Multiple sclerosis and related disorders最新文献

{"title":"Profiling peripheral blood oxidative stress in multiple sclerosis","authors":"Thomas Minton ,&nbsp;Kelly Hares ,&nbsp;Kevin Kemp ,&nbsp;Juliana Redondo ,&nbsp;Neil J Scolding ,&nbsp;Claire M Rice","doi":"10.1016/j.msard.2026.107039","DOIUrl":"10.1016/j.msard.2026.107039","url":null,"abstract":"<div><h3>Background</h3><div>Oxidative stress is implicated in the pathophysiology of multiple sclerosis (MS), but the potential of oxidative stress responses as MS biomarkers has not been systematically explored.</div></div><div><h3>Methods</h3><div>Over 12 months, we measured serial plasma concentrations or activity, and peripheral blood mononuclear cell (PBMC) expression of master antioxidant regulators, downstream antioxidant enzymes, and plasma end products of oxidation in blood from people with MS (pwMS), including a cohort commencing disease modifying therapy (DMT). Multivariable regression models were employed adjusting for age, sex, disease duration, smoking, and repeated measures.</div></div><div><h3>Results</h3><div>40 control subjects and 78 pwMS participants (53 relapsing-remitting MS (RRMS), 11 primary progressive MS (PPMS) &amp; 14 secondary progressive MS (SPMS)) were included; 12 commenced dimethyl fumarate (DMF), 12 ocrelizumab and 7 natalizumab. <em>NFE2L2</em> (nuclear factor erythroid 2-related factor 2; Nrf2), <em>CAT</em> (catalase) and <em>GPX1</em> (glutathione peroxidase 1) expression were downregulated in SPMS, with increased concentration of end products of oxidation. Plasma peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) concentration was higher in pwMS. Nrf2 concentration, catalase activity and PBMC <em>SOD1</em> expression increased with DMF. PBMC <em>NFE2L2, GPX1</em> and <em>SOD1</em> expression increased with natalizumab. Effect sizes were relatively modest and inter-individual heterogeneity was high limiting potential clinical application. No significant associations with the Expanded Disability Status Scale were observed.</div></div><div><h3>Conclusions</h3><div>Our data support dysregulated oxidative stress responses in MS but individual oxidative stress components are unlikely to inform disease stratification and monitoring. However, a constellation of biomarkers, may have clinical utility and inform regarding MS pathophysiology and therapy.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107039"},"PeriodicalIF":2.9,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolebrutinib and the FDA","authors":"Gavin Giovannoni ,&nbsp;Christopher H Hawkes ,&nbsp;Jeannette Lechner-Scott ,&nbsp;Michael Levy ,&nbsp;E. Ann Yeh","doi":"10.1016/j.msard.2026.107038","DOIUrl":"10.1016/j.msard.2026.107038","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107038"},"PeriodicalIF":2.9,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different exercise types on physical function and psychological status in females with multiple sclerosis: A network meta-analysis","authors":"Yutong Wang ,&nbsp;Liang Li ,&nbsp;Chen Liu ,&nbsp;Tonggang Fan","doi":"10.1016/j.msard.2026.107036","DOIUrl":"10.1016/j.msard.2026.107036","url":null,"abstract":"<div><h3>Background</h3><div>As a therapeutic approach, physical activity can serve as a rehabilitation method for females with multiple sclerosis. However, the optimal exercise type remains unclear. This study aims to evaluate the effects of six distinct training programs on the physical function and psychological state of females with multiple sclerosis, thereby providing foundational guidance for rehabilitation treatment in this population.</div></div><div><h3>Method</h3><div>In September 2025, a comprehensive literature search was conducted across seven major databases (Embase, PubMed, Web of Science, Cochrane Library, Wanfang, CNKI, and CQVIP) to identify randomized controlled trials to study how physical activity interventions affect the physical function and psychological status in females with multiple sclerosis. These studies were subsequently analyzed through a frequency-based network meta-analysis framework.</div></div><div><h3>Results</h3><div>We conducted a systematic review analyzing 16 studies involving 579 participants. Among the six exercise modalities tested in the intervention groups, all demonstrated statistically significant efficacy compared to the control groups. However, pairwise comparisons between different exercise categories revealed minimal differences. Using the surface under the cumulative ranking curve (SUCRA) metric, researchers evaluated and ranked the impact of these interventions on both physical function and psychological status in females multiple sclerosis, FATIGUE: Yoga (SUCRA=81) &gt; RE (SUCRA=77) &gt; AE (SUCRA=67.6) &gt; CE (SUCRA=56.0) &gt; CT (SUCRA=30.8) &gt; MBE (SUCRA=25.7) &gt; RT(SUCRA=11.9); QoL-total: RE (SUCRA=69.7) &gt; AE (SUCRA=63.5) &gt; Yoga (SUCRA=63.0) &gt; RT (SUCRA=3.9); BALANCE: AE (SUCRA=89.7) &gt; Yoga (SUCRA=66.9) &gt; MBE (SUCRA=55.0) &gt; RE (SUCRA=36.7) &gt; RT (SUCRA=1.7); Qol-ph: MBE(SUCRA=82.0) &gt; Yoga (SUCRA=78.7) &gt; AE (SUCRA=45.1) &gt; CE (SUCRA=35.8) &gt; RT (SUCRA= 8.5); DEPRESS: Yoga (SUCRA=74.6) &gt; AE (SUCRA=66.3) &gt; CT (SUCRA=53.0) &gt; CE (SUCRA=49.9) &gt; MBE (SUCRA=45.6) &gt; RT (SUCRA=10.6), Qol-mh: Yoga (SUCRA=79.5) &gt; MBE (SUCRA=68.5) &gt; CE (SUCRA=53.9) &gt; AE (SUCRA=46.4) &gt; RT (SUCRA=1.8).</div></div><div><h3>Conclusions</h3><div>For females with multiple sclerosis, regular physical activity boosts physical function and psychological status outcomes. Among these activities, yoga is the most effective way to improve their psychological well-being.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107036"},"PeriodicalIF":2.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial magnetic stimulation outcomes as biomarkers of multiple sclerosis disease progression: A structured literature review","authors":"Nicholas J. Snow,&nbsp;Basel O. Mohamed ,&nbsp;Sarah A. Duraid ,&nbsp;Michelle Ploughman","doi":"10.1016/j.msard.2026.107035","DOIUrl":"10.1016/j.msard.2026.107035","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is an immune-mediated central nervous system (CNS) disease and a leading cause of disability in young adults. Chronic disability progression is an unmet challenge for persons with MS and an area of interest for the development of biomarkers. Transcranial magnetic stimulation (TMS) is a putative technique for the development of MS biomarkers. However, TMS outcomes have not been extensively reviewed as biomarkers of disability progression in MS to date. This structured literature review assessed longitudinal and cross-sectional studies of TMS and disability progression in MS. Of the TMS techniques reviewed, central motor conduction time (CMCT), motor evoked potential (MEP) onset latency, and MEP amplitude demonstrated the best clinical performance as markers of CNS demyelination and neuro-axonal damage. While studies showed notable cross-sectional differences in TMS outcomes between persons with progressive and relapsing MS, these findings were less well-supported by longitudinal studies. Across studies, effect sizes were variable, sensitivity and specificity were underreported, and correlations with disability outcomes were heterogeneous. Studies were limited by small sample sizes, short follow-up periods, lack of standardized disability progression definition and TMS methods, and low reporting of diagnostic accuracy. We found insufficient evidence to presently justify the use of TMS techniques as biomarkers of MS disease progression. Future studies should address current limitations.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107035"},"PeriodicalIF":2.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence analysis of lesion dynamics and brain volume in patients with multiple sclerosis","authors":"Clemens Bettray ,&nbsp;Thanos Tsaktanis ,&nbsp;Angelika Mennecke ,&nbsp;Gabriel Bazan Serrano ,&nbsp;Stefan Lang ,&nbsp;Hannes Lücking ,&nbsp;Ludwig Singer ,&nbsp;Stefan Gerner ,&nbsp;Veit Rothhammer ,&nbsp;Arnd Dörfler ,&nbsp;Manuel Alexander Schmidt","doi":"10.1016/j.msard.2026.107033","DOIUrl":"10.1016/j.msard.2026.107033","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Material and Methods</h3><div>This retrospective study included 888 MRI examinations from 455 patients with MS (2016–2020). Longitudinal analyses were performed in 234 patients with ≥2 scans (667 MRIs), and an early MS cohort comprised 302 patients (580 scans). Automated segmentation (mdbrain® v3.4.0) provided lesion metrics and age/sex/skull-volume-adjusted brain volumes from routine 3D FLAIR and native T1-weighted sequences acquired under real-world clinical conditions. Pathological atrophy was defined as a normative z-score &lt; –2. Generalized estimating equations (GEE) evaluated predictors of atrophy.</div></div><div><h3>Results</h3><div>Proxy radiological phenotype groups were defined as lesion-led (43.2%), cortex-led (35.4%), and NAWM-led (21.4%); clinical phenotypes included RRMS (82%), SPMS (14%), and PPMS (4%). EDSS correlated with lesion volume (ρ=0.28, <em>p</em>&lt;.001) and total brain volume (ρ=–0.32, <em>p</em>&lt;.001). In 433 longitudinal intervals, 11.8% showed mdbrain-defined atrophy. Higher EDSS (OR 1.53, 95% CI 1.28–1.83, <em>p</em>&lt;.001) and longer follow-up (OR 2.24, 95% CI 1.36–3.70, <em>p</em>=.001) independently predicted atrophy; ABVL showed only borderline significance (<em>p</em>=.071). Lesion dynamics were not independently predictive of atrophy (<em>p</em>&gt;.60). ABVL alone showed low discriminative value (AUC 0.571), whereas EDSS + interval length achieved AUC 0.766.</div></div><div><h3>Conclusion</h3><div>Gray-matter–predominant atrophy correlated more strongly with disability than lesion burden and frequently occurred in the absence of new lesions, indicating lesion-independent neurodegenerative processes that were observed across the defined proxy radiological phenotype groups. AI-based quantitative MRI offers reproducible atrophy assessment in real-world practice and may support quantitative MRI-based monitoring frameworks that include brain volume loss and facilitate detection of subclinical progression.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107033"},"PeriodicalIF":2.9,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life, productivity loss, and mental health service utilization among parents of children with neuroinflammatory disorders: A cross-sectional study","authors":"Ramesh Lamsal ,&nbsp;E. Ann Yeh ,&nbsp;Eleanor Pullenayegum ,&nbsp;Wendy J. Ungar","doi":"10.1016/j.msard.2026.107032","DOIUrl":"10.1016/j.msard.2026.107032","url":null,"abstract":"<div><h3>Background</h3><div>Children with neuroinflammatory disorders (NDs) require caregiving, affecting parental health and employment. This study assessed parents’ productivity losses, mental health services use, health-related quality of life (HRQoL), and care-related QoL.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled children with NDs and parents at a single center. Data on productivity losses and mental health services use for both parents were collected. Respondent parents’ HRQoL and care-related QoL were measured using Health Utilities Index (HUI3) and Care-related Quality of Life (CarerQol) instrument. HUI3 scores were compared to Canadian parental norms. Annual parental costs per two-parent household and societal costs were estimated.</div></div><div><h3>Results</h3><div>Forty-seven parent-child dyads participated. Mean ages were 43.76 (SD 6.31) years for respondent parents and 12.00 (SD 3.34) years for children. Work and/or usual activity disruptions were reported by 86 % (31/36) of respondent parents and 78 % (28/36) of partners. Twenty-two percent (8/36) of respondent parents and 8 % (3/36) of partners used mental health services due to caregiving stress. Median (IQR) annual household costs for parents and society were CAD 2,767.87 (1,414.78–7,894.43). Mann-Whitney U test revealed no statistical difference in HUI-3 scores between parents of children with NDs (<em>n</em> = 46, median:0.93) and Canadian population parental norms (<em>n</em> = 2,799, median:0.93), <em>W</em> = 426434, <em>p</em> = 0.13. Mean CarerQol-7D and VAS scores were 85.97 (SD11.94) and 7.68 (SD1.08), respectively.</div></div><div><h3>Conclusion</h3><div>Parents of children with NDs reported work and/or daily activity disruptions and household costs; their HRQoL was comparable to Canadian parental norms. Larger studies with comparison groups of parents of healthy children are needed to confirm these findings.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107032"},"PeriodicalIF":2.9,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence of clinical outcomes and adherence to ofatumumab in the UK and the impact of a patients support programme: A retrospective, non-interventional cohort study","authors":"David Paling ,&nbsp;David Cottrell ,&nbsp;Ruth Hamlin ,&nbsp;Colin O’Leary ,&nbsp;Owen Pearson ,&nbsp;Agne Straukiene ,&nbsp;Pyry Kivi ,&nbsp;Wendy Rice ,&nbsp;Sarah Al-Azki ,&nbsp;Nazanin Kondori","doi":"10.1016/j.msard.2026.107030","DOIUrl":"10.1016/j.msard.2026.107030","url":null,"abstract":"<div><h3>Background</h3><div>Ofatumumab is the only anti-CD20 monoclonal antibody disease modifying therapy available for self- administration for adults with active relapsing remitting multiple sclerosis (RMS). This study aimed to investigate real-world adherence and clinical outcomes of ofatumumab-treated patients in the UK and looked at the impact of a patient support program called Kesimpta Connect (KC PSP) on these outcomes.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study examined adherence to ofatumumab in 155 RMS patients recruited from six UK MS centres. The primary objective of the study was to describe the medication possession ratio (MPR) adherence of ofatumumab treated patients over a 13-month period. The study also looked at clinical effectiveness measures, including change in annualized relapse rates (ARR). Safety and secondary-care use was also assessed in this study.</div></div><div><h3>Results</h3><div>103 patients had data available to be assessed for adherence and clinical effectiveness. 87 % (n=90) of patients had an MPR adherence of 0.80 or greater and higher proportion of non-KC PSP users reported adherence of greater than 0.80 than KC PSP users (98.4 % vs 69.2 %). The total ARR decreased during the follow-up period from 0.33 (95 % CI 0.23-0.40) prior to ofatumumab initiation to 0.06 (95 % CI 0.01-0.11) 12-months after initiation. In terms of safety, 38.1 % (n=59/155) patients reported experiencing an adverse event during the follow-up period; one was reported to be severe. However, no patients reported discontinuing ofatumumab during the study follow-up period.</div></div><div><h3>Conclusion</h3><div>This study provides evidence of good adherence for RMS patients using ofatumumab. Further, there is evidence of clinical effectiveness based on reduction in ARR post-ofatumumab initiation, as well as tolerability and a favourable safety profile. The results of this study support the continued use of ofatumumab in providing effective RMS disease management in the UK NHS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107030"},"PeriodicalIF":2.9,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of multiple sclerosis in UK general practice; Risk of infections and mortality","authors":"Ana Ruigomez ,&nbsp;Parminderjit Kaur Jayia ,&nbsp;Luis-Alberto Garcia-Rodriguez","doi":"10.1016/j.msard.2026.107029","DOIUrl":"10.1016/j.msard.2026.107029","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is a leading cause of severe neurological disability and is associated with substantial comorbidity. Infections represent a major complication, and patients with MS have an increased risk of mortality.</div><div>This population-based descriptive cohort study examined the natural history of MS in general practice, focusing on incidence, comorbidities, infection risk, and mortality. Patients with incident MS between 2000 and 2016 were identified from the Clinical Practice Research Datalink (CPRD) and compared with a matched cohort from the general population. Incidence rates, associated risk factors, and subsequent risks of infection and mortality were assessed.</div><div>The incidence rate of MS was 8.84 cases per 100,000 person-years (95% confidence interval: 8.63–9.06), with higher rates observed in females and individuals aged 30–49 years. Comorbidities and prior infections were significantly associated with an MS diagnosis. Patients with MS had an increased risk of developing infections, particularly central nervous system infections (hazard ratio: 3.43; 95% confidence interval: 1.90–6.19). Mortality rate among patients with MS was nearly twice that of the general population. Male sex, smoking, and being underweight were associated with an elevated risk of mortality, while respiratory diseases and infections were the most common causes of death.</div><div>These findings, derived from routine general practice data, provide valuable insights for clinicians managing patients with MS. They highlight the increased susceptibility of patients with MS to infections and their elevated mortality risk. Furthermore, they identify modifiable risk factors, such as smoking and comorbidities, that may be targeted to improve patient outcomes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107029"},"PeriodicalIF":2.9,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of multiple sclerosis from 1990 to 2021 and projections to 2040: A comprehensive analysis from the global burden of disease study","authors":"Jing Tan ,&nbsp;Daobin Han","doi":"10.1016/j.msard.2026.107027","DOIUrl":"10.1016/j.msard.2026.107027","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a leading cause of neurological disability in young adults, with a striking female predominance. Understanding of its temporal and geographic patterns is crucial for informing public health strategies.</div></div><div><h3>Methods</h3><div>Data from the Global Burden of Disease (GBD) 2021 study were used to assess the burden of MS from 1990 to 2021 at global, regional, and national levels. Estimates of incidence, deaths, and disability-adjusted life years (DALYs) were stratified by age, sex, and Socio-demographic Index (SDI). Temporal trends were evaluated using the estimated annual percentage change (EAPC). Bayesian Age-Period-Cohort (BAPC) modeling was employed to forecast the burden through 2040. Additionally, frontier analysis, decomposition analysis, inequality assessment, and estimation of the smoking-attributable burden were conducted.</div></div><div><h3>Results</h3><div>Between 1990 and 2021, the absolute numbers of MS incident cases, deaths, and DALYs increased globally due to population growth and aging. In contrast, age-standardized incidence rates remained relatively constant, while both age-standardized mortality and DALYs rates experienced modest declines. Females consistently bore a higher burden across all metrics and age groups. Frontier analysis revealed significant performance gaps, and BAPC projections suggested a continued gradual decline in global age-standardized mortality and DALY rates through 2040. Despite these encouraging trends, smoking remained a substantial modifiable risk factor.</div></div><div><h3>Conclusion</h3><div>MS continues to impose a significant global burden, with persistent regional and socioeconomic disparities. This highlights the necessity for targeted public health strategies, including early diagnosis, accessible treatment, functional rehabilitation, and preventive measures such as smoking cessation, to reduce disparities and optimize outcomes worldwide.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107027"},"PeriodicalIF":2.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First demyelinating attack in children: A twelve year single center cohort","authors":"Alessandro Santagostino Barbone ,&nbsp;Thea Giacomini ,&nbsp;Silvia Casabona ,&nbsp;Elisa De Grandis ,&nbsp;Lucrezia Sartore ,&nbsp;Maria Grazia Calevo ,&nbsp;Federica Maria Bozzano ,&nbsp;Emanuela Maria Mobilia ,&nbsp;Matilde Inglese ,&nbsp;Maria Cellerino ,&nbsp;Maria Stella Vari ,&nbsp;Ramona Cordani ,&nbsp;Giampaola Pesce ,&nbsp;Elisabetta Amadori ,&nbsp;Edoardo Canale ,&nbsp;Pasquale Striano ,&nbsp;Andrea Rossi ,&nbsp;Martina Resaz ,&nbsp;Silvia Buratti ,&nbsp;Giacomo Brisca ,&nbsp;Maria Margherita Mancardi","doi":"10.1016/j.msard.2026.107026","DOIUrl":"10.1016/j.msard.2026.107026","url":null,"abstract":"<div><h3>Introduction</h3><div>Acquired demyelinating syndromes (ADS) of the central nervous system in children present a diagnostic challenge due to overlapping presentations. Differentiating monophasic from potentially recurrent conditions, such as pediatric-onset multiple sclerosis (POMS), myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and other seronegative ADS, is essential for treatment and prognosis. This study aimed to characterize the initial presentation of pediatric ADS and evaluate the evolution of diagnosis over time to better guide treatment.</div></div><div><h3>Methods</h3><div>A retrospective study of 59 children with ADS diagnosed at a tertiary pediatric center in Italy (2012–2024) was conducted. Initial classifications included MS, acute disseminated encephalomyelitis (ADEM), clinically isolated syndrome (CIS), optic neuritis (ON), neuromyelitis optica spectrum disorder (NMOSD), or “Indeterminate”. Final diagnoses were categorized as MS, MOGAD, or \"Other\" demyelinating conditions. Demographic, clinical, MRI, CSF, and outcome were analyzed. Statistical comparisons among groups used Mann–Whitney U, Chi-square, or Fisher’s exact tests (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>At final diagnosis, older age at onset, absence of preceding infection and characteristic MRI findings (periventricular/callosal lesions, cerebellar involvement) were more frequent in MS group. Younger age, preceding infection, fever, irritability, and cortical involvement were associated with MOGAD. Nearly one-third of final MS cases (29%) were initially CIS or ON, while no ADEM cases converted to MS. “Other” ADS (non-MS/MOG-IgG antibody negative patients) showed more severe initial disability (<em>p</em> = 0.01). Transition to adult neurology was significantly higher in MS (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>these findings underscore the heterogeneity of pediatric ADS at onset and the value of accurate acute management and longitudinal follow-up to refine diagnosis and guide treatment.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107026"},"PeriodicalIF":2.9,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}