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Mult Scler 2022 Jun 28:13524585221102584. Epub 2022 Jun 28.

Mellen Center for MS Treatment and Research, Cleveland Clinic, Cleveland, OH, USA.

Background: Ozanimod, an oral sphingosine 1-phosphate receptor 1 and 5 modulator, is approved in multiple countries for treatment of relapsing forms of MS.

Objective: To characterize long-term safety and efficacy of ozanimod.

Methods: Patients with relapsing MS who completed a phase 1‒3 ozanimod trial were eligible for an open-label extension study (DAYBREAK) of ozanimod 0. Read More

Neurohospitalist 2022 Jul 25;12(3):556-558. Epub 2022 Apr 25.

Division of Neuroimmunology and Neuroinfectious Diseases, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.

We present a unique case of a 59-year-old woman with atypical Susac syndrome and prominent involvement of the spinal cord. She initially presented with progressive headaches, lower extremity weakness and hearing loss. Her MRI brain showed multiple enhancing lesions and her MRI spine showed a T8 enhancing lesion as well as a C2 cord infarct. Read More

BMC Musculoskelet Disord 2022 Jun 20;23(1):593. Epub 2022 Jun 20.

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: It was aimed to investigate the musculoskeletal status in individuals diagnosed with skeletal discrepancies.

Methods: This case-control study was performed on 35 patients with developmental skeletal discrepancies listed for orthognathic surgery as a case group and 33 patients who were nominated for wisdom tooth removal as a control group. All participants were aged 18-40 years and the research was carried out in the period between May 2018 and May 2019. Read More

JBMR Plus 2022 Jun 29;6(6):e10616. Epub 2022 Apr 29.

Department of Medicine Indiana University School of Medicine Indianapolis IN USA.

The osteopetroses are a group of rare genetic diseases caused by osteoclast dysfunction or absence. The hallmark of osteopetrosis is generalized increased bone mineral density (BMD). However, the bone is fragile and fractures are common. Read More

Medicine (Baltimore) 2022 Jun 17;101(24):e29395. Epub 2022 Jun 17.

Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Rationale: Prompt diagnosis of nontuberculous Mycobacterial (NTM) vertebral osteomyelitis is challenging, yet necessary to prevent serious morbidity and mortality. Here, we report 3 cases of vertebral osteomyelitis caused by NTM with imaging findings.

Patient Concerns: Case 1, a 58-year-old male patient, was admitted to our hospital because of the presence of a pulmonary mass for 6 months with cough and chest pain. Read More

J Neurol Neurosurg Psychiatry 2022 Jun 16. Epub 2022 Jun 16.

Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), San Francisco, California, USA

Background: Chronic demyelination is a major contributor to axonal vulnerability in multiple sclerosis (MS). Therefore, remyelination could provide a potent neuroprotective strategy. The ReBUILD trial was the first study showing evidence for successful remyelination following treatment with clemastine in people with MS (pwMS) with no evidence of disease activity or progression (NEDAP). Read More

Acta Radiol Open 2022 Jun 2;11(6):20584601221105228. Epub 2022 Jun 2.

Department of Radiology and Medical Imaging, Ministry of Health, Oyoun Aljawa General Hospital - Al-Qassim, Oyoun Aljawa, Kingdom of Saudi Arabia.

Background: Magnetic Resonance Imaging (MRI) is considered a vital in depicting multiple sclerosis (MS) lesions. Current studies demonstrate that proton density (PD) weighted images (WI) are superior to T2 WI in detecting MS lesions (plaques) in the spinal cord.

Purpose: To evaluate the diagnostic value of filtered fused PD/T2 weighted images in detecting cervical spinal cord MS lesions. Read More

J Neurol 2022 May 31. Epub 2022 May 31.

UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.

Background: Siponimod is a sphingosine 1-phosphate receptor modulator approved for active secondary progressive multiple sclerosis (aSPMS) in most countries; however, phase 3 EXPAND study data are from an SPMS population with/without disease activity. A need exists to characterize efficacy/safety of siponimod in aSPMS.

Methods: Post hoc analysis of participants with aSPMS (≥ 1 relapse in 2 years before study and/or ≥ 1 T1 gadolinium-enhancing [Gd +] magnetic resonance imaging [MRI] lesions at baseline) receiving oral siponimod (2 mg/day) or placebo for up to 3 years in EXPAND. Read More

Cureus 2022 Apr 20;14(4):e24319. Epub 2022 Apr 20.

Neurology, Vidant Medical Center/East Carolina University, Greenville, USA.

We present the case of a 26-year-old male who was found to have human herpesvirus 6 (HHV-6) in his cerebrospinal fluid (CSF) during acute presentation of multiple sclerosis (MS). Paresthesia of the lower extremities was his only symptom during the initial presentation, and workup for MS was not included during this evaluation. A single dose of IV steroids failed to improve his condition, and symptoms became more severe. Read More

Front Neurol 2022 28;13:813965. Epub 2022 Apr 28.

EA4391 Excitabilité Nerveuse and Thérapeutique, Université Paris Est Créteil, Créteil, France.

Fatigue is the most commonly reported symptom in patients with multiple sclerosis (MS). It is a worrisome, frequent, and debilitating manifestation that could occur at any time during the course of MS and in all its subtypes. It could engender professional, familial, and socioeconomic consequences and could severely compromise the patients' quality of life. Read More

Surg Neurol Int 2022 31;13:125. Epub 2022 Mar 31.

Department of Orthopaedic Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States.

Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system that may present with a wide variety of clinical presentations. However, there can be substantial overlap between symptoms from MS and those caused by lumbar spondylosis and/or postviral plexopathies.

Case Description: A 33-year-old female with a history of an L5-S1 anterior lumbar interbody fusion and exposure to the SARS-CoV-2 virus developed postoperative worsening of her symptoms interpreted as "radiculopathy. Read More

Neurology 2022 Jun 25;98(24):1015-1020. Epub 2022 Apr 25.

From the North Texas Institute of Neurology and Headache (A.F.O.), Plano; Multiple Sclerosis Institute of Texas (A.M.H.), Houston; Joi Life Wellness Multiple Sclerosis Neurology Center (M.J.W.), Smyrna, GA; Providence Brain and Spine Institute (J.D.B., C.C., T.L.S., E.B., S.L.C.), Portland, OR; and Alphabet Health (G.J.), New York.

Multiple sclerosis (MS) has historically been underdiagnosed and undertreated among African Americans. Recent evidence suggests that African Americans with MS have a different clinical presentation, increased disease incidence and burden, and worse long-term outcomes vs their White counterparts. Due to limited data available for African Americans in MS clinical trials, it is difficult to make informed, generalizable conclusions about the natural history, prognosis, and therapeutic response in this population. Read More

Neurol Clin 2022 05 31;40(2):249-259. Epub 2022 Mar 31.

Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA.

Multiple sclerosis (MS) is an autoimmune inflammatory disease that results in demyelination of the central nervous system (CNS). MS affects as many as 350,000 individuals in the United States and commonly presents before the age of 45 years. Patients with MS, as the general population, are likely to encounter degenerative changes of the spine as they age, and this can pose a unique challenge to both patients with MS and physicians, as both conditions can have a great deal of symptomatic overlap despite stark differences in management. Read More

Mult Scler Relat Disord 2022 Jun 13;62:103808. Epub 2022 Apr 13.

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Centre for Human Brain Health, University of Birmingham, Birmingham, UK. Electronic address:

Relapsing-remitting MS (RRMS) is characterised by the patients' experience of periods of exacerbation in symptoms. The fear associated with the relapse influence the quality of life in patients and their relationship with bodily experiences. Previous studies suggested that health anxiety (HA) contributes to fear of relapse but have not investigated cognitive mechanisms involved in developing and maintaining the fear of relapse in patients and we were interested to test this relationship. Read More

Front Immunol 2022 31;13:852563. Epub 2022 Mar 31.

Neurologic Clinic and Policlinic and MS Center, Department of Head, Spine and Neuromedicine, University Hospital Basel, Basel, Switzerland.

Objective: This study aims to confirm the prognostic value of baseline serum neurofilament light chain (sNfL) for on-study disease activity and worsening in patients with relapsing MS (RMS).

Background: Previous studies suggested that sNfL could be a prognostic biomarker in RMS. In the phase 3 ASCLEPIOS I/II trials in which ofatumumab demonstrated better efficacy outcomes than teriflunomide, treatment with ofatumumab also led to significantly reduced sNfL levels compared to teriflunomide treatment. Read More

Acta Neuropathol Commun 2022 04 11;10(1):51. Epub 2022 Apr 11.

Department of Experimental Medical Science, Lund University, 223 62, Lund, Sweden.

Recent studies suggest that metabolic changes and oxygen deficiency in the central nervous system play an important role in the pathophysiology of multiple sclerosis (MS). In our present study, we investigated the changes in oxygenation and analyzed the vascular perfusion of the spinal cord in a rodent model of MS. We performed multispectral optoacoustic tomography of the lumbar spinal cord before and after an oxygen enhancement challenge in mice with experimental autoimmune encephalomyelitis (EAE), a model for MS. Read More

Sci Rep 2022 04 9;12(1):6000. Epub 2022 Apr 9.

Institute of Synaptic Physiology, ZMNH, University Medical Center Hamburg-Eppendorf, Falkenried, 94 20251, Hamburg, Germany.

The transient receptor potential melastatin 4 (TRPM4) channel contributes to disease severity in the murine experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis and to neuronal cell death in models of excitotoxicity and traumatic brain injury. As TRPM4 is activated by intracellular calcium and conducts monovalent cations, we hypothesized that TRPM4 may contribute to and boost excitatory synaptic transmission in CA1 pyramidal neurons of the hippocampus. Using single-spine calcium imaging and electrophysiology, we found no effect of the TRPM4 antagonists 9-phenanthrol and glibenclamide on synaptic transmission in hippocampal slices from healthy mice. Read More

Mult Scler 2022 Apr 3:13524585221084577. Epub 2022 Apr 3.

Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.

Background: The MSBase prediction model of treatment response leverages multiple demographic and clinical characteristics to estimate hazards of relapses, confirmed disability accumulation (CDA), and confirmed disability improvement (CDI). The model did not include Multiple Sclerosis Severity Score (MSSS), a disease duration-adjusted ranked score of disability.

Objective: To incorporate MSSS into the MSBase prediction model and compare model accuracy with and without MSSS. Read More

Invest Radiol 2022 Mar 21. Epub 2022 Mar 21.

From the Departments of Neuroradiology Neurology, AP-HP, Henri Mondor University Hospital, Créteil, France EA 4391, Université Paris Est Créteil, Créteil, France Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland Siemens Healthcare SAS, Saint-Denis, France.

Objectives: Fluid and white matter suppression (FLAWS) is a recently proposed magnetic resonance sequence derived from magnetization-prepared 2 rapid acquisition gradient-echo providing 2 coregistered datasets with white matter- and cerebrospinal fluid-suppressed signal, enabling synthetic imaging with amplified contrast. Although these features are high potential for brain multiple sclerosis (MS) imaging, spinal cord has never been evaluated with this sequence to date. The objective of this work was therefore to assess diagnostic performance and self-confidence provided by compressed-sensing (CS) 3-dimensional (3D) FLAWS for cervical MS lesion detection on a head scan that includes the cervical cord without changing standard procedures. Read More

Cureus 2022 Feb 14;14(2):e22191. Epub 2022 Feb 14.

Department of Neurology, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR.

Radiologically isolated syndrome (RIS) refers to an entity in which an MRI of the brain, spine, or both demonstrates incidental white matter lesions that are characteristic of a demyelinating disease in morphology and location. High-risk RIS may require disease-modifying treatment (DMT). A complex interaction among genetic and environmental factors leads to self-reactive immune mechanisms, which are believed to have a pivotal role in the pathogenesis of demyelinating diseases. Read More

Clin Neurol Neurosurg 2022 04 14;215:107210. Epub 2022 Mar 14.

Neurology & Neurophysiology Center, Vienna, Austria. Electronic address:

Objectives: There are indications that SARS-CoV-2 can trigger new onset or relapses of neuro-immunological disease. We report a patient with relapsing remitting multiple sclerosis (RRMS) under disease-modifying therapy (DMT) who experienced a relapse of RRMS after mild COVID-19.

Case Report: The patient is a 27-year-old female with RRMS who developed a third exacerbation of RRMS under DMT two weeks after mild COVID-19. Read More

Ann Neurol 2022 06 9;91(6):814-820. Epub 2022 Apr 9.

Neurology Clinic and Policlinic, Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.

Objective: Intrathecal Immunoglobulin M synthesis (IgM ) and spinal MRI lesions are both strong independent predictors of higher disease activity and severity in multiple sclerosis (MS). We investigated whether IgM is associated with spinal cord manifestation and higher neuroaxonal damage in early MS.

Methods: In 122 patients with a first demyelinating event associations between (1) spinal versus (vs) non-spinal clinical syndrome (2) spinal vs cerebral T2-weighted (T2w) and (3) contrast-enhancing (CE) lesion counts with IgG (vs IgG ) or IgM (vs IgM ) were investigated by logistic regression adjusted for age and sex, respectively. Read More

Mult Scler Relat Disord 2022 Apr 25;60:103705. Epub 2022 Feb 25.

Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, Oh 44195, United States.

Objective: Burnout is a healthcare quality problem, linked to negative impacts in patient care and healthcare providers. The pandemic prompted clinicians to adapt virtual practices and adopt more flexible, autonomous schedules. However, the impact of flexible scheduling and autonomy on provider burnout is unknown. Read More

Cell Immunol 2022 03 5;373:104500. Epub 2022 Mar 5.

Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China. Electronic address:

Multiple sclerosis (MS) was one of the major conditions causing neurological dysfunction and was an incurable progressive central nervous system disease. Experimental autoimmune encephalomyelitis (EAE) was the most commonly used experimental model of MS. Artemisinin have been shown to exhibit anti-inflammatory effects through unclear mechanisms. Read More

Eur J Neurol 2022 Jul 4;29(7):2024-2035. Epub 2022 Apr 4.

Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.

Background And Purpose: In the REFLEX trial (ClinicalTrials.gov identifier: NCT00404352), patients with a first clinical demyelinating event (FCDE) displayed significantly delayed onset of multiple sclerosis (MS; McDonald criteria) when treated with subcutaneous interferon beta-1a (sc IFN β-1a) versus placebo. This post hoc analysis evaluated the effect of sc IFN β-1a on spatio-temporal evolution of disease activity, assessed by changes in T2 lesion distribution, in specific brain regions of such patients and its relationship with conversion to MS. Read More

Mult Scler 2022 Mar 9:13524585221076717. Epub 2022 Mar 9.

Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

Background: Magnetic resonance imaging (MRI) measurements of gray matter (GM) atrophy and magnetization transfer ratio (MTR; correlate of myelination) may provide better insights than conventional MRI regarding brain tissue integrity/myelination in multiple sclerosis (MS).

Objective: To examine the effect of siponimod in the EXPAND trial on whole-brain and GM atrophy, newly formed normalized magnetization transfer ratio (nMTR) lesions, and nMTR-assessed integrity of normal-appearing brain tissue (NABT), cortical GM (cGM), and normal-appearing white matter (NAWM).

Methods: Patients with secondary progressive multiple sclerosis (SPMS) received siponimod (2 mg/day;  =1037) or placebo ( = 523). Read More

Inflammopharmacology 2022 Apr 2;30(2):385-396. Epub 2022 Mar 2.

Department of Spine Surgery, Ganzhou People's Hospital, No. 16, Meiguan Avenue, Zhanggong District, Ganzhou, 341000, Jiangxi, China.

Osteopontin (OPN) is a multifunctional cytokine and adhesion molecule, as well as an unusual regulator for both innate and adaptive immune responses. Several immune cells can produce OPN, including dendritic cells (DCs), macrophages, and T lymphocytes. OPN expression is reported to be increased in a wide range of disorders, including autoimmunity, cancer, and allergy. Read More

Mult Scler 2022 Mar 1:13524585221079731. Epub 2022 Mar 1.

Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) and MS Center, Departments of Head, Spine and Neuromedicine, Clinical Research, Biomedicine, Biomedical Engineering, University Hospital and University of Basel, Basel, Switzerland.

Background: Ofatumumab is approved for the treatment of relapsing multiple sclerosis (RMS). Ongoing safety reporting is crucial to understand its long-term benefit-risk profile.

Objective: Report the safety and tolerability of ofatumumab in RMS after extended treatment up to 3. Read More

Ethiop J Health Sci 2021 Sep;31(5):1043-1052

Assistant Professor of Neurology, Department of Neurology College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Background: Brain and spine magnetic resonance image (MRI) have an invaluable importance in diagnosing multiple sclerosis (MS) in low prevalence countries such as Ethiopia. The objective of our study was to characterize the neuroimaging features and associated factors in Multiple sclerosis patients in Addis Ababa, Ethiopia.

Method: A cross-sectional observational study was conducted in 30 multiple sclerosis patients at Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia. Read More

Neurol Neuroimmunol Neuroinflamm 2022 05 25;9(3). Epub 2022 Feb 25.

From the Neurology Clinic and Policlinic (J.M., T.S., M.J.W., R.S., J.K., S.S., P.B., T.D., M.B., A.C., C.T., K.P., A.-K.P., S.R., L.K., C.G., O.Y.), Departments of Head, Spine and Neuromedicine, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel; Translational Imaging in Neurology (ThINk) Basel (J.M., S.S., M.B., A.C., C.T., K.P., C.G., O.Y.), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland; Department of Biomedical Engineering (P.C., C.J., F.S., J.W., C.G.), University of Basel, Allschwil, Switzerland; Medical Imaging Analysis Center AG (M.A., J.W.); Section of Neuroradiology (T.L.), Clinic for Radiology & Nuclear Medicine, University Hospital Basel and University of Basel, Switzerland; Reha Rheinfelden (K.P.), Rheinfelden, Switzerland; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (S.A., A.D., A.B., J.W., F.P.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Gillberg Neuropsychiatry Center (N.H.), Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Neurology (S.F., M.W., K.M., T.M., N.I., J.-I.K.), Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Neurology (J.-I.K.), Brain and Nerve Center, Fukuoka Central Hospital, International University of Health and Welfare, Fukuoka; and Translational Neuroscience Center (J.-I.K.), Graduate School of Medicine, and School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa, Japan.

Background And Objectives: The choroid plexus has been shown to play a crucial role in CNS inflammation. Previous studies found larger choroid plexus in multiple sclerosis (MS) compared with healthy controls. However, it is not clear whether the choroid plexus is similarly involved in MS and in neuromyelitis optica spectrum disorder (NMOSD). Read More