Multiple sclerosis and related disorders最新文献

{"title":"Correlation between IGFBP7 and inflammatory cytokines in patients with multiple sclerosis","authors":"Shi Yijun ,&nbsp;Yao Zhenyu ,&nbsp;Ma Yan ,&nbsp;Zhai Yufei ,&nbsp;Zhang Guojun","doi":"10.1016/j.msard.2026.107051","DOIUrl":"10.1016/j.msard.2026.107051","url":null,"abstract":"<div><h3>Background</h3><div>Inflammatory cytokines contribute to neuroinflammation in multiple sclerosis (MS), yet their diagnostic value in serum and cerebrospinal fluid (CSF) remains inconsistent. Insulin-like growth factor binding protein 7 (IGFBP7) has been implicated in inflammatory and repair-related pathways, but its clinical relevance and relationship with cytokine activity in MS are not well defined.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the diagnostic and clinical relevance of serum and CSF inflammatory cytokines and IGFBP7 in MS, and to determine whether combining IGFBP7 with key cytokines improves diagnostic discrimination.</div></div><div><h3>Methods</h3><div>A retrospective cohort included 139 patients with MS to 148 non-inflammatory neurological controls (NINCs). A prospective study included 20 patients with MS (surum and CSF), 20 healthy controls (serum), and 20 NINCs (CSF). Tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, and IGFBP7 were quantified using chemiluminescence immunoassay or ELISA. Group differences, MS subtype comparisons, correlations with disability, and diagnostic performance were assessed.</div></div><div><h3>Results</h3><div>In the retrospective cohort, serum and CSF TNF-α and IL-8 were higher in MS patients than in NINCs. CSF TNF-α and serum IL-1β levels were higher in secondary progressive MS (SPMS) than relapsing-remitting MS (RRMS). In the prospective cohort, CSF IGFBP7 levels were higher in MS than in NINCs and showed a significant positive correlation with CSF TNF-α (<em>P</em> &lt; 0.001). Both CSF TNF-α (AUC = 0.711) and IGFBP7 (AUC = 0.885) demonstrated diagnostic utility, and their combination improved discrimination (AUC = 0.939). No biomarker was significantly associated with Expanded Disability Status Scale (EDSS) scores.</div></div><div><h3>Conclusions</h3><div>CSF IGFBP7 was found to be closely associated with CSF TNF-α, showing potential diagnostic utility in MS. A dual-marker model combining CSF IGFBP7 and TNF-α improved diagnostic performance, suggesting that IGFBP7 reflects inflammatory processes relevant to MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107051"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191539","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":"Comment to “Brain state analysis of EEG predicts multiple sclerosis and mirrors disease duration and burden”","authors":"Jeroen Van Schependom","doi":"10.1016/j.msard.2026.107052","DOIUrl":"10.1016/j.msard.2026.107052","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107052"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191538","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":"Thirty-year trends in the prevalence and incidence of multiple sclerosis (MS) in Mazandaran Province: Application of advanced statistical methods","authors":"Roya Nikbakht ,&nbsp;Seyed Mohammad Baghbanian ,&nbsp;Sharaeh Eskandarieh ,&nbsp;Roja Nikaeen ,&nbsp;Mohammadali Sahraian ,&nbsp;Abolfazl Hosseinnataj","doi":"10.1016/j.msard.2026.107045","DOIUrl":"10.1016/j.msard.2026.107045","url":null,"abstract":"<div><h3>Background</h3><div>Mazandaran province in Iran, identified as a high-prevalence area, has lacked comprehensive long-term studies on MS trends. This study aims to fill that gap by analyzing three decades of MS incidence and prevalence in Mazandaran using advanced statistical methods.</div></div><div><h3>Methods</h3><div>This longitudinal study included clinically diagnosed MS cases from the two most populous cities in Mazandaran utilizing data from the national MS registry spanning 1994 to 2023. Prevalence and age-adjusted incidence rates were calculated, and annual percentage change (APC) was assessed using joint point regression. Bayesian statistical methods were applied for comprehensive trend analysis.</div></div><div><h3>Results</h3><div>A total of 1333 MS patients were identified, the mean (±sd) age at diagnosis was 28.58±8.52 years. MS prevalence increased from 0.19 per 100,000 in 1994 to 127.24 per 100,000 in 2023. The age-adjusted incidence rate rose from 0.14 (95 %CI: 0–0.5) in 1994 to a peak of 10.44 (95 %CI: 7.8–13.0) in 2018, then declined to 4.39 (95 %CI: 2.7–6.1) in 2023. The APC in MS incidence was +14.1 % until 2018, followed by a -15.32 % decrease thereafter. Significant differences in mean age, Expanded Disability Status Scale (EDSS) score and MS type were observed before and after 2018. The Bayesian methods indicated that evaluated predictors were not statistically significant for MS prevalence.</div></div><div><h3>Conclusion</h3><div>This study demonstrates a marked increase in MS incidence in Mazandaran province until 2018, followed by a subsequent decline. The rising prevalence and decreasing mean age at diagnosis underscore the need for continued surveillance and further research to determine whether the recent decline in incidence will persist.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107045"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190769","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":"Reduced retinal neuronal injury as a consequence of high efficacy DMT treatment: an OCT study","authors":"Antonio Francesco Vacca ,&nbsp;Su-Chun Huang ,&nbsp;Elisa Idini ,&nbsp;Giancarlo Coghe ,&nbsp;Marzia Fronza ,&nbsp;Lorena Lorefice ,&nbsp;Eleonora Cocco ,&nbsp;Christian Cordano ,&nbsp;Jessica Frau","doi":"10.1016/j.msard.2026.107049","DOIUrl":"10.1016/j.msard.2026.107049","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the impact of disease-modifying treatments (DMTs) on retinal ganglion cell-inner plexiform layer (GCIPL) thickness.</div></div><div><h3>Methods</h3><div>We analyzed 174 retinal optical coherence tomography (OCT) scans from 90 MS patients (female-to-male ratio 3:1; mean age 39.3 years; median EDSS 2.0; mean disease duration 8.1 years). Bilateral macular scans were obtained at baseline and follow-up using spectral-domain OCT (Spectralis, Heidelberg Engineering, Germany) between 2017 and 2023. Patients were divided into moderate-efficacy (ME-DMT, <em>N</em> = 34) and high-efficacy (HE-DMT, <em>N</em> = 56) groups. The primary measure was global GCIPL thickness, with analysis conducted via independent <em>t</em>-tests and a mixed linear regression model to determine annualized GCIPL change.</div></div><div><h3>Results</h3><div>The HE-DMT group had a significantly lower annual GCIPL atrophy rate (0.07 ± 0.38 µm/year) compared to the ME-DMT group (0.64 ± 0.86 µm/year, <em>p</em> &lt; 0.0001). Mixed linear regression confirmed these findings, accounting for covariates and baseline characteristics.</div></div><div><h3>Conclusions</h3><div>HE-DMTs appear to slow GCIPL atrophy, suggesting a potential neuroprotective effect. These results underscore the value of retinal imaging in tracking MS treatment efficacy and neurodegeneration.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107049"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142979","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":"2026-04-01","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":"Associations between personality traits and cognitive function in multiple sclerosis and neuromyelitis optica spectrum disorder: A cross-sectional study","authors":"Omid Mirmosayyeb ,&nbsp;Mohammad Yazdan Panah ,&nbsp;Mehra Fekri ,&nbsp;Aysa Shaygannejad ,&nbsp;Saeed Vaheb ,&nbsp;Vahid Shaygannejad","doi":"10.1016/j.msard.2026.107037","DOIUrl":"10.1016/j.msard.2026.107037","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are chronic demyelinating diseases of the central nervous system frequently associated with cognitive impairment (CI). Although both disorders share overlapping neurological manifestations, they differ substantially in underlying pathophysiology and disease course. Despite the clinical relevance of personality traits and cognition in chronic neurological disorders, the relationship between cognitive function and the five major personality domains remains insufficiently characterized in MS patients. Moreover, this relationship has not yet been adequately investigated in NMOSD patients. This study aimed to explore the associations between personality traits and cognitive function in MS patients and NMOSD patients.</div></div><div><h3>Methods</h3><div>This cross-sectional study incorporated 100 MS patients and 53 NMOSD patients between March and November 2024 in Isfahan, Iran. The Symbol Digit Modalities Test (SDMT) and Mini-Mental State Examination (MMSE) were used to assess cognitive performance. Personality traits were evaluated using the NEO Five-Factor Inventory (NEO-FFI). Hierarchical regression models determined significant predictors of cognitive performance.</div></div><div><h3>Results</h3><div>In multivariable analyses, Conscientiousness was significantly associated with cognitive performance in both groups. In MS patients, Conscientiousness was independently associated with higher SDMT (B = 0.25, p = 0.003). Among NMOSD patients, Conscientiousness was significantly associated with higher SDMT (B = 0.45, p &lt; 0.001) and MMSE (B = 0.09, p = 0.035). Additionally, Agreeableness was inversely associated with SDMT in NMOSD patients (B = -0.38, p = 0.009).</div></div><div><h3>Conclusion</h3><div>These findings indicate that some personality traits, particularly Conscientiousness, are associated with cognitive performance in MS and NMOSD. While these associations have been identified in MS, they are preliminary findings in NMOSD and highlight the clinical relevance of personality traits in interpreting cognitive assessments and supporting more personalized approaches to cognitive care.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107037"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132364","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 and safety of percutaneous balloon compression for trigeminal neuralgia associated with multiple sclerosis: A systematic review and meta-analysis","authors":"Bardia Hajikarimloo ,&nbsp;Salem M. Tos ,&nbsp;Ibrahim Mohammadzadeh ,&nbsp;Arman Hasanzade ,&nbsp;Dorsa Najari ,&nbsp;Azin Ebrahimi ,&nbsp;Mohammad Amin Habibi","doi":"10.1016/j.msard.2026.107068","DOIUrl":"10.1016/j.msard.2026.107068","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a secondary cause of trigeminal neuralgia (TN). The prevalence of TN caused by MS (MS-TN) is 20 times higher than that of other causes. Along with pharmacological treatments, several other options are available for MS-TN patients, such as percutaneous balloon compression (PBC). This study aimed to evaluate the clinical outcomes and complications of PBC in patients with MS-TN.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature search on April 7, 2025, to identify studies reporting clinical outcomes in patients with MS-TN and PBC.</div></div><div><h3>Results</h3><div>Twelve studies comprising 386 patients met inclusion criteria. At the initial follow-up, the pooled pain-free rate was 65% (95% CI: 40%–86%) and the pooled adequate pain relief rate was 91% (95% CI: 81%–98%). At the subsequent follow-up, pooled estimates were 33% (95% CI: 16%–52%) for pain freedom and 77% (95% CI: 46%–98%) for adequate pain relief. Across studies, the pooled complication rate after PBC in MS-TN was 16% (95% CI: 10%–23%).</div></div><div><h3>Conclusions</h3><div>PBC is an effective and relatively safe treatment option for managing MS-TN patients. It shows promising immediate pain relief and can be considered for patients needing quick pain reduction. Future studies should directly compare PBC with other minimally invasive treatments using large datasets to identify the best option for MS-TN patients.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107068"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192231","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":"Results of a pilot randomized controlled trial of a COM-B-based physical activity behavior-change intervention in people newly diagnosed with multiple sclerosis","authors":"Trinh LT Huynh ,&nbsp;Robert W Motl","doi":"10.1016/j.msard.2026.107031","DOIUrl":"10.1016/j.msard.2026.107031","url":null,"abstract":"<div><h3>Purpose</h3><div>This pilot randomized controlled trial (RCT) evaluated the efficacy of a behavioral intervention grounded in the Capability-Opportunity-Motivation-Behavior (COM-B) model delivered via online coaching and newsletters for promoting physical activity (PA) in people newly diagnosed with multiple sclerosis (PNDwMS).</div></div><div><h3>Methods</h3><div>This unblinded, parallel-group, RCT included 50 PNDwMS (disease duration ≤ 2 years) who were randomized into either PA intervention (<em>n</em> = 25) or waitlist control (WLC) (<em>n</em> = 25) conditions. The intervention was delivered over 16 weeks by a researcher uninvolved in randomization. Data were collected pre- and post-intervention. Primary outcomes included device-measured (steps/day, light PA [LPA], moderate-to-vigorous PA [MVPA]) and self-reported PA (Godin Leisure-Time Exercise Questionnaire [GLTEQ] and International Physical Activity Questionnaire [IPAQ]). Secondary outcomes included fatigue, depression, anxiety, and health-related quality of life (HRQOL). Data were analyzed (intent-to-treat) using condition-by-time mixed-effects ANOVA.</div></div><div><h3>Results</h3><div>There were significant condition-by-time interactions on device-measured (MVPA) and self-reported (IPAQ) PA as well as depression and mental HRQOL (all <em>p</em> ≤ .05). There were moderate and significant improvements in MVPA (Δ11.2 min/day, 95% CI: 8.8, 13.7, <em>d</em> = 0.5) and IPAQ (Δ11.4 units, 95% CI: 10.4, 12.3, <em>d</em> = 0.7), HADS-D (Δ1.4 units, 95% CI: 1.3, 1.5, <em>d</em> = 0.5), and SF-12 MCS (Δ5.6 units, 95% CI: 5.1, 6.1, <em>d</em> = 0.6) scores in the PA intervention condition, but not in the WLC condition.</div></div><div><h3>Conclusion</h3><div>These findings provide preliminary evidence for the efficacy of the COM-B-based behavioral intervention for increasing PA and improving mental health outcomes in PNDwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 107031"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125956","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":"Altered serotonergic system and mood behaviors in a cuprizone-induced model of demyelination","authors":"Souhoudji Themoi Demsou ,&nbsp;Nahla Ouard ,&nbsp;Alpha Amadou Bah ,&nbsp;Assmaâ Tali ,&nbsp;Rajaâ Jebbouj ,&nbsp;Markus Kipp ,&nbsp;Samir Ahboucha","doi":"10.1016/j.msard.2026.106991","DOIUrl":"10.1016/j.msard.2026.106991","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system and is globally estimated to affect 2 new people/100.000/year. MS patients show among other symptoms mood changes including anxiety and depression. Serotonin (5-hydroxytryptamine; 5-HT) is a monoamine neurotransmitter that has been related to mood changes. We address the hypothesis that 5-HT neurotransmission may be altered in chronic MS, and for this, we evaluate the 5-HT system together with anxiety and depressive behaviors in an animal model of cuprizone (CPZ)-treated C57BL/6 mice. Animals were fed 0.2% CPZ for 5 weeks, and controls were given a standard diet. Demyelination was assessed with Luxol fast blue (LFB) stain and immunohistochemistry (IHC) with the antigens myelin proteolipid protein (PLP). 5-HT and its transporter protein (SERT) were assessed by IHC with antigens 5-HT and SERT respectively. Anxiety and depressive behaviors were assessed using the dark/light box and the forced swim tests respectively. Our findings show obvious demyelination in CPZ-treated mice together with increased 5-HT immunostaining of neurons of the dorsal and median raphe nuclei and their cortical projections. The 5-HT increase was concomitant to a decreased density of SERT fibers. Time spent in the light compartment reflecting an anxiety state, together with immobility time reflecting a depressive state were both increased in CPZ-treated mice. Our results show that exposure to CPZ for 5 weeks increases 5-HT and its cortical projections together with reduced SERT, suggesting an increased production of 5-HT and its availability. Our findings support the possible involvement of the 5-HT system in behavioral changes, demyelination and probably inflammatory processes in MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"108 ","pages":"Article 106991"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132308","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":"2026-04-01","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}