Multiple sclerosis and related disorders最新文献

{"title":"Patterns of cognitive decline across different multiple sclerosis clinical courses","authors":"André Augusto Lemos Vidal de Negreiros,&nbsp;Larissa Carla de Paula Gois,&nbsp;Mariana Moreira Soares de Sá,&nbsp;Gabriel de Deus Vieira,&nbsp;Luciana Ramalho Pimentel-Silva,&nbsp;Alfredo Damasceno","doi":"10.1016/j.msard.2024.106172","DOIUrl":"10.1016/j.msard.2024.106172","url":null,"abstract":"<div><h3>Background</h3><div>It is still unclear whether patients with progressive MS (PMS) present a distinct pattern of cognitive impairment (CI) and different trajectories of cognitive and clinical decline compared to patients with relapsing-remitting MS (RRMS) with similar age. In addition, the role of reserve (cognitive and cerebral) in cognitive decline in the different forms of MS is not fully understood, and some studies suggest that its effects reduce in the progressive forms.</div></div><div><h3>Objective</h3><div>To assess the trajectories of cognitive decline in RRMS and PMS patients with similar age, also evaluating the predictive power of baseline clinical and MRI features on cognitive outcomes at follow-up.</div></div><div><h3>Methods</h3><div>Fifty-four patients were enrolled (30 PMS, 24 RRMS) and underwent brain MRI (3T – FreeSurfer and Spinal Cord Toolbox), clinical examination (Expanded Disability Status Scale – EDSS; Timed 25-Foot Walk Test - T25FW; and the Nine Hole Peg Test - 9HPT) and neuropsychological evaluation (Brief Repeatable Battery of Neuropsychological Tests – BRBN, Tower of London (TOL) test and Boston Naming Test at baseline (time 1) and after 4 years (time 2). We also evaluated cognitive and brain reserve. We defined CI as the presence of impairment in &gt;1 domain.</div></div><div><h3>Results</h3><div>At baseline (time 1), 37.2 % of the individuals presented CI and 52.4 % at time 2, which was more frequent in the PMS group. There was also a higher frequency of impairment in the visual memory and Information Processing Speed (IPS) cognitive domains in the PMS group in both study times. However, there were no major statistical differences between RMS/PMS groups in the evolution of clinical, cognitive and neuroimaging variables after 4 years of follow-up, except for a worse verbal memory decline (<em>p</em> = 0.040) and corpus callosum atrophy (<em>p</em> = 0.014) in PMS group. For EDSS worsening, the best predictive factor was the spinal cord area (β = -0.428), and for T25FW, the striatum volume (β = -0.467). For cognitive deterioration, striatum volume and cortical thickness were the best predictors. We found a protective effect of cognitive reserve on the decline of the domains of planning (β = 0.601) and IPS (β = 0.482) for the overall sample and the PMS group (β = 0.498 and β = 0.468, respectively).</div></div><div><h3>Conclusions</h3><div>We found cognitive deterioration after four years of follow-up in RRMS and PMS groups. Nevertheless, there were no major differences between these groups (with similar age, education and disease duration) in the trajectories of clinical, cognitive and neuroimaging variables during this 4-year period. We observed a protective effect of cognitive reserve in the overall sample and the PMS group.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106172"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687537","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":"Observational study of gadolinium-enhancing lesions in MRI in patients with multiple sclerosis from the Spanish Mediterranean coast: Seasonal variability and relationship with climatic factors","authors":"Celia Romero Del Rincón ,&nbsp;Berta Claramonte-Clausell ,&nbsp;Clara Aguirre ,&nbsp;Marta Domiguez-Gallego ,&nbsp;Virginia Meca-Lallana ,&nbsp;Antonio Belenguer Benavides","doi":"10.1016/j.msard.2024.106164","DOIUrl":"10.1016/j.msard.2024.106164","url":null,"abstract":"<div><h3>Introduction</h3><div>Environmental factors appear to play an important role in the development and course of Multiple Sclerosis (MS). Seasonal variability in disease activity has been described and it is postulated that it may vary according to geographical area. The aim of this study is to analyse the monthly distribution of activity observed on Magnetic Resonance Imaging (MRI) and to look for a possible relationship with climate in patients with relapsing remitting MS.</div></div><div><h3>Material and methods</h3><div>Retrospective observational study, carried out in the population of one hospital on the Spanish Mediterranean coast. A total of 238 MRI scans of 51 patients were evaluated. Climatological data were obtained from the Spanish State Meteorological Agency from 2012 to 2016. Activity was defined as contrast-enhancing lesions.</div></div><div><h3>Results</h3><div>The distribution of gadolinium-enhancing lesions was found to be non-uniform across months (<em>p</em> = 0.008). Visual inspection suggests higher activity in July and August. Regarding weather, tropical nights (defined as days with a minimum temperature above 20 °C) were associated with increased risk of MRI activity (OR = 1.06, <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>These findings suggest a non-uniform monthly distribution of gadolinium-enhancing lesions and an association between warmer nights and increased MRI activity, pointing to a potential impact of environmental factors on multiple sclerosis activity in neuroimaging.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106164"},"PeriodicalIF":2.9,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687531","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":"Assessing the landscape and charting paths: UK neurology trainees’ opinions on neuroinflammation subspecialty","authors":"Tarunya Arun,&nbsp;Kate Petheram,&nbsp;Emma Tallantyre,&nbsp;Helen Ford,&nbsp;Jeremy Chataway,&nbsp;Niall Mac Dougall,&nbsp;Anisha Doshi,&nbsp;Christina Englezou,&nbsp;Rachel Farrell,&nbsp;Stella Hughes,&nbsp;Gavin Mc Donnell,&nbsp;Katy Murray,&nbsp;Richard Rees,&nbsp;Neil Robertson,&nbsp;Klaus Schmierer,&nbsp;Ruth Dobson,&nbsp;On behalf of the Association of British Neurologists, Special interest group for MS and neuroinflammation","doi":"10.1016/j.msard.2024.106144","DOIUrl":"10.1016/j.msard.2024.106144","url":null,"abstract":"<div><div>Therapeutics of neuroinflammatory disorders including multiple sclerosis is one of the fastest growing areas in neurology. However, pressures on higher specialty training in neurology together with an expanding curriculum have led to challenges in adequately preparing trainees for a subspecialist career. In this study we set out to understand current perceptions and barriers to training in neuroinflammatory disorders among neurology trainees in the UK. A structured questionnaire was used to assess trainees' perspectives on training opportunities and career aspirations. Findings reveal significant gaps in training, including insufficient training opportunities, lack of mentorship, and concerns about managing complex treatment regimes. We used these findings to develop structured action points with aim of improving training and retention in this subspecialty. These include early exposure to subspecialty experiences, enhanced mentorship, and equal access to training opportunities regardless of geographical location. Our findings underscore the need for further curriculum development in neurology training, potentially combining early support with dedicated fellowships later in training, in order to ensure sustainability of neuroinflammation as a subspecialty and to meet the growing demand for expertise in MS and related conditions.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106144"},"PeriodicalIF":2.9,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695699","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":"A qualitative study on the experiences of autologous haematopoietic stem cell transplant for Multiple Sclerosis","authors":"Laura Davenport ,&nbsp;Mathew McCauley ,&nbsp;Liam Smyth ,&nbsp;Audrey Reynolds ,&nbsp;Maria Gaughan ,&nbsp;Niall Tubridy ,&nbsp;Chris McGuigan ,&nbsp;Fiadhnait O'Keeffe","doi":"10.1016/j.msard.2024.106165","DOIUrl":"10.1016/j.msard.2024.106165","url":null,"abstract":"<div><h3>Aim</h3><div>Autologous haematopoietic stem cell transplant (HSCT) is an effective treatment for people with highly-active relapsing multiple sclerosis (MS), who are not adequately responding to disease-modifying therapies. To date, research has predominantly focused on disease-specific outcome measures. There is a lack of research exploring patient experiences of this complex treatment. The study aims to explore the experience of considering and receiving HSCT treatment for MS.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted online with 12 adults with MS who had undergone HSCT treatment. Interview topics covered the experience of deciding on the treatment, the HSCT process itself, and the patient-reported outcomes following HSCT. Interviews were audio-recorded and transcribed verbatim. A thematic analysis approach was employed.</div></div><div><h3>Results</h3><div>Three main themes were identified: (1) <em>Balancing hope and fear</em> explores the decision-making experience when considering HSCT as a treatment; (2) <em>Distinct emotional experience,</em> highlights the unique challenges faced on all stages of the treatment journey; and (3) <em>Adjusting to outcomes,</em> explores how participants make sense of the aftermath of the treatment, including managing the ongoing uncertainty of MS and complications arising from HSCT.</div></div><div><h3>Discussion</h3><div>HSCT is a complex treatment, both physically and psychologically for pwMS. A comprehensive and holistic care pathway is required to support people with MS at all stages of the treatment process, to ensure patient-centred planning and care.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106165"},"PeriodicalIF":2.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644576","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":"Utility of icobrain for brain volumetry in multiple sclerosis clinical practice","authors":"Ai-Lan Nguyen ,&nbsp;Maria Pia Sormani ,&nbsp;Dana Horakova ,&nbsp;Eva H Havrdova ,&nbsp;Michael H Barnett ,&nbsp;Nicola De Stefano ,&nbsp;Marco Battaglini ,&nbsp;Manuela Vaneckova ,&nbsp;Elaine Lui ,&nbsp;Frank Gaillard ,&nbsp;Patricia M Desmond ,&nbsp;Hayden Prime ,&nbsp;Mineesh Datta ,&nbsp;Anneke Van der Walt ,&nbsp;Vilija G Jokubaitis ,&nbsp;Femke Podevyn ,&nbsp;Robert Zivadinov ,&nbsp;Bianca Weinstock-Guttman ,&nbsp;Marie B D'hooghe ,&nbsp;Guy Nagels ,&nbsp;Helmut Butzkueven","doi":"10.1016/j.msard.2024.106148","DOIUrl":"10.1016/j.msard.2024.106148","url":null,"abstract":"<div><h3>Background</h3><div>Few studies on multiple sclerosis (MS) have explored the variability of percentage brain volume change (PBVC) measurements obtained from different clinical MRIs. In a retrospective multicentre cohort study, we quantified the variability of annualised PBVC in clinical MRIs.</div></div><div><h3>Methods</h3><div>Clinical MRIs of relapse-onset MS patients were assessed by icobrain. Volumetric data were analysed on same-scanner and different-scanner MRI pairs if they passed quality control criteria. Alignment similarity between two images had to be comparable to same-scanner scan-rescan images.</div></div><div><h3>Results</h3><div>Of 6826 MRIs, 85 % had appropriate volumetric sequences and 4446 serial MRI pairs were analysed. 3334 (75 %) MRI pairs from 1207 patients met the inclusions. The PBVC of included MRI pairs showed variance of 0.78 % for same-scanner pairs and 0.80 % for different-scanner pairs. Further selection of included MRI pairs with the best variance resulted in 1885 (42 %) MRI pairs with PBVC variance of 0.34 %. Excluded MRI pairs with poor alignment similarity had variances of 2.97 % for same-scanner pairs and 20.79 % for different-scanner pairs.</div></div><div><h3>Conclusion</h3><div>Icobrain should be utilised for PBVC determination only on selected MRIs with the best alignment similarity. Applying strict selection criteria for the included MRI pairs and longitudinal imaging on the same scanner remain mandatory to reduce PBVC variability.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106148"},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple sclerosis disease-modifying therapy use in the department of veteran affairs and Medicare: A comparative analysis","authors":"Daniel M. Hartung ,&nbsp;Glenn D. Graham ,&nbsp;Mitchell Wallin ,&nbsp;Steven Leipertz ,&nbsp;Rebecca Spain","doi":"10.1016/j.msard.2024.106159","DOIUrl":"10.1016/j.msard.2024.106159","url":null,"abstract":"<div><h3>Background</h3><div>High-cost disease-modifying therapies (DMT) for multiple sclerosis (MS) have created affordability challenges for people with MS (PwMS) and payers. The Department of Veterans Affairs (VA) is the largest integrated healthcare system in the US and uses a variety of approaches to manage utilization and cost of MS DMT. The objective of this paper is to compare national utilization trends in the VA to the US Medicare program, another large federal public healthcare program.</div></div><div><h3>Methods</h3><div>Counts of PwMS prescribed DMT from 2012 to 2021 in the VA and Medicare programs were used to estimate changes utilization over this period. For each DMT, we estimated the proportion of all DMT users treated in each year. Trends in utilization were compared to identify differences in how these systems manage DMT use. We compared demographics and DMT use between PwMS in the VA to previously published estimates from a Medicare cohort of PwMS.</div></div><div><h3>Results</h3><div>DMT use in PwMS was comparable in VA and Medicare programs (65.9 % vs 69.7 %). In younger (&lt;50 years) PwMS, DMT use was more prevalent in the VA compared to Medicare (85.8 % vs 76.9 %). Between 2012 and 2021, the proportion of patients on DMT using a lower-efficacy agent (interferon beta and glatiramer) declined in both the VA (90–32 %) and Medicare (81–38 %). Oral DMT use (primarily fumarates and sphingosine 1-phosphate [S1P] modulators) increased to a similar degree such that by 2021, 39 % of patients in both systems were receiving oral DMT. Use of high-efficacy B cell depleting DMT (ocrelizumab, ofatumumab, and rituximab) was consistently higher in the VA than in Medicare. Despite the approval of generic glatiramer and dimethyl fumarate in 2015 and 2020 respectively, 49 % of glatiramer and 58 % of fumarate utilization in the Medicare program continued to be for a branded product in 2021.</div></div><div><h3>Conclusions</h3><div>Greater DMT use among younger PwMS along with more frequent use of high-efficacy B cell depleting DMT in VA has the potential to reduce disability and attendant healthcare system costs. Generic DMT adoption in the Medicare program was lower than might be expected. Future studies should evaluate the relationship between DMT utilization, costs, and health outcomes in these populations.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106159"},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705621","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":"Untackling the economics of multiple sclerosis: A systematic review of economic evaluations of disease-modifying therapies indicated for multiple sclerosis","authors":"Dr Panagiotis Petrou","doi":"10.1016/j.msard.2024.106161","DOIUrl":"10.1016/j.msard.2024.106161","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Multiple sclerosis (MS) comprises a chronic, neurodegenerative, and inflammatory illness of the central nervous system that affects 2.8 million people worldwide. MS is only treatable, and to this direction, the disease armamentarium has been significantly enriched with new agents, albeit with burgeoning costs and engulfed by uncertainty. The scope of this review is to assess the efficiency of MS agents.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a systematic literature review, spanning from 2000 to 2023 on adult patients with any form of MS, receiving any MS indicated modality and whose outcome was ICUR and ICER. The methodological quality of the studies was assessed with the Quality of Health Economics Studies tool.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified 57 studies that met the inclusion criteria. Studies were hailing from 20 countries and a multitude of methodological approaches were documented across several types of MS. A substantial level of divergence regarding results was noted. Country setting, study perspective (societal vs payer) the selection of the benchmark treatment, data extrapolation beyond the reported timeframe of the trial and time horizon of the model exerted a substantial impact on the results. Dimethyl fumarate was consistently interrelated with a positive cost-effectiveness ratio. The same applies for fampridine, while Cladribine was proved to be a dominating agent. Ocrelizumab also evinced efficiency. The same applies for the early data of Siponimod and ofatumumab, however the breadth of their studies lags compares to other agents, and these results have to be further corroborated. On the contrary Interferons demonstrated a non-efficient profile and their use as a comparative benchmark arm brought about several complications regarding the incremental financial aspect of economic evaluations, since they are commonly used as such. The results of fingolimod and natalizumab studies are embroiled in uncertainty. Moreover, the efficiency factor was positively correlated by earlier access of patients to these products, rather than delayed one. Result discrepancies among the same country were also imputed to the adopted utility and disutility values and the methodological approach for data extrapolation. Results were sensitive to an array of factors. Among them, the effectiveness of the products, coupled with the cost of the agents emerged as the most important drivers. Uncertainty was further compounded by several other parameters such as discounting, efficacy waning, horizon of the study, disability base rate and utility of the patients. We also outlined that the efficiency of product is pertinent to the disease type. Results such as dominance must be interpreted with caution since in certain cases a dominating agent was proved to be as such by capitalizing on marginal incremental health gains, compared to the standard comparative treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106161"},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695723","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":"The multiple sclerosis gut microbiome and disease activity: A systematic review","authors":"Sophia Jette ,&nbsp;Constance de Schaetzen ,&nbsp;Chia-Chen Tsai ,&nbsp;Helen Tremlett","doi":"10.1016/j.msard.2024.106151","DOIUrl":"10.1016/j.msard.2024.106151","url":null,"abstract":"<div><h3>Background</h3><div>The gut microbiome is a potential therapeutic target for multiple sclerosis (MS), yet its association with disease activity remains unclear. We systematically reviewed the literature to investigate the relationship between the gut microbiome and MS disease activity, course, and disability progression.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, EMBASE, Web of Science and Google Scholar (01/2011–02/2024) to identify relevant observational or interventional studies published in English. Case reports were ineligible. Outcomes included disease activity (e.g. relapses, MRI), course (e.g. relapsing-remitting/secondary-progressive [RR/SPMS]) and disability progression (e.g. using the Expanded Disability Status Scale [EDSS]). Study quality was evaluated using the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>Four longitudinal and nineteen cross-sectional studies were included, totaling 1760 persons with MS. Most were female (1237/1760, 70 %) and had RRMS (1378/1760, 78 %). The majority of studies (67 %;10/15) examining gut diversity (alpha or beta) did not find an association with disease activity, course or progression. However, several gut taxa exhibited significant associations with study outcomes, including eight that varied in consistent directions: a higher abundance of <em>Actinobacteria, Bacteroidota</em> and <em>Roseburia inulinivorans</em> were associated with better MS outcomes (e.g. lower EDSS scores), while higher abundances of <em>Streptococcus, Clostridium nexile, Clostridium scindens</em> and <em>Collinsella aerofaciens</em> were associated with worse outcomes (e.g. higher MRI lesion volumes).</div></div><div><h3>Conclusions</h3><div>Gut diversity was not associated with MS-related outcomes in most studies whereas several gut taxa were, including higher abundances of short chain-fatty acid producers (e.g. <em>Bacteroidota</em>) showing associations with lower EDSS scores. Most studies were cross-sectional, limiting interpretation of findings; longitudinal studies are warranted.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106151"},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a relationship between CSF Interleukin 34 Level and clinicoradiological activity and IgG index in patients with MS?","authors":"Şeyda Figül Gökçe ,&nbsp;Aslı Bolayır ,&nbsp;Burhanettin Çiğdem","doi":"10.1016/j.msard.2024.106150","DOIUrl":"10.1016/j.msard.2024.106150","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis is an autoimmune, inflammatory, and disabling disease that is subject to research, with the aspects of its pathogenesis awaiting clarification. It is essential to predict the prognosis of the disease and find the responsible mechanisms and molecules to become a treatment option. In this regard, researching the impact of Interleukin 34, with its immunomodulatory properties, on the clinicoradiological activity effect of MS and determining its role, if any, may be guiding.</div></div><div><h3>Methods</h3><div>The study included 52 MS patients who underwent lumbar puncture at the diagnosis stage, and dimethyl fumarate treatment was initiated in these patients. During a one-year prospective follow-up, CSF IL-34 levels of 26 patients with clinical and/or radiological activity and 26 patients without activity were evaluated for prediction of disease activity. Additionally, CSF IL-34 levels of 26 control patients who underwent lumbar puncture due to pseudotumor cerebri but were not diagnosed with this disorder and whose CSF examinations were normal and were compared with MS patients. Our study also included the Immunoglobulin G index and investigated its relationship with IL-34.</div></div><div><h3>Results</h3><div>The IL-34 level was higher in the MS patient group compared to the control group. No significant difference was identified between MS patient groups with and without clinical and/or radiological activity. A weak correlation without statistical significance was found between IL-34 and the IgG index.</div></div><div><h3>Conclusion</h3><div>The IL-34 level did not correlate with clinical and radiological activity in MS patients. However, the high IL-34 level observed in the patient group in comparison with the control group may be significant for MS pathogenesis. Furthermore, IL-34 may be a useful biomarker candidate for MS diagnosis, similar to the IgG index.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106150"},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687526","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":"Development and psychometric evaluation of the treatment management adherence scale for children with multiple sclerosis","authors":"Didem Yüksel ,&nbsp;Figen Yardimci","doi":"10.1016/j.msard.2024.106162","DOIUrl":"10.1016/j.msard.2024.106162","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric multiple sclerosis (pMS) is a chronic inflammatory, demyelinating, and neurodegenerative disease affecting the central nervous system in children and adolescents The aim of this correlational, comparative study was to develop an assessment scale for adherence to treatment management in pMS.</div></div><div><h3>Methods</h3><div>Two measurement tools were used to develop a scientifically sound tool to assess adherence in pediatric patients (12–18 years) diagnosed with multiple sclerosis (MS). Cases of pMS (<em>n</em> = 120) in 7 hospitals in Turkey were included between August 2021-February 2022. The tools were a \"Sociodemographic and Disease-Related Information\" and a newly developed \"Treatment Management Adherence Scale for Children with Multiple Sclerosis”. The form and questionnaire were completed by the children through online using the Zoom platform in approximately 10 min. The questionnaire on adherence contains 16 items related to the disease and treatment, scored in a 5-point Likert type. Face validity was established by pretesting with 20 children, and construct validity was established using the statistical methods of exploratory factor analysis and confirmatory factor analysis. For the reliability of the scale, Cronbach's Alpha and omega coefficients, item test correlation values, split-half, test-retest techniques were used.</div></div><div><h3>Results</h3><div>There were 120 eligible patients, 71.2 % girls, with mean age (±SD) 13,6 ± 2,2 years at disease onset and 15,7 ± 1,5 at the time of the study, all under disease-modifying therapy. The sample size and items were sufficient to conduct a factor analysis. The Cronbach's Alpha and Omega value was 0.75, indicating participants’ opinions were consistent across items. The mean content validity index was 0.93, showing the scale represented the measured data, and the exploratory factor analysis showed the scale measures adherence in 55 % of patients (desired figures: &gt;0.80 and 40–60 % respectively). The 16 items of the questionnaire were grouped into 4 dimensions. These dimensions were termed 'physiological', 'self-concept', 'role function' and 'interdependence', in line with different styles of adaptation. The total score can be between 16 and 80, with higher scores indicating strong adherence to treatment. The mean total score of 54,3 ± 9,53 (min=31, max= 75) in this study was in the “moderate adherence” range.</div></div><div><h3>Conclusions</h3><div>This new scale is the first to assess adherence in pMS. The study supports its validity, reliability, and likelihood to address adjustment issues in children and adolescents with MS accurately and can be recommended for clinical use.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 106162"},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623937","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}