesion orientation relative to WM tracts, surface-in gradients and veins. Jacobian deformation was used to assess lesion expansion over 6 months, while magnetization transfer ratio (MTR) imaging was used to assess remyelination.</p><p><strong>Results: </strong>At baseline, 33% of lesions were aligned with veins, 2% along WM tracts, 0% with surface-in gradients, and 4% orthogonal to veins. No significant differences were observed in lesion shape, while lesions aligned with surface-in gradients and with veins had lower volume compared to all remaining orientations. At follow-up, 13% of lesions expanded and 7% contracted. The directions for both expansion and contraction were 18% and 8%, respectively, along WM tracts, 20% and 15% parallel to veins, 22% and 23% orthogonal to veins and 0% and 1% along surface-in gradients. Bexarotene had no effect on lesion expansion or contraction, but MTR significantly increased in lesions aligned with surface-in gradients and veins.</p><p><strong>Interpretation: </strong>Lesion expansion and shrinkage are affected by venous and WM tract factors, but these do not influence bexarotene's capacity to promote remyelination. This, instead, appears to be affected by surface-in factors. To limit lesion expansion and maximize tissue repair, multiple processes may need to be targeted.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heterozygous variants in AP4S1 are not associated with a neurological phenotype.
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-27 DOI: 10.1002/acn3.52302
Vicente Quiroz, Umar Zubair, Luca Schierbaum, Amy Tam, Nicole Battaglia, Joshua Rong, Habibah A P Agianda, Julian E Alecu, Kathryn Yang, Darius Ebrahimi-Fakhari

Biallelic loss-of-function variants in AP4S1 cause childhood-onset hereditary spastic paraplegia. A recent report suggested that heterozygous AP4S1 variants lead to a syndrome of lower limb spasticity and dysregulation of sphincter function. We critically evaluate this claim against clinical observations in 28 heterozygous carriers of the same AP4S1 variant (NM_007077.3: c.289C>T, p.Arg97Ter). In these 14 males and 14 females (mean age: 37.6 ± 4.9 years [SD], range: 30-50 years), we ascertain no increased prevalence of neurological manifestations. Alternative causes should be considered when evaluating patients with heterozygous AP4S1 variants and neurological symptoms, as misattribution of pathogenicity can impact clinical care and genetic counseling.

{"title":"Heterozygous variants in AP4S1 are not associated with a neurological phenotype.","authors":"Vicente Quiroz, Umar Zubair, Luca Schierbaum, Amy Tam, Nicole Battaglia, Joshua Rong, Habibah A P Agianda, Julian E Alecu, Kathryn Yang, Darius Ebrahimi-Fakhari","doi":"10.1002/acn3.52302","DOIUrl":"https://doi.org/10.1002/acn3.52302","url":null,"abstract":"<p><p>Biallelic loss-of-function variants in AP4S1 cause childhood-onset hereditary spastic paraplegia. A recent report suggested that heterozygous AP4S1 variants lead to a syndrome of lower limb spasticity and dysregulation of sphincter function. We critically evaluate this claim against clinical observations in 28 heterozygous carriers of the same AP4S1 variant (NM_007077.3: c.289C>T, p.Arg97Ter). In these 14 males and 14 females (mean age: 37.6 ± 4.9 years [SD], range: 30-50 years), we ascertain no increased prevalence of neurological manifestations. Alternative causes should be considered when evaluating patients with heterozygous AP4S1 variants and neurological symptoms, as misattribution of pathogenicity can impact clinical care and genetic counseling.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CSF cytokine, chemokine and injury biomarker profile of glial fibrillary acidic protein (GFAP) autoimmunity.
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-27 DOI: 10.1002/acn3.52305
Yahel Segal, Georgios Mangioris, Vanda Lennon, Binxia Yang, Divyanshu Dubey, Eoin P Flanagan, Andrew McKeon, John R Mills, Michel Toledano, Ivana Vodopivec, Sean J Pittock, Anastasia Zekeridou

Defining the CSF cytokine/chemokine and injury biomarker signature of glial fibrillary acidic protein (GFAP) autoimmunity can inform immunopathogenesis. CSF GFAP-IgG-positive samples (N = 98) were tested for 17 cytokines/chemokines, neurofilament light chain (NfL), and GFAP (ELLA, Bio-Techne). Controls included non-inflammatory (N = 42), AQP4-IgG-positive (N = 83), CNS infections (N = 13), and neurosarcoidosis (N = 32). IL5, IL6, IL10, IL8/CXCL8, CXCL9, CXCL10, CXCL13, BAFF, GM-CSF, IFN-gamma, and TNF-alpha concentrations were higher compared to non-inflammatory controls (P < 0.01). GFAP concentrations were similar to those of AQP4-IgG-positive patients; NfL was higher (P < 0.001) and correlated with MRI changes and outcomes. CSF cytokine/chemokine findings in GFAP autoimmunity correlate with histopathology; GFAP and NfL hold promise as disease biomarkers.

确定胶质纤维酸性蛋白(GFAP)自身免疫的脑脊液细胞因子/凝血因子和损伤生物标志物特征可为免疫发病机制提供信息。对 CSF GFAPgG 阳性样本(N = 98)进行了 17 种细胞因子/凝血因子、神经丝蛋白轻链(NfL)和 GFAP(ELLA,Bio-Techne)检测。对照组包括非炎症性(42 例)、AQP4-IgG 阳性(83 例)、中枢神经系统感染(13 例)和神经肉芽肿病(32 例)。与非炎症对照组相比,IL5、IL6、IL10、IL8/CXCL8、CXCL9、CXCL10、CXCL13、BAFF、GM-CSF、IFN-gamma 和 TNF-α 的浓度更高(P<0.05)。
{"title":"CSF cytokine, chemokine and injury biomarker profile of glial fibrillary acidic protein (GFAP) autoimmunity.","authors":"Yahel Segal, Georgios Mangioris, Vanda Lennon, Binxia Yang, Divyanshu Dubey, Eoin P Flanagan, Andrew McKeon, John R Mills, Michel Toledano, Ivana Vodopivec, Sean J Pittock, Anastasia Zekeridou","doi":"10.1002/acn3.52305","DOIUrl":"https://doi.org/10.1002/acn3.52305","url":null,"abstract":"<p><p>Defining the CSF cytokine/chemokine and injury biomarker signature of glial fibrillary acidic protein (GFAP) autoimmunity can inform immunopathogenesis. CSF GFAP-IgG-positive samples (N = 98) were tested for 17 cytokines/chemokines, neurofilament light chain (NfL), and GFAP (ELLA, Bio-Techne). Controls included non-inflammatory (N = 42), AQP4-IgG-positive (N = 83), CNS infections (N = 13), and neurosarcoidosis (N = 32). IL5, IL6, IL10, IL8/CXCL8, CXCL9, CXCL10, CXCL13, BAFF, GM-CSF, IFN-gamma, and TNF-alpha concentrations were higher compared to non-inflammatory controls (P < 0.01). GFAP concentrations were similar to those of AQP4-IgG-positive patients; NfL was higher (P < 0.001) and correlated with MRI changes and outcomes. CSF cytokine/chemokine findings in GFAP autoimmunity correlate with histopathology; GFAP and NfL hold promise as disease biomarkers.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to α-synuclein conformational antibodies fused to penetratin are effective in models of Lewy body disease
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-27 DOI: 10.1002/acn3.52266

Annals of Clinical and Translational Neurology 2016; 3(8): 588–606. doi: 10.1002/acn3.321

The authors regret that an error occurred during the assembly of Fig. 1A and C where the incorrect panel was used to represent the non-tg Pen-D5 and the α-syn tg control condition. The corrected figure is provided in the attachment. We apologize for this error.

{"title":"Correction to α-synuclein conformational antibodies fused to penetratin are effective in models of Lewy body disease","authors":"","doi":"10.1002/acn3.52266","DOIUrl":"10.1002/acn3.52266","url":null,"abstract":"<p>Annals of Clinical and Translational Neurology 2016; 3(8): 588–606. doi: 10.1002/acn3.321</p><p>The authors regret that an error occurred during the assembly of Fig. 1A and C where the incorrect panel was used to represent the non-tg Pen-D5 and the α-syn tg control condition. The corrected figure is provided in the attachment. We apologize for this error.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 2","pages":"454"},"PeriodicalIF":4.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Remote neurodegeneration in the lumbosacral cord one month after spinal cord injury: a cross-sectional MRI study
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-27 DOI: 10.1002/acn3.52298
Silvan Büeler, Collene E. Anderson, Veronika Birkhäuser, Patrick Freund, Oliver Gross, Thomas M. Kessler, Christian W. Kündig, Lorenz Leitner, Nomah Mahnoor, Ulrich Mehnert, Raphael Röthlisberger, Stephanie A. Stalder, Stéphanie van der Lely, Carl M. Zipser, Gergely David, Martina D. Liechti

Objective

To characterize structural integrity of the lumbosacral enlargement and conus medullaris within one month after spinal cord injury (SCI).

Methods

Lumbosacral cord MRI data were acquired in patients with sudden onset (<7 days) SCI at the cervical or thoracic level approximately one month after injury and in healthy controls. Tissue integrity and loss were evaluated through diffusion tensor (DTI) and T2*-weighted imaging (cross-sectional area [CSA] measurements). Associations with the degree of neurological impairment were assessed using linear mixed-effects models.

Results

Twenty-one patients with SCI showed lower white matter (WM) fractional anisotropy (FA) (≤−13.3%) and higher WM radial diffusivity (≤14.6%) compared to 27 healthy controls. Differences were most pronounced in the lateral columns of WM. CSA measurements revealed no group differences. For the lateral columns, lower FA values were associated with lower motor scores and lower amplitudes of motor evoked potentials. For the dorsal columns, lower FA values were associated with lower amplitudes of somatosensory evoked potentials from the lower extremities.

Interpretation

One month after SCI, first signs of WM degeneration were apparent, without indication of tissue loss. The more pronounced differences observed in the lateral column could be attributed to anterograde degeneration of the motor tracts. The variability among DTI measurements remote from the lesion site can be partially explained by the degree of the SCI-induced neurological impairment. Together with previous studies, our findings indicate that impaired tissue integrity precedes tissue loss. The presented techniques have potential applications in monitoring the progression of various neurological diseases.

目的描述脊髓损伤(SCI)后一个月内腰骶部增生和髓圆锥的结构完整性:方法:采集突发脊髓损伤(SCI)患者的腰骶部脊髓 MRI 数据(结果:21 名 SCI 患者的腰骶部脊髓 MRI 显示出较低的白内障厚度:与27名健康对照者相比,21名脊髓损伤患者的白质(WM)分数各向异性(FA)较低(≤-13.3%),WM径向扩散率较高(≤14.6%)。WM侧柱的差异最为明显。CSA测量结果显示没有组间差异。在侧柱,较低的FA值与较低的运动评分和较低的运动诱发电位振幅有关。就背侧列而言,较低的FA值与较低的下肢躯体感觉诱发电位振幅有关:SCI 一个月后,WM 退化迹象初显,但无组织缺失迹象。在侧柱观察到的更明显差异可能是由于运动束的逆行退化所致。远离病变部位的 DTI 测量结果之间的差异可部分归因于 SCI 引起的神经损伤程度。结合之前的研究,我们的发现表明,组织完整性受损先于组织缺失。所介绍的技术在监测各种神经系统疾病的进展方面具有潜在的应用价值。
{"title":"Remote neurodegeneration in the lumbosacral cord one month after spinal cord injury: a cross-sectional MRI study","authors":"Silvan Büeler,&nbsp;Collene E. Anderson,&nbsp;Veronika Birkhäuser,&nbsp;Patrick Freund,&nbsp;Oliver Gross,&nbsp;Thomas M. Kessler,&nbsp;Christian W. Kündig,&nbsp;Lorenz Leitner,&nbsp;Nomah Mahnoor,&nbsp;Ulrich Mehnert,&nbsp;Raphael Röthlisberger,&nbsp;Stephanie A. Stalder,&nbsp;Stéphanie van der Lely,&nbsp;Carl M. Zipser,&nbsp;Gergely David,&nbsp;Martina D. Liechti","doi":"10.1002/acn3.52298","DOIUrl":"10.1002/acn3.52298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To characterize structural integrity of the lumbosacral enlargement and conus medullaris within one month after spinal cord injury (SCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lumbosacral cord MRI data were acquired in patients with sudden onset (&lt;7 days) SCI at the cervical or thoracic level approximately one month after injury and in healthy controls. Tissue integrity and loss were evaluated through diffusion tensor (DTI) and T2*-weighted imaging (cross-sectional area [CSA] measurements). Associations with the degree of neurological impairment were assessed using linear mixed-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one patients with SCI showed lower white matter (WM) fractional anisotropy (FA) (≤−13.3%) and higher WM radial diffusivity (≤14.6%) compared to 27 healthy controls. Differences were most pronounced in the lateral columns of WM. CSA measurements revealed no group differences. For the lateral columns, lower FA values were associated with lower motor scores and lower amplitudes of motor evoked potentials. For the dorsal columns, lower FA values were associated with lower amplitudes of somatosensory evoked potentials from the lower extremities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>One month after SCI, first signs of WM degeneration were apparent, without indication of tissue loss. The more pronounced differences observed in the lateral column could be attributed to anterograde degeneration of the motor tracts. The variability among DTI measurements remote from the lesion site can be partially explained by the degree of the SCI-induced neurological impairment. Together with previous studies, our findings indicate that impaired tissue integrity precedes tissue loss. The presented techniques have potential applications in monitoring the progression of various neurological diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 3","pages":"523-537"},"PeriodicalIF":4.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pediatric, adult, and late onset multiple sclerosis: Cognitive phenotypes and gray matter atrophy
IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-24 DOI: 10.1002/acn3.52291
Ermelinda De Meo, Emilio Portaccio, Rosa Cortese, Luis Ruano, Benedetta Goretti, Claudia Niccolai, Francesco Patti, Clara Chisari, Paolo Gallo, Paola Grossi, Angelo Ghezzi, Marco Roscio, Flavia Mattioli, Chiara Stampatori, Marta Simone, Rosa Gemma Viterbo, Raffaello Bonacchi, Assunta Maria Rocca, Elisa Leveraro, Antonio Giorgio, Nicola De Stefano, Massimo Filippi, Matilde Inglese, Maria Pia Amato

Objectives

We aim to investigate cognitive phenotype distribution and MRI correlates across pediatric-, elderly-, and adult-onset MS patients as a function of disease duration.

Methods

In this cross-sectional study, we enrolled 1262 MS patients and 238 healthy controls, with neurological and cognitive assessments. A subset of 222 MS patients and 92 controls underwent 3T-MRI scan for brain atrophy and lesion analysis. Multinomial probabilistic models identified likelihood of belonging to cognitive phenotypes (“preserved-cognition,” “mild verbal memory/semantic fluency,” “mild multi-domain,” “severe attention/executive,” and “severe multi-domain”) and experiencing MRI abnormalities based on disease duration and age at onset.

Results

In all groups, the likelihood of “preserved-cognition” phenotype decreased, whereas “mild multi-domain” increased with longer disease duration. In pediatric- and adult-onset patients, the likelihood of “mild verbal memory/semantic fluency” phenotypes decreased with longer disease duration, and that of “severe multi-domain” increased with longer disease duration. Only in adult-onset patients, the likelihood of “severe executive/attention” phenotype increased with longer disease duration. All groups displayed escalating probabilities of cortical, thalamic, hippocampal, and deep gray matter atrophy over disease course. Compared to adult, pediatric-onset patients showed lower probability of experiencing thalamic atrophy with longer disease duration, while elderly-onset showed higher probability of experiencing cortical and hippocampal atrophy.

Interpretation

Age at MS onset significantly influences the distribution of cognitive phenotypes and the patterns of regional gray matter atrophy throughout the disease course.

{"title":"Pediatric, adult, and late onset multiple sclerosis: Cognitive phenotypes and gray matter atrophy","authors":"Ermelinda De Meo,&nbsp;Emilio Portaccio,&nbsp;Rosa Cortese,&nbsp;Luis Ruano,&nbsp;Benedetta Goretti,&nbsp;Claudia Niccolai,&nbsp;Francesco Patti,&nbsp;Clara Chisari,&nbsp;Paolo Gallo,&nbsp;Paola Grossi,&nbsp;Angelo Ghezzi,&nbsp;Marco Roscio,&nbsp;Flavia Mattioli,&nbsp;Chiara Stampatori,&nbsp;Marta Simone,&nbsp;Rosa Gemma Viterbo,&nbsp;Raffaello Bonacchi,&nbsp;Assunta Maria Rocca,&nbsp;Elisa Leveraro,&nbsp;Antonio Giorgio,&nbsp;Nicola De Stefano,&nbsp;Massimo Filippi,&nbsp;Matilde Inglese,&nbsp;Maria Pia Amato","doi":"10.1002/acn3.52291","DOIUrl":"10.1002/acn3.52291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to investigate cognitive phenotype distribution and MRI correlates across pediatric-, elderly-, and adult-onset MS patients as a function of disease duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, we enrolled 1262 MS patients and 238 healthy controls, with neurological and cognitive assessments. A subset of 222 MS patients and 92 controls underwent 3T-MRI scan for brain atrophy and lesion analysis. Multinomial probabilistic models identified likelihood of belonging to cognitive phenotypes (“preserved-cognition,” “mild verbal memory/semantic fluency,” “mild multi-domain,” “severe attention/executive,” and “severe multi-domain”) and experiencing MRI abnormalities based on disease duration and age at onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all groups, the likelihood of “preserved-cognition” phenotype decreased, whereas “mild multi-domain” increased with longer disease duration. In pediatric- and adult-onset patients, the likelihood of “mild verbal memory/semantic fluency” phenotypes decreased with longer disease duration, and that of “severe multi-domain” increased with longer disease duration. Only in adult-onset patients, the likelihood of “severe executive/attention” phenotype increased with longer disease duration. All groups displayed escalating probabilities of cortical, thalamic, hippocampal, and deep gray matter atrophy over disease course. Compared to adult, pediatric-onset patients showed lower probability of experiencing thalamic atrophy with longer disease duration, while elderly-onset showed higher probability of experiencing cortical and hippocampal atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Age at MS onset significantly influences the distribution of cognitive phenotypes and the patterns of regional gray matter atrophy throughout the disease course.</p>\u0000 </section>\u0000 </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"12 3","pages":"512-522"},"PeriodicalIF":4.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.52291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Annals of Clinical and Translational Neurology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1