Multiple sclerosis and related disorders最新文献

{"title":"Multiple sclerosis and related disorders multiple sclerosis across Isfahan Province, Iran: Urban–rural disparities and no association with air quality measures","authors":"Masoud Etemadifar ,&nbsp;Shakila Bagheri ,&nbsp;Ahmadreza Dehghani ,&nbsp;Fatemeh Sabeti ,&nbsp;Mohsen Raeisidehkordi ,&nbsp;Mehri Salari ,&nbsp;Kamran Rezaei","doi":"10.1016/j.msard.2026.107025","DOIUrl":"10.1016/j.msard.2026.107025","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) prevalence varies worldwide and appears to be rising in Iran. Environmental factors like air pollution have been hypothesized to contribute to MS risk. This study aimed to map MS prevalence across Isfahan Province and evaluate differences by sex and urban versus rural setting, as well as to assess any association between ambient air pollution and MS prevalence.</div></div><div><h3>Methods</h3><div>Data from 11,456 provincially registered MS patients in 28 counties in Isfahan, Iran, were examined in this cross-sectional ecological study. Official population estimates were used to calculate the county-level MS point prevalence per 100,000 population in 2023, stratified by sex. Ratios of females to males were calculated. Annual average PM₂.₅ levels for each county were obtained from state sources for the same period. MS prevalence was compared between urban and rural counties, and correlation/regression analyses were used to test associations with pollutant levels.</div></div><div><h3>Results and conclusion</h3><div>The prevalence of MS varied widely, ranging from 322.7 in Isfahan County to 15.4 per 100,000 in rural Jarghouyeh. Although there was no significant correlation between the sex disparity and overall prevalence, females were more affected in every county (F/M ratio: 2.0–9.0). Although PM₂.₅ levels in Isfahan were extremely high (annual mean=41 μg/m³, &gt;8 times the WHO guideline of 5 μg/m³), we found no significant correlation between ambient pollutant concentrations and MS prevalence in the province.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107025"},"PeriodicalIF":2.9,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046879","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":"Inter-assay variability in anti–JC virus testing for natalizumab: A Spanish cohort","authors":"Luis Fernández Espigares ,&nbsp;Alicia Fernández Panadero ,&nbsp;María Díaz Sánchez ,&nbsp;José Luis Casado Chocán ,&nbsp;Eduardo Durán Ferreras","doi":"10.1016/j.msard.2026.107023","DOIUrl":"10.1016/j.msard.2026.107023","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate anti–JC virus (JCV) antibody testing is essential for progressive multifocal leukoencephalopathy (PML) risk stratification in natalizumab-treated patients. This study assessed evaluated inter-assay concordance between ImmunoWELL™ JCV IgG and STRATIFYJCV™ DxSelect™.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional inter-assay concordance study including 48 patients with multiple sclerosis treated with natalizumab. Paired serum samples were analyzed using both assays. Binary serostatus and ordinal risk categories (negative, low, intermediate, high) according to antibody index value were compared.</div></div><div><h3>Results</h3><div>STRATIFYJCV™ identified 4.2% of patients as JCV positive versus 33.3% with ImmunoWELL™, an eightfold difference. Overall binary agreement was 66.7%, with PABAK 0.33 (95% CI 0.12–0.54) and significant directional discordance (p = 0.0005). Most discordant results reflected upward reclassification from negative to low or intermediate categories. Only one patient changed high-risk status. A single discordant negative result was identified.</div></div><div><h3>Conclusions</h3><div>ImmunoWELL™ and STRATIFYJCV™ show relevant inter-assay variability, predominantly affecting low antibody index values, while preserving substantial agreement at clinically decisive high-risk thresholds. These findings support cautious interpretation of ImmunoWELL™ results and highlight the need for further virological validation.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107023"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034581","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":"Associations of smoking, infections, early-life exposures, and concussion with progressive-onset versus relapse-onset multiple sclerosis: A case-control study","authors":"Ying Li ,&nbsp;Alice Saul ,&nbsp;Bruce Taylor ,&nbsp;Anne-Louise Ponsonby ,&nbsp;Steve Simpson-Yap ,&nbsp;Leigh Blizzard ,&nbsp;Simon Broadley ,&nbsp;Jeannette Lechner-Scott ,&nbsp;Ingrid van der Mei ,&nbsp;Ausimmune/AusLong investigator group","doi":"10.1016/j.msard.2026.107020","DOIUrl":"10.1016/j.msard.2026.107020","url":null,"abstract":"<div><h3>Background</h3><div>Among environmental factors associated with multiple sclerosis (MS) susceptibility, few studies have examined different onset types. It remains unclear whether risk factors for primary progressive MS (PPMS) are comparable to those for relapse-onset MS (RMS). This study aimed to explore the association between selected environmental factors and PPMS risk, and compare their effect sizes with RMS.</div></div><div><h3>Methods</h3><div>We used a case-control design with participants from two datasets: the Primary-Progressive MS Study (2015–2021) and the Australian Multi-center Study of Environment and Immune Function (2003–2006). Questionnaires collected data on smoking, infectious and concussion history before MS onset, supplement intake before age 15, and breastfeeding history. Unconditional, conditional, and weighted multivariable logistic regression evaluated associations with PPMS and RMS onset risk.</div></div><div><h3>Results</h3><div>A significant positive association was observed between tobacco smoking prior to onset (≥20 pack-years: odds ratio (OR)=1.75, 95% confidence interval (CI)=0.96–3.20, P for trend=0.03) and history of infectious mononucleosis before MS onset (OR=1.74, 95% CI=1.05–2.88) in PPMS. Having vitamin supplements before age 15 (OR=0.52, 95% CI=0.31–0.87) and being breastfed during infancy (&gt;6 months vs. never: OR=0.52, 95% CI=0.27–0.98) were associated with reduced PPMS risk. For RMS, tobacco smoking prior to onset (ever smoker OR=1.62, 95% CI=1.15–2.30; ≥20 pack-years: OR=2.17, 95% CI=1.20–3.80, P for trend=0.007) and infectious mononucleosis (OR=1.76, 95% CI=1.19–2.61) were also significantly associated with increased risk, with no difference in effect sizes compared to PPMS. Other infections, supplement intake, and being breastfed were not associated with RMS risk. Marijuana smoking and concussion history were not associated with either PPMS or RMS.</div></div><div><h3>Conclusions</h3><div>PPMS shares some common risk factors with RMS, such as tobacco smoking and infectious mononucleosis, with similar effect sizes. This suggests PPMS and RMS may share underlying disease mechanisms. Further studies are needed to validate the role of other factors associated with PPMS onset.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107020"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165977","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":"Treatment outcomes of high-efficacy disease-modifying therapies in patients with relapsing-remitting multiple sclerosis: A longitudinal observational study.","authors":"Raed Alroughani, Samar Farouk Ahmed","doi":"10.1016/j.msard.2026.107024","DOIUrl":"https://doi.org/10.1016/j.msard.2026.107024","url":null,"abstract":"<p><strong>Background: </strong>The evolution of high-efficacy disease-modifying therapies (HE-DMTs) has significantly shifted the management of relapsing-remitting multiple sclerosis (RRMS). Real-world evidence highlighted the role of HE-DMTs in improving disability and controlling disease activity.</p><p><strong>Objectives: </strong>To assess the real-world effectiveness, treatment patterns, and discontinuation patterns of HE-DMTs, including cladribine, natalizumab, ocrelizumab, alemtuzumab, fingolimod, and rituximab in RRMS patients.</p><p><strong>Methods: </strong>This is a retrospective, observational, longitudinal, multicenter study that included 1,408 RRMS patients treated with HE-DMTs. Data were extracted from the Kuwaiti national MS registry. The primary objective of this study was to assess the proportion of patients with relapse-free status at 12 months. Secondary objectives included confirmed disability progression (CDP), confirmed disability improvement (CDI), Expanded Disability Status Scale (EDSS) changes, proportion of patients with no evidence of disease activity (NEDA-3), and treatment discontinuation patterns. Statistical analysis included descriptive analysis, paired-sample tests, and McNemar's tests.</p><p><strong>Results: </strong>After 12 months of treatment, first-line HE-DMTs resulted in high relapse-free (≥80%) and NEDA-3 (≥75%) rates, especially with ocrelizumab (90.6%, 82.7%, respectively) and natalizumab (88.4%, 81.9%, respectively). Significant EDSS reductions were achieved with natalizumab (-0.80), ocrelizumab (-0.46), and rituximab (-0.66) in patients receiving first-line HE-DMTs (p < 0.001). CDI rates were the highest with alemtuzumab (40.6%) and rituximab (22.1%) in the first-line setting. Discontinuation rates were highest for alemtuzumab due to scheduled stopping (86.9%), fingolimod due to adverse events (17.3%), and natalizumab due to JC virus sero-positivity (65.7%). Ocrelizumab had the lowest discontinuation rate (5.4%), mainly due to pregnancy confirmation or planning (56.5%).</p><p><strong>Conclusion: </strong>Early initiation of HE-DMTs in RRMS patients had a significant clinical impact on disease activity and disability. Treatment effectiveness parameters were lower with later lines of therapy, highlighting the importance of early therapeutic intervention. High tolerability varied among DMTs, demonstrating the need for individualized treatment decisions.</p>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"107024"},"PeriodicalIF":2.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202250","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":"Baseline severe disability as a predictor of treatment escalation to rituximab in AQP4-IgG–positive NMOSD patients: A retrospective cohort study","authors":"Chayangkoon Siripornmongkol,&nbsp;Metha Apiwattanakul,&nbsp;Saharat Aungsumart","doi":"10.1016/j.msard.2026.107022","DOIUrl":"10.1016/j.msard.2026.107022","url":null,"abstract":"<div><h3>Introduction</h3><div>Azathioprine and mycophenolate mofetil remain widely used as first-line immunosuppressive therapies for neuromyelitis optica spectrum disorder (NMOSD) in resource-limited settings. However, a subset of patients experience ongoing disease activity or treatment intolerance requiring escalation to rituximab. Identification of clinical factors associated with treatment escalation may improve treatment strategies.</div></div><div><h3>Objectives</h3><div>To identify clinical factors associated with escalation from azathioprine and mycophenolate mofetil to rituximab in AQP4-IgG–positive NMOSD patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of AQP4-IgG–positive NMOSD patients treated at the Neurological Institute of Thailand between 2019 and 2024. Patients initially treated with azathioprine or mycophenolate mofetil were followed until escalation to rituximab or last follow-up. Baseline demographic, clinical, and laboratory variables were analyzed using logistic regression to identify factors associated with treatment escalation.</div></div><div><h3>Results</h3><div>Among 173 patients, 35 (20.23%) required escalation to rituximab. In multivariable analysis, baseline severe disability (EDSS ≥6 prior to first-line therapy) was independently strongly associated with treatment escalation to rituximab (OR 18.19, 95% CI 2.22–148.95; p=0.007). Other demographic and laboratory variables were not independently associated.</div></div><div><h3>Conclusion</h3><div>Baseline severe disability was strongly associated with subsequent escalation to rituximab. Early identification of high-risk patients may support more individualized treatment strategies and inform future policy decisions in resource-limited healthcare systems.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107022"},"PeriodicalIF":2.9,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034515","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":"Low prevalence of inflammatory bowel disease among patients with seropositive neuromyelitis optica spectrum disorder in two large referral centers","authors":"Carolyn Akers ,&nbsp;Philippe A. Bilodeau ,&nbsp;Mattia Wruble Clark ,&nbsp;Taymour Hashemzadeh ,&nbsp;Michael Levy ,&nbsp;Shamik Bhattacharyya ,&nbsp;Ilya Kister","doi":"10.1016/j.msard.2026.107021","DOIUrl":"10.1016/j.msard.2026.107021","url":null,"abstract":"<div><div>Patients with Neuromyelitis Optica Spectrum Disorders (NMOSD) have a well-recognized predilection to autoimmune comorbidities, of which systemic lupus erythematosus (SLE), Sjögren's syndrome (SjS), and autoimmune thyroid diseases are the most common. The question of whether some autoimmune diseases, such as inflammatory bowel disease (IBD), may not be overrepresented (or may even be underrepresented) in NMOSD has not received much attention. Here, we retrospectively reviewed the electronic medical records of all patients diagnosed with NMOSD in our two large referral centers (NYU and MGB), as well as patients with two neuroinflammatory disorders as comparator groups (myelin oligodendrocyte glycoprotein antibody disease (MOGAD) and MS), and calculated the rates of IBD, SLE, SjS, autoimmune thyroid disorders, and myasthenia gravis (MG) in these groups. We found that 1 out of 347 NMOSD patients had a diagnosis of IBD (0.3%), and this patient was seronegative for anti-AQP4 autoantibodies, while 4/271 patients in the MS group (1.5%), 2 of whom were exposed to anti-CD20 therapy, had IBD, and 2/366 MOGAD patients (0.8%), neither of whom was exposed to anti-CD20 therapy, had IBD. In contrast, the rate of the other four autoimmune conditions was significantly higher in NMOSD (24%) than in MOGAD (8.5%, <em>p</em> &lt; 0.0001) or MS (5.2%, <em>p</em> &lt; 0.0001). Thus, IBD was not diagnosed in any of our 317 seropositive NMOSD patients, despite the fact that this group had a higher use of B-cell depletion than patients with MS and MOGAD. We discuss the various hypotheses that may explain this observation.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107021"},"PeriodicalIF":2.9,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034514","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":"Clinical, imaging, and immunological features of GFAP astrocytopathy: a systematic review with regional comparison","authors":"Ekdanai Uawithya ,&nbsp;Piyachai Siriphiphatcharoen ,&nbsp;Ben Benjapibal ,&nbsp;Supawit Kittipadakul ,&nbsp;Sasitorn Siritho","doi":"10.1016/j.msard.2026.107019","DOIUrl":"10.1016/j.msard.2026.107019","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aims to analyze the clinical, laboratory, and imaging characteristics of GFAP astrocytopathy, with attention to differences between Asian and non-Asian populations.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Scopus from inception through June 2025 for case reports, case series, and observational studies involving adult patients with GFAP astrocytopathy. Fifteen studies, including 538 patients, were analyzed. Data on clinical presentations, MRI findings, and laboratory results were extracted and compared across regions.</div></div><div><h3>Results</h3><div>We identified a total of 2,272 studies, of which 15 were included in our final analysis, comprising 538 patients. Our analysis identified three main clinical phenotypes: meningoencephalitis (164/371, 44.2%), meningoencephalomyelitis (94/371, 25.3%), and myelitis (26/371, 7.0%). The most common clinical symptoms were headache (186/470, 39.6%), abnormal movements (160/473, 33.8%), fever (172/538, 32.0%), and psychiatric symptoms (111/471, 23.6%). MRI findings frequently showed lesions in the periventricular (85/434, 19.6%) and subcortical regions (80/432, 18.5%). Perivascular and meningeal enhancements represented the most common radiological findings. Laboratory findings revealed positive GFAP antibodies in either serum or CSF. Co-existence of other antibodies in CSF and serum was also observed, most notably anti-AQP4, anti-MOG, and anti-NMDAR.</div></div><div><h3>Conclusion</h3><div>GFAP astrocytopathy is characterized by a wide range of clinical and radiological manifestations, most commonly presenting as meningoencephalitis, meningoencephalomyelitis, or myelitis, with meningoencephalitis being the most prevalent clinical syndrome observed in this study. Commonly reported symptoms include headache, fever, abnormal movements, and psychiatric symptoms. The disease exhibits diverse neurological and imaging features. Regional differences suggest that genetics, diagnostic practices, and cultural factors may influence symptom profiles. These findings highlight the need for standardized diagnostic criteria and further research across diverse populations.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107019"},"PeriodicalIF":2.9,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034629","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 scoping review of diet-focused resources to improve depression and anxiety among people with multiple sclerosis","authors":"Georgia Brice ,&nbsp;Anthony P. James ,&nbsp;Daniel Rudaizky ,&nbsp;Lucinda J. Black ,&nbsp;Eleanor Dunlop ,&nbsp;Rebecca D. Russell","doi":"10.1016/j.msard.2026.107017","DOIUrl":"10.1016/j.msard.2026.107017","url":null,"abstract":"<div><div>Depression and anxiety are more prevalent in people with multiple sclerosis (MS) than in the general population. A high-quality diet has been shown to have beneficial effects on MS symptoms, including mental health outcomes. Adults with MS gather information from a range of resources with the aim of improving their diet and mental health. However, the development and nature of diet-focused resources aimed at improving mental health in adults with MS remain unclear. We conducted a scoping review to identify and map diet-focused resources aimed at improving depression and anxiety in adults with MS. From 956 resources screened (<em>n</em> = 834 articles and other resources retrieved from databases; <em>n</em> = 98 resources retrieved from websites; <em>n</em> = 17 resources retrieved from organisations; <em>n</em> = 7 retrieved from citation searching), 64 were included (<em>n</em> = 42 resources from organisations or web searches, e.g., podcast episodes, blog posts, web articles; <em>n</em> = 20 peer-reviewed articles; <em>n</em> = 1 mobile application in development; <em>n</em> = 1 book). Resources mentioned an extensive range of dietary information linked to depression and anxiety for people with MS. These resources involved a combination of input from experts (<em>n</em> = 54), organisations (<em>n</em> = 23), lived experience (<em>n</em> = 22), authors/journalists (<em>n</em> = 5), or co-design (<em>n</em> = 1); however, six resources were based solely on lived experience. Twenty resources were not directly accessible to people with MS. There is a need to develop co-designed and accessible diet-focused resources to improve mental health in people with MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107017"},"PeriodicalIF":2.9,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034630","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 detection of paramagnetic rim lesions and their association with disease burden in multiple sclerosis","authors":"Olavi Misin ,&nbsp;Anni Piispanen ,&nbsp;Markus Matilainen ,&nbsp;Riitta Parkkola ,&nbsp;Mikko Nyman ,&nbsp;Teija Sainio ,&nbsp;Jussi Hirvonen ,&nbsp;Laura Airas","doi":"10.1016/j.msard.2026.107012","DOIUrl":"10.1016/j.msard.2026.107012","url":null,"abstract":"<div><h3>Background</h3><div>Paramagnetic rim lesions (PRLs) are an emerging MRI biomarker in multiple sclerosis (MS). On susceptibility-sensitive MRI, PRLs are characterized by a paramagnetic shift at the lesion rim corresponding to iron-laden macrophages and microglia, and PRL detection can hence be viewed as a proxy for lesion-associated smoldering inflammation in MS brain. The aim of this study was to identify PRLs in a standard university hospital setting to explore the associations between PRL burden and MS-related clinical and paraclinical parameters.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed all 3T brain MRI studies performed as part of MS patient management at a tertiary university hospital in Finland between September 2021 and December 2023. PRLs were visually identified on filtered phase images from susceptibility-weighted imaging (SWI) sequences. Brain volumetric data were extracted from post-contrast 3D T1-weighted images using an automated quantification tool (cNeuro® cMRI). Clinical and laboratory variables were obtained by manual chart review from electronic medical records.</div></div><div><h3>Results</h3><div>The final cohort included 206 patients. 34% of patients had at least one PRL (the PRL1+ group). The median number of PRLs in the PRL1+ group was 2 and the maximum number was 11. Within the PRL1+ group, PRL count correlated positively with Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS) and T2 lesion volume. Patients with PRLs had significantly smaller thalami compared to those without PRLs.</div></div><div><h3>Discussion</h3><div>Our real-world data reinforce evidence that PRLs are linked to more severe disease and demonstrate that PRL identification using manufacturer-reconstructed SWI filtered phase images provides a feasible imaging parameter to assess progression-associated pathology in MS in a standard clinical setting.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107012"},"PeriodicalIF":2.9,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019191","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":"Efficacy of fresh frozen plasma and human albumin in therapeutic plasma exchange for refractory neuromyelitis optica spectrum disorders and multiple sclerosis exacerbation: A two-tertiary care center study","authors":"Bhume Kanokvichitra ,&nbsp;Chutithep Teekaput ,&nbsp;Kitti Thiankhaw ,&nbsp;Saharat Aungsumart ,&nbsp;Metha Apiwattanakul","doi":"10.1016/j.msard.2026.107018","DOIUrl":"10.1016/j.msard.2026.107018","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic plasma exchange (TPE) is an established rescue therapy for steroid-refractory demyelinating attacks in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). The optimal replacement fluid for TPE—human albumin or fresh frozen plasma (FFP)—remains uncertain, particularly in resource-limited settings.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study at two tertiary care centers in Thailand, comparing the efficacy and safety of albumin versus FFP as replacement fluids in TPE. Adult patients with NMOSD or MS experiencing refractory exacerbation were included. Clinical outcomes were evaluated using the Expanded Disability Status Scale (EDSS) and Opticospinal Impairment Scale (OSIS), including visual and motor subscales, at baseline, post-treatment, day 90, and day 180. The primary outcome was the proportion of patients achieving favorable functional outcome (EDSS &lt; 6) at day 180.</div></div><div><h3>Results</h3><div>Among 67 patients (97 % NMOSD), 41 received albumin and 26 received FFP. At day 180, 75.6 % in the albumin group and 73.1 % in the FFP group achieved a favorable outcome (P = 1.00). EDSS and OSIS scores improved significantly in both groups over time, with albumin associated with greater motor recovery and FFP with superior visual improvement. Adverse events were mild and comparable between groups.</div></div><div><h3>Conclusion</h3><div>TPE using either albumin or FFP is effective and safe for treating steroid-refractory NMOSD and MS. Given that FFP is more readily available and often less costly than albumin, especially in developing countries, it may serve as a practical alternative in resource-limited healthcare settings.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107018"},"PeriodicalIF":2.9,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011426","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}