Multiple sclerosis and related disorders最新文献

{"title":"Effects of lower extremity proprioceptive neuromuscular facilitation exercises versus resistance training on gait, balance, and fatigue in patients with multiple sclerosis: A randomized controlled study","authors":"Metehan Öğüt ,&nbsp;Hakan Polat ,&nbsp;Yasemin Ekmekyapar Firat ,&nbsp;Nevin Ergun","doi":"10.1016/j.msard.2026.107099","DOIUrl":"10.1016/j.msard.2026.107099","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the effects of lower extremity Proprioceptive Neuromuscular Facilitation (PNF) exercises on balance, gait, and fatigue in patients with Multiple Sclerosis (pwMS).</div></div><div><h3>Method</h3><div>Twenty-six pwMS (18 females, 8 males), aged 18-65 years, and an EDSS score of ≤5.5 were included in the study. Patients were randomly allocated to the PNF group (PNFG) or the resistance training group (RTG) (n = 13/group) and performed lower extremity PNF exercises or resistance training, respectively, three times per week for six weeks. Static and dynamic balance were assessed using the Tandem Stance Test (TST) and the Four-Square Step Test (FSST), respectively. Gait was evaluated using the Timed 25-Foot Walk (T25-FW) test, and fatigue using the Fatigue Severity Scale (FSS). Assessments were performed at baseline and after six weeks.</div></div><div><h3>Results</h3><div>Both groups showed significant within-group improvements across balance, gait, and fatigue measures (all within-group p &lt; 0.001). Between-group comparisons of change scores demonstrated significantly larger improvements for PNFG versus RTG on: TST—right (Δ = 7.55 vs 4.11 s; p &lt; 0.001; Cohen’s d = 0.76), TST—left (Δ = 6.96 vs 2.60 s; p &lt; 0.001; d = 1.22), FSST (Δ = −3.24 vs −1.07 s; p &lt; 0.001; d = −1.47), and T25-FW (Δ = −4.25 vs −1.29 s; p &lt; 0.001; d = −1.50). There was no significant between-group difference for fatigue (FSS Δ = −0.35 vs −0.34; p = 0.884; d = −0.03). However, ANCOVA analyses adjusting for baseline values, and sensitivity analyses including age, BMI, and baseline EDSS, revealed no statistically significant between-group differences for any outcome, with small-to-medium effect sizes.</div></div><div><h3>Conclusion</h3><div>Both lower extremity PNF exercises and resistance training effectively improve balance, gait, and fatigue in pwMS. After accounting for baseline performance and relevant covariates, PNF did not confer additional statistically significant benefits over resistance training. Nevertheless, incorporating PNF into rehabilitation programs remains a practical approach to enhance neuromuscular coordination and functional mobility, and it may be combined with conventional strengthening exercises and targeted fatigue-management strategies for more comprehensive outcomes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107099"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378165","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":"2026-04-01","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":"Frailty, Disability, and Comorbidity in Multiple Sclerosis: Overlap and Distinct Associations with Quality of Life and Falls","authors":"Tobia Zanotto ,&nbsp;Nida’ Al Worikat ,&nbsp;Anna Zanotto ,&nbsp;Sharon G Lynch ,&nbsp;Jacob J Sosnoff","doi":"10.1016/j.msard.2026.107043","DOIUrl":"10.1016/j.msard.2026.107043","url":null,"abstract":"<div><h3>Background</h3><div>Owing to the global aging of people with multiple sclerosis (pwMS), there is an emerging need to distinguish neurological disability from age-related conditions in this population.</div></div><div><h3>Objective</h3><div>To examine the overlap between frailty, disability, and comorbidity in pwMS, and their associations with quality of life (QoL) and falls.</div></div><div><h3>Methods</h3><div>Two hundred and three pwMS (mean age=51.8 ± 12.6 years; median Patient Determined Disease Steps (PDDS) score=1.0 [IQR=2.0]; 73.9% women) underwent established assessments of frailty (FRAIL scale, Tilburg frailty indicator, and frailty index), disability (PDDS), comorbidity (Charlson comorbidity index), QoL (MSQoL-54), and falls (12-month fall-history survey).</div></div><div><h3>Results</h3><div>Frailty, disability, and comorbidity were distinct but overlapping: 1.5–10.3% of participants had frailty alone, 4.4–14.3% had disability alone, and 11.8–14.3% had comorbidity alone; between 9.4% and 19.7% had all three. Multivariable quantile and logistic regression analyses revealed that all frailty measures were more strongly associated with lower QoL (median regression coefficients ≤-4.76, p-values˂0.001) and greater odds of falling (OR_s ≥1.47, p-values≤0.001) than disability or comorbidity. Participants with all three conditions had significantly worse physical QoL and a higher median number of falls than those with any one condition alone.</div></div><div><h3>Conclusions</h3><div>Frailty, disability, and comorbidity represent separate conditions in pwMS, as they can present in isolation, and each has distinct associations with QoL and falls. Comprehensive assessment of all three conditions may enhance risk stratification and inform individualized rehabilitation and aging support strategies.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107043"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102790","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 experience of cladribine treatment in relapsing multiple sclerosis: A Romanian multicenter nationwide study","authors":"Rodica Balasa ,&nbsp;Laura Barcutean ,&nbsp;Smaranda Maier ,&nbsp;Marian Pop ,&nbsp;Andrei Fulop ,&nbsp;Oana Vrinceanu ,&nbsp;Irene Davidescu ,&nbsp;Adriana Dulamea ,&nbsp;Mihaela Simu ,&nbsp;Cristina Panea ,&nbsp;Valeria Albu ,&nbsp;Aurelia Filipoiu ,&nbsp;Raluca Lupu ,&nbsp;Corina Roman-Filip ,&nbsp;Monica Sabau ,&nbsp;Carmen Adella Sirbu ,&nbsp;Mihaela Lungu ,&nbsp;Vitalie Vacaras ,&nbsp;Bogdan Ignat ,&nbsp;Cristina Tiu","doi":"10.1016/j.msard.2026.107063","DOIUrl":"10.1016/j.msard.2026.107063","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is an incurable disease of the central nervous system that affects young adults and determines significant disability. The past decade has seen a change in the treatment options, moving toward disease-modifying therapies. cladribine (Cladribine) tablets are the only short-course oral immune reconstitution therapy approved for highly active relapsing MS (RMS). Romanian authorities approved the full reimbursement in July 2021.</div></div><div><h3>Materials and methods</h3><div>We conducted a multicenter, observational, post-marketing, real-world cohort study in Romania that included all patients with MS (PwMS) who completed at least one cycle of CLD with at least three months of follow-up as of September 2024. Demographic variables and MS clinical characteristics regarding each patient were recorded. No Evidence of Disease Activity (NEDA-3) was assessed at one and two years after CLD initiation. The primary outcome was the proportion and characteristics of PwMS achieving NEDA-3 at 12 and 24 months after CLD initiation and the identification of predictors of failure in achieving NEDA-3.</div></div><div><h3>Results</h3><div>A total of 348 PwMS cases were included, of which CLD was the first DMT option in 129 (37.1%). At one year, 76.74% of the patients with complete available data fulfilled all criteria, achieving NEDA-3 status, with similar proportions between previously DMT-treated PwMS and naïve PwMS. In the univariate analysis, the onset of long-tract involvement, as compared to infratentorial (OR = 6.32, <em>p</em> = 0.01), and the number of Gd-enhancing lesions (OR = 1.12, <em>p</em> = 0.02), were significantly associated with increased odds of not achieving NEDA-3 at one year. In the multivariate model, long tracts (OR = 10.28, <em>p</em> = 0.006), higher baseline EDSS (OR = 1.39, <em>p</em> = 0.01), and longer disease duration (OR = 0.92, <em>p</em> = 0.04) were independent predictors.</div></div><div><h3>Conclusions</h3><div>The initiation of CLD treatment was associated with achieving NEDA-3 at one year in &gt;70% of cases. CLD demonstrated an improvement in MS control, irrespective of the patients’ demographics, RMS history, or prior DMT exposure. CLD treatment has a favorable safety profile and a high level of patient adherence.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107063"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191540","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":"Aging does not affect the relationship between OCT and clinical or MRI outcome measures","authors":"S. Kaçar ,&nbsp;Julia R. Jelgerhuis ,&nbsp;J. Killestein ,&nbsp;F. Barkhof ,&nbsp;M.M. Schoonheim ,&nbsp;B.M.J. Uitdehaag ,&nbsp;E.M.M. Strijbis","doi":"10.1016/j.msard.2026.107046","DOIUrl":"10.1016/j.msard.2026.107046","url":null,"abstract":"<div><h3>Background</h3><div>Neurodegeneration in multiple sclerosis (MS) is intertwined with normal aging. The standard approach to address this overlap is statistical correction for the confounding effects of age, but it remains unclear to what extent this successfully isolates disease-specific processes from those related to aging.</div></div><div><h3>Objectives</h3><div>We aimed to investigate how age influences cross-sectional associations between retinal measures—retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL)—and both MRI and clinical outcomes in MS.</div></div><div><h3>Methods</h3><div>We compared two MS cohorts: (1) a cohort selected on birth year (Project Y) and (2) an age-heterogeneous MS cohort (PrograMS). Multilevel linear regression models were used to assess cross-sectional associations. Models were adjusted for sex, history of optic neuritis, and disease duration. In the heterogeneous cohort, age was included as an additional covariate.</div></div><div><h3>Results</h3><div>In both the birth-year cohort (<em>N</em> = 378) and the heterogeneous cohort (<em>N</em> = 206), we observed significant associations between RNFL and GCIPL thickness and several MRI measures including whole brain volume, white matter volume, lesion volume, and thalamus volume, as well as clinical outcome measures, such as Expanded Disability Status Scale (EDSS), Symbol Digit Modality Test (SDMT). While effect sizes varied, the direction remained consistent. Including age as a covariate did not substantially change associations. For example, both RNFL and GCIPL thickness were associated with EDSS in the birth-year cohort (RNFL: β = -0.020, <em>p</em> &lt; 0.001; GCIPL: β = -0.017, <em>p</em> = 0.005) and in the age-heterogeneous cohort (RNFL: β = -0.024, <em>p</em> = 0.010; GCIPL: β = -0.033, <em>p</em> &lt; 0.001), and showed consistent directionality in their associations with MRI-derived brain volumes.</div></div><div><h3>Discussion</h3><div>Our findings reveal significant cross-sectional associations between RNFL and GCIPL thickness and several MRI and clinical measures, with consistent directionality across both cohorts, and largely independent of age.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107046"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181142","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 high-heel sign: revisiting neurological semiology from Charcot’s era to modern patient-reported outcomes in multiple sclerosis","authors":"Juliana Santiago-Amaral","doi":"10.1016/j.msard.2026.107048","DOIUrl":"10.1016/j.msard.2026.107048","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107048"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166064","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":"Leg strength and neural activation deficits in older adults with multiple sclerosis","authors":"Yinan Zhang ,&nbsp;Fernanda L. Schumacher ,&nbsp;Leatha A. Clark ,&nbsp;Brian C. Clark","doi":"10.1016/j.msard.2026.107050","DOIUrl":"10.1016/j.msard.2026.107050","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) causes immune-mediated inflammation and neurodegeneration in the central nervous system, often leading to weakness and impaired mobility. In older adults with MS, it can be challenging to distinguish MS vs. age-related contributions to weakness. Studies are needed to examine the neuromuscular mechanisms of age-related declines in muscle strength to better understand their relative contribution to weakness in older adults with MS.</div></div><div><h3>Objectives</h3><div>To investigate the neuromuscular mechanisms underlying age-related declines in muscle strength and their contribution to weakness in older adults with MS.</div></div><div><h3>Methods</h3><div>We conducted a study to determine whether older adults with MS exhibit differences in knee extensor voluntary (neural) activation, MRI-derived muscle volume, and skeletal muscle contractile quality compared to age-, sex-, and BMI-matched individuals without MS. Group comparisons were performed using nonparametric statistical analyses.</div></div><div><h3>Results</h3><div>In 10 older adults with MS and 10 age-, sex-, and BMI-matched controls, participants with MS had reduced isokinetic strength relative to body weight (MS 0.95 N·m/kg [0.77, 1.06], controls 1.48 N·m/kg [1.23, 1.66]) and summed torque relative to muscle volume (MS 10.31 × 10³ N·m/cm³ [8.24 × 10³, 11.84 × 10³], controls 13.32 × 10³ N·m/cm³ [12.50 × 10³, 13.59 × 10³]). In MS compared to controls, we also observed reduced peak isometric strength relative to muscle volume (MS 0.47 N·m/cm³ [0.37, 0.51], controls 0.58 N·m/cm³ [0.56, 0.63]) and reduced isokinetic strength relative to muscle volume (MS 0.37 N·m/cm³ [0.33, 0.42], controls 0.56 N·m/cm³ [0.52, 0.56]). Quadriceps muscle volume was similar in participants with MS (168.42 cm³ [158.55, 196.74]) and controls (183.26 cm³ [175.62, 202.25]). There was decreased neural activation parameters in MS including central activation ballistic torque (CAB) ratio (MS 0.31 [0.18, 0.35], controls 0.46 [0.40, 0.57]) and voluntary activation (MS 87.87% [84.09, 90.09], controls 94.82% [92.89, 95.78]). No statistically significant correlations between neuromuscular function and MS clinical outcomes were found.</div></div><div><h3>Conclusion</h3><div>Neuromuscular function deficits in older adults with MS are largely attributed to impaired neural activation without significant differences in muscle quality compared with controls.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107050"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137740","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":"Lower limb strength asymmetry and its association with functional changes in persons with multiple sclerosis","authors":"Callie Evanchick ,&nbsp;Nicholas Lopez ,&nbsp;Elizabeth S. Gromisch ,&nbsp;Marc Campo ,&nbsp;Heather M. DelMastro","doi":"10.1016/j.msard.2026.107067","DOIUrl":"10.1016/j.msard.2026.107067","url":null,"abstract":"<div><h3>Background</h3><div>Lower limb (LL) asymmetry is associated with fatigue, instability, and fear of falling in persons with MS (PwMS). However, research is limited on how LL strength asymmetry contributes to functional status changes in PwMS.</div></div><div><h3>Objectives</h3><div>To determine if there is a difference in LL strength asymmetry between functional status groups in PwMS and identify which asymmetry score indicates a change in functional status in PwMS.</div></div><div><h3>Methods</h3><div>This secondary analysis of a cross-sectional study collected the 12-item MS Walking Scale (MSWS-12) to classify PwMS (<em>n</em> = 183) into functional groups (minimal: 0–24.99, mild: 25–49.99, moderate: 50–74.99, or severe: 75–100). Peak isometric torque and asymmetry of hip abduction (HA), extension (HE), and flexion (HF), knee extension (KE) and flexion (KF), and ankle plantarflexion (APF) and dorsiflexion (ADF) were captured. Differences between functional groups were examined. Receiver operating characteristic analyses were performed on significant differences. Optimal cutoff scores were identified. Exploratory regressions examined asymmetry cut-off scores and function.</div></div><div><h3>Results</h3><div>Overall differences between functional groups occurred in KF (<em>P</em> &lt; 0.001), ADF (<em>P</em> = 0.012), and KE (<em>P</em> = 0.013) asymmetry. KF (cut-off: ≥19.74%, sensitivity: 67.19%, specificity: 92.86%) and ADF (cut-off: ≥14.29%, sensitivity: 67.39%, specificity: 82.14%) had useful asymmetry cut-off scores (sensitivity and specificity totaled ≥1.5). KF asymmetry (aOR: 264.75, 95%CI: 4.33, 16,199.33, <em>P</em> = 0.008) was a significant predictor of function.</div></div><div><h3>Conclusions</h3><div>Only KE, KF and ADF asymmetry differed between the functional levels. The asymmetry differentiating between the minimal and severe functional groups was above the typically used 10% criterion, and KF asymmetry was predictive of functional change in PwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107067"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191537","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":"No evidence of disease activity after fingolimod treatment: A three-year real-world comparison of pre- and post-treatment outcomes in multiple sclerosis","authors":"Ulvi Samadzade ,&nbsp;Said Alizada ,&nbsp;Can Caliskan ,&nbsp;Orkhan Mammadov ,&nbsp;Serkan Ozakbas","doi":"10.1016/j.msard.2026.107044","DOIUrl":"10.1016/j.msard.2026.107044","url":null,"abstract":"<div><h3>Background</h3><div>Real-world data on fingolimod effectiveness in multiple sclerosis (MS) remain valuable, particularly in switch cohorts and across phenotypes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center observational study including MS patients with RRMS or SPMS who received fingolimod and had complete symmetric 3-year pre- and 3-year post-treatment clinical follow-up data. Outcomes included changes in annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS) over the 3-year pre/post periods, and the proportion achieving NEDA-3 during the 3-year on-treatment period.</div></div><div><h3>Results</h3><div><strong>:</strong>A total of 657 patients were analyzed (596 RRMS; 61 SPMS). In RRMS, ARR decreased from 0.34±0.39 in the 3 years pre-treatment to 0.08±0.20 in the 3 years on fingolimod (<em>p</em> &lt; 0.001), and mean EDSS changed from 1.48±1.27 to 1.43±1.36 (<em>p</em> = 0.152). In SPMS, ARR changed from 0.61±0.52 to 0.27±0.32 (<em>p</em> &lt; 0.001), while EDSS increased from 5.08±1.01 to 6.10±1.31 (<em>p</em> &lt; 0.001). NEDA-3 was achieved by 415/596 (69.6 %) RRMS patients and 10/61 (16.4 %) SPMS patients during the 3-year on-treatment period.</div></div><div><h3>Conclusion</h3><div>In this real-world switch cohort, fingolimod was associated with a marked reduction in relapse activity in RRMS, while disability worsening persisted in SPMS. NEDA-3 rates differed substantially by phenotype, supporting phenotype-specific expectations and the value of real-world risk stratification.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107044"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137784","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":"Elevated expression of the NLRP3 inflammasome in post-mortem brain white matter and immune cells in multiple sclerosis","authors":"Almudena Otálora-Alcaraz ,&nbsp;Melody Cui Sun ,&nbsp;Nicole Hofman ,&nbsp;Lisa Costelloe ,&nbsp;Hugh Kearney ,&nbsp;Jack A. Prenderville ,&nbsp;Eric J. Downer","doi":"10.1016/j.msard.2026.107040","DOIUrl":"10.1016/j.msard.2026.107040","url":null,"abstract":"<div><h3>Background</h3><div>The nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain-containing 3 (NLRP3) inflammasome is a signalling hub associated with the pathogenesis of neuroinflammatory conditions such as multiple sclerosis (MS). NLRP3 inflammasome activation requires interplay between pathogen-/damage-associated molecular patterns and other soluble factors, which initiates inflammation to promote the secretion of the cytokine, interleukin (IL)-1β.</div></div><div><h3>Objective</h3><div>To determine if the expression of NLRP3 inflammasome signalling components is altered in the brain and in immune cells in MS.</div></div><div><h3>Methods</h3><div>Using post-mortem brain tissue from 21 cases, including 8 non-MS control, 7 primary progressive (PP) MS and 6 secondary progressive (SP) MS cases, alongside peripheral blood mononuclear cells (PBMCs) isolated from 45 subjects including healthy controls (<em>n</em> = 23), and people with (pw) a relapsing remitting (RR) (<em>n</em> = 15), SP (<em>n</em> = 5) or PP (<em>n</em> = 2) form of MS, we profiled the expression of NLRP3 inflammasome components, both centrally in CNS white matter, and peripherally in immune cells.</div></div><div><h3>Results</h3><div>The expression of <em>NLRP3, IL1B, IL18, CASP1</em> and <em>PYCARD</em> transcripts were elevated in chronic active lesions (CALs) in PPMS cases, with no significant alterations determined in SPMS CNS tissue. Furthermore, NLRP3-dependent IL-1β release, alongside <em>NLRP3, IL1B</em> and <em>GSDMD</em> expression, were significantly elevated in immune cells isolated from pwMS (primarily RRMS), when compared to PBMCs from healthy controls.</div></div><div><h3>Conclusion</h3><div>The expression of NLRP3 inflammasome components is dysregulated in MS, both in the brain and in PBMCs. This suggests that uncontrolled NLRP3 inflammasome activity takes place at certain stages of MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107040"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191481","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}