Multiple sclerosis and related disorders最新文献_第7页

Lack of external validity of the MOG-AR score in a North American cohort 在北美队列中缺乏MOG-AR评分的外部有效性

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-08 DOI: 10.1016/j.msard.2026.106987

Mulan Jiang, Anastasia Vishnevetsky, Mattia Wruble Clark, Monique Anderson, Takahisa Mikami, Rebecca Gillani, Fabian Murillo, Joao Vitor Mahler Ferreira Oliveira, Rebecca Salky, Gabriela Romanow, Michael Levy, Philippe A. Bilodeau

引用次数: 0

Why don’t all adults get multiple sclerosis? 为什么不是所有的成年人都得多发性硬化症？

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-08 DOI: 10.1016/j.msard.2026.106988

Christopher H Hawkes , Gavin Giovannoni , Jeanette Lechner-Scott , Michael Levy , Ann Yeh

引用次数: 0

Exposure to tobacco smoke during pregnancy and the risk of multiple sclerosis in offspring: A systematic review and meta-analysis 孕期接触烟草烟雾与后代患多发性硬化症的风险：一项系统综述和荟萃分析。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-08 DOI: 10.1016/j.msard.2026.106980

Mohamed Ezzat M. Mansour , Omar Kassar , Khalid Radwan Alsaadany , Mohamed Awad E. Ahmed , Mufreh Amin , Mohamed H. Khalil , Yomna Emad Abdalla

Introduction

Smoking is a common factor that contributes to the development of Multiple sclerosis during embryogenesis. Several studies found a correlation between maternal or paternal smoking and the development of Multiple sclerosis in offspring. Given inconclusive findings from recent studies, we aim to conduct a systematic review and meta-analysis of the relation between parental tobacco smoking and the risk of Multiple sclerosis in offspring.

Methods

We systematically conducted comprehensive search screening including (PubMed, Scopus, Web of Science, Embase, and Cochrane Library) until July 2025. This study aimed to assess the relation between exposure to tobacco smoke during pregnancy (maternal and paternal smoking) and the risk of Multiple sclerosis in offspring. Pooled estimates were calculated using a random-effects model. The PROSPERO registration is CRD420251117243.

Results

This study included nine studies involving 1,405,641 participants, including 5,452 Multiple sclerosis patients. We did not find a correlation between maternal smoking during and before pregnancy and risk of Multiple sclerosis in offspring (OR = 1.13, 95% CI [0.9, 1.43], P-value= 0.30, I²= 53.7%), (OR = 1.11, 95% CI [0.83, 1.48], P-value= 0.48, I² = 0%) respectively. We found a statistically significant association between paternal smoking and the risk of Multiple sclerosis in offspring (OR 1.62, 95% CI [1.24; 2.11], P-value= 0.00036, I²= 0%).

Conclusion

These findings highlight a complex relationship between parental smoking and offspring risk of MS. We observed no clear association for maternal smoking, whereas paternal smoking was associated with an increased risk in offspring. However, neither result is definitive, and further well-designed prospective studies are required to confirm these associations and clarify underlying mechanisms.

简介：吸烟是导致胚胎发育过程中多发性硬化症发生的一个常见因素。几项研究发现，母亲或父亲吸烟与后代患多发性硬化症之间存在相关性。鉴于最近的研究结果不确定，我们的目标是对父母吸烟与后代多发性硬化症风险之间的关系进行系统回顾和荟萃分析。方法：我们系统地进行了全面的检索筛选，包括（PubMed、Scopus、Web of Science、Embase和Cochrane Library），截止到2025年7月。本研究旨在评估怀孕期间暴露于烟草烟雾（母亲和父亲吸烟）与后代多发性硬化症风险之间的关系。汇总估计使用随机效应模型计算。普洛斯彼罗的注册号是CRD420251117243。结果：本研究包括9项研究，涉及1,405,641名参与者，包括5,452名多发性硬化症患者。我们没有发现孕期和孕前吸烟与后代多发性硬化症风险之间的相关性（OR = 1.13, 95% CI [0.9, 1.43]， p值= 0.30,I2= 53.7%），（OR = 1.11, 95% CI [0.83, 1.48]， p值= 0.48,I2= 0%）。我们发现父亲吸烟与后代患多发性硬化症的风险有统计学意义的关联（OR 1.62, 95% CI [1.24; 2.11]， p值= 0.00036,I2= 0%）。结论：这些发现强调了父母吸烟与后代ms风险之间的复杂关系。我们没有观察到母亲吸烟与ms风险之间的明确关联，而父亲吸烟与后代ms风险增加有关。然而，这两个结果都不是决定性的，需要进一步精心设计的前瞻性研究来证实这些关联并阐明潜在的机制。

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引用次数: 0

Letter to editor: Response to ‘psychological resilience as a mediator between depression and health-related quality of life in relapsing-remitting multiple sclerosis patients’ 致编辑的信：对“心理弹性作为复发缓解型多发性硬化症患者抑郁与健康相关生活质量之间的中介”的回应。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-08 DOI: 10.1016/j.msard.2026.106986

Claudia Alonso, Farren B.S. Briggs

引用次数: 0

Theory of mind in multiple sclerosis: Three-month follow-up effects after double-blind tDCS and video-training, a pilot study 多发性硬化症的心理理论：双盲tDCS和视频训练后三个月的随访效果，一项试点研究

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-07 DOI: 10.1016/j.msard.2026.106983

Lidia Ammendola , Daniela Malangone , Maria Cropano , Mariachiara Gaita , Anna della Calce , Luigi Maffei , Nicola Moccaldi , Pasquale Arpaia , Giuseppe Romano , Luigi Trojano , Giacomo Lus , Gabriella Santangelo , Paolo De Blasiis , Elisabetta Signoriello , Simona Raimo

Objective

Theory of Mind (ToM) deficits are common in people with Multiple Sclerosis (PwMS). This pilot study evaluated the feasibility of an ecologically valid ToM training in PwMS and examined whether experimental transcranial direct current stimulation (tDCS) intervention targeting the prefrontal cortex could enhance its effects on cognitive and affective ToM components across verbal and nonverbal modalities.

Methods

Two studies were conducted. Study 1 employed a single-case design with three PwMS undergoing a 16-week video-based ToM training. ToM performance was assessed at baseline, post-intervention, and 3-month follow-up. Study 2 included 12 PwMS randomly assigned to receive ToM training with either active tDCS (dlPFC or vmPFC) or sham stimulation. tDCS was delivered twice weekly (2 mA, 20 minutes) over 16 weeks.

Results

In Study 1, participants showed improvements in cognitive ToM (verbal and nonverbal), and selective improvement in verbal affective ToM. In Study 2, both active tDCS groups exhibited improvements in cognitive and affective ToM compared to the sham group.

Conclusions

ToM training seems to be useful in improving cognitive and verbal affective ToM in PwMS, especially when combined with prefrontal tDCS. However, nonverbal affective ToM appears resistant to intervention, suggesting the need for targeted strategies. These preliminary findings support a personalized, multimodal approach to social cognitive rehabilitation in MS.

目的：心理理论（ToM）缺陷在多发性硬化症（PwMS）患者中很常见。本初步研究评估了经颅直流电刺激（tDCS）在PwMS中进行生态有效的ToM训练的可行性，并研究了针对前额叶皮层的实验性经颅直流电刺激（tDCS）干预是否可以增强其在言语和非言语模式下对认知和情感ToM成分的影响。方法进行两项研究。研究1采用单病例设计，三名PwMS接受为期16周的视频ToM培训。在基线、干预后和3个月随访时评估ToM的表现。研究2包括12名随机分配的PwMS接受ToM训练，其中包括活动tDCS （dlPFC或vmPFC）或假刺激。tDCS每周2次（2 mA， 20分钟），持续16周。结果在研究1中，参与者的认知ToM（言语和非言语）有所改善，言语情感ToM有选择性改善。在研究2中，与假手术组相比，两个活跃的tDCS组在认知和情感上都表现出改善。ConclusionsToM训练似乎是有用的在改善认知和语言情感汤姆在pwm,尤其是当结合前额tDCS。然而，非语言情感的汤姆似乎对干预有抵抗力，这表明需要有针对性的策略。这些初步研究结果支持一种个性化的、多模式的方法来治疗多发性硬化症的社会认知康复。

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引用次数: 0

Cognitive reserve and its contribution to predicting cognitive performance in multiple sclerosis 认知储备及其对多发性硬化症患者认知表现的预测作用

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-07 DOI: 10.1016/j.msard.2026.106985

Sadra Habibi Moini , Majid Hamidi , Ali Rezaei , Zahra Sarvestani , Zahra Azizan , Seyed Ehsan Mohammadianinejad , Mohammad Hossein Harirchian

Background

Cognitive impairment is a prevalent challenge in individuals with multiple sclerosis (MS). Cognitive reserve (CR), a multifaceted concept has been shown to have a protective role against cognitive decline. This study explores the association between cognitive reserve as measured by Cognitive Reserve Index questionnaire (CRIq), cognitive scores, and patients’ characteristics in MS patients. Additionally, we compared the predictive value of CR in cognitive function when measured by education alone versus the CRIq to examine the advantages of latter model.

Materials and methods

A total of 81 patients (39.22 ± 8.09 years old, 64 female) were recruited for the study and completed the interview. Cognitive function was evaluated with the “Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). CRIq and depression questionnaires were also obtained.

Results

CRIq score had significant correlation with all three age-adjusted cognitive test scores (rho = 0.551, 0.392, 0.418 for information processing speed, verbal memory and visuospatial memory respectively, p < 0.001 for all tests). The inclusion of CRIq significantly improved the cognitive function models, accounting for an additional 10.8% to 18.7% of the explained variance beyond age, and clinical predictors. In hierarchical regression models, education did not provide significant additional predictive value beyond CRIq scores across all three cognitive tests.

Conclusions

The CRIq provides a more comprehensive measure of CR than formal education alone, underscoring the multidimensional nature of cognitive enrichment in adults.

认知障碍是多发性硬化症（MS）患者普遍面临的挑战。认知储备（Cognitive reserve， CR）是一个多方面的概念，已被证明对认知衰退具有保护作用。本研究探讨认知储备指数问卷（cognitive reserve Index questionnaire, CRIq）、认知评分与MS患者特征之间的关系。此外，我们比较了仅通过教育和CRIq测量认知功能时CR的预测价值，以检验后者模型的优势。材料与方法共招募81例患者（39.22±8.09岁，女性64例）完成访谈。认知功能采用“国际多发性硬化症简短认知评估（BICAMS）”进行评估。同时获得CRIq和抑郁问卷。结果scriq评分与三项年龄调整后的认知测试得分均有显著相关（信息处理速度、言语记忆和视觉空间记忆的rho分别为0.551、0.392、0.418,p < 0.001）。CRIq的纳入显著改善了认知功能模型，在年龄和临床预测因子之外的解释方差中占10.8%至18.7%。在层次回归模型中，教育并没有提供显著的额外预测价值，除了在所有三个认知测试中的CRIq分数。CRIq提供了一种比单独的正规教育更全面的认知能力评估方法，强调了成人认知能力丰富的多维性。

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引用次数: 0

Binaural hearing, neurological disability and brain imaging in Multiple Sclerosis 多发性硬化症的双耳听力、神经功能障碍和脑成像

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-07 DOI: 10.1016/j.msard.2026.106982

Gary Rance , Julien Zanin , Daniel Merlo , Anneke van der Walt

Multiple sclerosis is an inflammatory autoimmune disease characterized by focal destruction of myelin within the central nervous system. Auditory deficits are a relatively frequent, but often underdiagnosed symptom. This study examined sound detection threshold and functional hearing ability in a cohort of patients with multiple sclerosis.

Thirty adults with relapsing-remitting multiple sclerosis and 30 age, gender and hearing-level matched controls underwent peripheral and central auditory assessments. These included audiometric (sound detection threshold) measurement, binaural speech perception, spatial hearing (Listening in Spatialized Noise test) and self-perceived hearing/communication disability rating (Speech, Spatial and Qualities of Hearing Questionnaire). Correlations with neurological disability, white matter lesion count, lesion volume and whole brain volume were evaluated.

Average sound detection levels for individuals with multiple sclerosis were abnormal in one or both ears for 18/30 participants and outside age-based population norms in 17/60 ears. Binaural speech perception was significantly poorer (P<.001) in listening conditions requiring localization of sound sources and participants rated their everyday hearing/communication ability lower than matched controls (P=.001). Importantly, peripheral hearing loss did not account for the observed speech deficits. Rather, poorer speech perception moderately correlated with greater disability and lower brain volume, and poorer binaural processing was strongly correlated with increased lesion and lower brain volumes.

The findings of this study are consistent with disruption of auditory neural activity occurring as a result of demyelination in the central pathways and global neurodegeneration. Clinicians should be aware that both peripheral- and central deficits severe enough to affect the quality of life of patients are common in multiple sclerosis.

多发性硬化症是一种炎症性自身免疫性疾病，其特征是中枢神经系统髓磷脂的局灶性破坏。听觉缺陷是一种相对常见的症状，但经常被误诊。本研究检测了一组多发性硬化症患者的声音检测阈值和功能性听力。30名患有复发缓解型多发性硬化症的成年人和30名年龄、性别和听力水平匹配的对照组接受了外周和中枢听觉评估。这些测试包括听力测量（声音检测阈值）、双耳语音感知、空间听力（空间噪声听力测试）和自我感知听力/沟通障碍评分（语音、空间和听力质量问卷）。评估与神经功能障碍、白质病变计数、病变体积和全脑体积的相关性。18/30的多发性硬化症患者单耳或双耳平均声音检测水平异常，17/60的患者超出了基于年龄的人群标准。在需要定位声源的听力条件下，双耳语音感知明显较差（P= 0.001），参与者对其日常听力/沟通能力的评价低于匹配对照组（P= 0.001）。重要的是，周围性听力损失并不能解释观察到的语言缺陷。相反，较差的言语感知与更大的残疾和更小的脑容量中度相关，较差的双耳处理与损伤增加和更小的脑容量密切相关。这项研究的结果与听觉神经活动的破坏是一致的，这是中枢通路脱髓鞘和全局神经变性的结果。临床医生应该意识到，严重到足以影响患者生活质量的外周和中枢缺陷在多发性硬化症中很常见。

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引用次数: 0

Revealing the clinical significance of PASAT rejection in multiple sclerosis: Insights from patient-reported and clinician-assessed outcomes 揭示PASAT排斥在多发性硬化症中的临床意义：来自患者报告和临床评估结果的见解。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-07 DOI: 10.1016/j.msard.2026.106984

Jessica Podda , Federica Di Antonio , Ludovico Pedullà , Erica Grange , Mario Alberto Battaglia , Andrea Tacchino , Giampaolo Brichetto

Background

The Paced Auditory Serial Addition Test (PASAT) is widely used to assess cognitive functioning and fatigability in people with Multiple Sclerosis (PwMS). However, its poor acceptability and high refusal rates may limit its clinical interpretability, while potentially conveying meaningful information beyond test performance.

Objectives

To determine whether PASAT rejection at the first assessment represents a clinically meaningful marker of overall vulnerability in PwMS, reflected by a tendency toward worsening across demographic, disease-related and clinical domains, using both patient-reported and clinician-assessed outcomes.

Methods

One-way ANOVAs or non-parametric equivalents were run to compare different groups defined by baseline PASAT performance (missing, low, high) in terms of demographic, disease-related and clinical variables.

Results

Retrospective data from 1154 PwMS were analyzed. Participants with missing PASAT (N=224) were significantly older (60.1±13.5 years), had longer disease duration (18.9±12.2 years), higher EDSS (6.1±2.0), lower educational level (9.9±3.9 years), poorer cognitive performances on the Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) (respectively, 17.4±6.5, 22.5±13.6), and higher level of required assistance in daily functioning as measured by the Functional Independence Measure (FIM) (91.1±29.3), compared with both low and high PASAT groups (all ps < 0.05).

Conclusions

PASAT rejection at first assessment identifies a subgroup of older PwMS with higher disability, lower education, and more pronounced cognitive and functional impairments, suggesting that test refusal may serve as a clinically relevant marker of overall vulnerability in MS.

背景：节奏性听觉连续加法测试（PASAT）被广泛用于评估多发性硬化症（PwMS）患者的认知功能和疲劳。然而，其较差的可接受性和高拒绝率可能会限制其临床可解释性，同时潜在地传达超出测试性能的有意义的信息。目的：利用患者报告和临床评估的结果，确定PASAT首次评估时的排斥反应是否代表了PwMS总体易感的临床有意义的标志物，反映了人口统计学、疾病相关和临床领域的恶化趋势。方法：采用单因素方差分析或非参数等效分析，比较不同组在人口统计学、疾病相关和临床变量方面的基线PASAT表现（缺失、低、高）。结果：对1154例PwMS患者的回顾性资料进行分析。缺失PASAT的参与者（N=224）明显年龄较大（60.1±13.5岁），病程较长（18.9±12.2年），EDSS较高（6.1±2.0年），受教育程度较低（9.9±3.9年），蒙特利尔认知评估（MoCA）和符号数字模态测试（SDMT）的认知表现较差（分别为17.4±6.5,22.5±13.6），功能独立性测试（FIM）测量的日常功能所需帮助水平较高（91.1±29.3）。PASAT低、高组比较，差异均有统计学意义（p < 0.05）。结论：PASAT首次评估时的拒绝识别出老年PwMS中残疾程度较高、受教育程度较低、认知和功能障碍更明显的亚组，这表明拒绝测试可能是MS整体易感性的临床相关标志。

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引用次数: 0

Brain states analysis of EEG predicts multiple sclerosis and mirrors disease duration and burden 脑状态分析的脑电图预测多发性硬化症和反映疾病的持续时间和负担

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-06 DOI: 10.1016/j.msard.2026.106981

István Mórocz , Mojtaba Jouzizadeh , Amir Hossein Ghaderi , Hamed Cheraghmakani , Seyed Mohammad Baghbanian , Reza Khanbabaie , Andrei Mogoutov

Background:

Any treatment of multiple sclerosis should preserve mental function, considering how cognitive deterioration interferes with quality of life. However, mental assessment is still realized with neuro-psychological tests without monitoring cognition on neurobiological grounds whereas the ongoing neural activity is readily observable and readable.

Objective:

The proposed method deciphers electrical brain states which as multi-dimensional cognetoms quantitatively discriminate normal from pathological patterns in an EEG.

Method:

Baseline recordings from a prior EEG study of 88 subjects, 36 with MS, were analyzed. Spectral bands served to compute cognetoms and categorize subsequent feature combination sets.

Result:

The brain states predictor correlates with disease burden and duration. Using cognetoms and spectral bands, a cross-sectional comparison separated patients from controls with a precision of 85% while using bands alone arrived at 79%.

Conclusion:

We demonstrate the efficiency of the quantitative data-driven method based on brain states analysis by contrasting EEG data of patients with MS and healthy subjects. The congruity with disease severity and duration is a neurophysiological indicator for disease accumulation over time. We discuss potential applications of the approach for the monitoring of disease time course and treatment efficacy in longitudinal clinical studies in psychiatry and neurology.

背景：考虑到认知退化对生活质量的影响，任何多发性硬化症的治疗都应该保持精神功能。然而，心理评估仍然是通过神经心理测试来实现的，没有基于神经生物学的认知监测，而正在进行的神经活动是容易观察和可读的。目的：提出了一种定量解读脑电图中作为多维认知体的脑电状态的方法。方法：对88名受试者（其中36名患有多发性硬化症）先前EEG研究的基线记录进行分析。光谱带用于计算认知集并对随后的特征组合集进行分类。结果：脑状态预测因子与疾病负担和病程相关。使用认知图和光谱带，横断面比较将患者与对照组分开，精确度为85%，而单独使用光谱带的准确率为79%。结论：通过对比MS患者和健康人的脑电图数据，证明了基于脑状态分析的定量数据驱动方法的有效性。与疾病严重程度和持续时间的一致性是疾病随时间积累的神经生理指标。我们讨论了该方法在精神病学和神经病学纵向临床研究中监测疾病病程和治疗疗效的潜在应用。

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引用次数: 0

A real-world study on persistence with ofatumumab in Canadian patients with multiple sclerosis 加拿大多发性硬化症患者持续使用ofatumumab的现实世界研究。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders

Pub Date : 2026-01-06 DOI: 10.1016/j.msard.2026.106976

Daniel Selchen , Rebecca Grant , Claire Magnussen , Jillian Murray , Calum S Neish

Background

In multiple sclerosis, disease-modifying therapies aim to reduce relapse rate and slow disease progression. An important component of successful disease control is treatment persistence, which is the time a patient remains on a therapy. The primary objective of this study was to examine persistence with ofatumumab in a real-world setting.

Methods

This was a retrospective cohort study using data from the Patient Support Program (clinicaltrials.gov number NCT06854341). Adults diagnosed with relapsing remitting multiple sclerosis who initiated ofatumumab were included. Persistence, defined as the number of days from ofatumumab initiation until discontinuation, was assessed from April 2021 to May 2024. Ofatumumab persistence was quantified by Kaplan-Meier estimates for discontinuation probabilities with corresponding 95% confidence intervals at 12, 24 and 36 months. Secondary objectives included a descriptive analysis of patients’ baseline demographic and clinical characteristics, and their association with discontinuation.

Results

The PSP included a total of 6377 patients, of which 5436 patients met the inclusion criteria and had information to assess discontinuation. Persistence probability with ofatumumab was 96.94% at 12-months, 95.02% at 24-months, and 92.26% at 36-months post index. During this period, 167 patients (3.1%) discontinued ofatumumab. The most common reasons for discontinuation included side effects (0.9%), trying to conceive/pregnancy (0.5%), and patient request (0.5%).

Conclusion

This study provides insights into real-world ofatumumab utilization among patients with multiple sclerosis and demonstrates that persistence with ofatumumab remained high over 3 years. These results complement data from controlled clinical trials and suggest that patients persist with ofatumumab.

背景：在多发性硬化症中，疾病改善疗法旨在降低复发率和减缓疾病进展。成功控制疾病的一个重要组成部分是治疗持久性，即患者继续接受治疗的时间。本研究的主要目的是在现实环境中检查ofatumumab的持久性。方法：这是一项回顾性队列研究，数据来自患者支持计划（clinicaltrials.gov编号NCT06854341）。被诊断为复发缓解型多发性硬化症且开始使用阿图单抗的成人纳入研究。从2021年4月至2024年5月评估持续性，定义为从ofatumumab开始到停药的天数。Ofatumumab的持续性通过Kaplan-Meier估计在12、24和36个月时具有相应的95%置信区间的停药概率进行量化。次要目的包括对患者基线人口统计学和临床特征及其与停药的关系进行描述性分析。结果：PSP共纳入6377例患者，其中5436例患者符合纳入标准，具有评估停药的信息。12个月时，使用ofatumumab的持续概率为96.94%，24个月时为95.02%，36个月时为92.26%。在此期间，167名患者（3.1%）停药。最常见的停药原因包括副作用（0.9%）、试图怀孕（0.5%）和患者要求（0.5%）。结论：该研究提供了多发性硬化症患者使用ofatumumab的真实情况，并证明ofatumumab的持续使用超过3年。这些结果补充了对照临床试验的数据，表明患者坚持使用ofatumumab。

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引用次数: 0