Article
Clinical Neurology
Christoph Mahler, Adrian-Minh Schumacher, Marcus Unterrainer, Lena Kaiser, Thomas Hollbacher, Simon Lindner, Joachim Havla, Birgit Ertl-Wagner, Maximilian Patzig, Klaus Seelos, Julia Neitzel, Matthias Maurer, Markus Krumbholz, Imke Metz, Wolfgang Bruck, Christine Stadelmann, Doron Merkler, Achim Gass, Vladimir Milenkovic, Peter Bartenstein, Nathalie L. Albert, Tania Kuempfel, Martin Kerschensteiner
Summary: The study evaluated the use of TSPO PET imaging to monitor CNS inflammation in natalizumab-associated PML lesions and distinguish them from multiple sclerosis lesions, showing potential for longitudinal monitoring of disease activity and differentiation of MS activity from PML progression.
Article
Clinical Neurology
Markus Kinner, Christian Prehn, Ruth Schneider, Christoph Schroeder, Eva Kolb, Ralf Gold, Robert Hoepner, Andew Chan
Summary: This study evaluated the neuropsychological disease course of NTZ-PML patients and found that working memory and visuospatial abilities are core deficits. NTZ-PML patients performed worse in neuropsychological examinations compared to controls, especially affecting visuospatial ability and working memory during different disease stages.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Alyssa A. Toorop, Zoe Y. G. van Lierop, Eva E. M. Strijbis, Charlotte E. Teunissen, Axel Petzold, Mike P. Wattjes, Frederik Barkhof, Brigit A. de Jong, Zoe L. E. van Kempen, Joep Killestein
Summary: Two patients with relapsing-remitting MS developed carryover PML after switching from natalizumab to ocrelizumab. Despite mild immune reconstitution inflammatory syndrome (IRIS) and increasing NfL levels, PML-IRIS lesions stabilized after treatment and both patients continued therapy with ocrelizumab.
NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION
(2021)
Article
Biochemistry & Molecular Biology
Roberto De Masi, Stefania Orlando, Silvia Armenise, Pantaleo Spagnolo, Ruggero Capra, Maria Carmela Costa
Summary: This case report investigates a Natalizumab-associated Progressive Multifocal Leukoencephalopathy (PML) with cerebellar localization and wakefulness disturbances. The study shows that awakening and clinical improvement occurred dramatically with the onset of immune reconstitution inflammatory syndrome (IRIS), which was mild in nature and colocalized with the PML lesion. MRI analysis revealed an increase in white matter volume and a decrease in grey matter during IRIS, while the cerebrospinal fluid volume consistently increased throughout the duration of PML. The brain parenchymal fraction decreased as expected, but the total brain volume remained stable. Neurodegeneration, supported by IRIS and humoral factors derived from the PML lesion, is believed to be the main cause of steady disability in Natalizumab-associated PML.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Clinical Neurology
Tobias Moser, Georg Zimmermann, Anna Baumgartner, Thomas Berger, Gabriel Bsteh, Franziska Di Pauli, Christian Enzinger, Elisabeth Fertl, Thomas Heller, Stefan Koppi, Paulus S. Rommer, Georg Safoschnik, Thomas Seifert-Held, Robert Stepansky, Johann Sellner
Summary: This study analyzed the course of multiple sclerosis (MS) patients in Austria after progressive multifocal leukoencephalopathy (PML) recovery and the long-term outcome of NAT-associated PML (NAT-PML). The study found that the number of NAT-PML cases is decreasing over time, and while many patients accumulated severe persistent neurological deficits after PML recovery, there was rare inflammatory MS-related disease activity.
JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Arpan Patel, James Sul, Marc L. Gordon, Jared Steinklein, Shayna Sanguinetti, Bidyut Pramanik, Dushyant Purohit, Vahram Haroutunian, Alex Williamson, Igor Koralnik, Asaff Harel
Summary: This case report highlights the first occurrence of PML with ocrelizumab monotherapy in a patient with progressive multiple sclerosis without prior immunomodulation. The patient presented with progressive visual disturbance and confusion, ultimately confirmed to have PML through autopsy.
Article
Clinical Neurology
Marc Puig-Casadevall, Gary Alvarez-Bravo, Ana Quiroga Varela, Rene Robles-Cedeno, Laura Sanchez Cirera, Albert Miguela, Gemma Laguillo, Xavier Montalban, Stephen L. Hauser, Lluis Ramio-Torrenta
Summary: This case report describes the occurrence of progressive multifocal leukoencephalopathy in a patient with relapsing-remitting multiple sclerosis treated with ocrelizumab without previous use of natalizumab. Although this condition is usually associated with natalizumab treatment, its occurrence with other immunosuppressive therapies has also been reported.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Manel Alleg, Morgane Solis, Seyyid Baloglu, Francois Cotton, Philippe Kerschen, Bertrand Bourre, Guido Ahle, Jean-Pierre Pruvo, Xavier Leclerc, Patrick Vermersch, Caroline Papeix, Elisabeth Maillart, Caroline Houillier, Cecile Molucon Chabrot, Beatrice Claise, Sandra Malak, Guillaume Martin-Blondel, Fabrice Bonneville, Alexis Caulier, Jean-Pierre Marolleau, Jerome Tamburini Bonnefoy, Philippe Agape, Celine Kennel, Xavier Roussel, Adrien Chauchet, Jerome De Seze, Samira Fafi-Kremer, Stephane Kremer
Summary: The study compared brain MRI findings in PML associated with rituximab, natalizumab treatments, and HIV infection. Different imaging features were observed in the three types of PML, with natalizumab-associated PML showing more inflammatory signs and cortex involvement, while rituximab and HIV-associated PML exhibited milder contrast enhancement and punctuate appearance. The differences in MRI findings may be related to varying levels of immunosuppression in the different patient groups.
EUROPEAN RADIOLOGY
(2021)
Article
Medicine, General & Internal
Viviana Lo Buono, Giangaetano D'Aleo, Simona Cammaroto, Maria Cristina De Cola, Francesca Palmese, Chiara Smorto, Silvia Marino, Giuseppe Venuti, Edoardo Sessa, Carmela Rifici, Francesco Corallo
Summary: This study reports a case of PML related to natalizumab and describes the longitudinal course of the disease, documenting the progressive deterioration of the patient's cognitive functioning. The findings expand the range of treatment-related complications associated with natalizumab and provide evidence for the early diagnosis of PML.
MEDICINA-LITHUANIA
(2022)
Article
Clinical Neurology
Gautier Breville, Igor J. Koralnik, Patrice H. Lalive
Summary: Isolated brainstem lesions at disease onset are extremely rare in PML cases, with most patients experiencing initial clinical worsening. However, some patients may achieve full or partial recovery despite the reserved prognosis due to the vital structures in the brainstem.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Review
Clinical Neurology
Laura E. Baldassari, Mike P. Wattjes, Irene C. M. Cortese, Achim Gass, Imke Metz, Tarek Yousry, Daniel S. Reich, Nancy Richert
Summary: Progressive multifocal leukoencephalopathy (PML) is a CNS infection caused by the JC virus. MRI is an important tool for detecting PML, showing the location and extent of lesions, as well as reflecting the disease progression and inflammation. Currently, there are no validated imaging-based outcome measures for use in PML clinical trials.
Review
Clinical Neurology
Shitiz Sriwastava, Durgesh Chaudhary, Samiksha Srivastava, Katherine Beard, Xue Bai, Sijin Wen, Syed Hassan Khalid, Robert P. Lisak
Summary: The incidence of PML in MS patients treated with S1PR modulators like fingolimod appears to be extremely low. Risk of PML increases with longer duration of treatment with S1PR modulators, and older age at the time of PML diagnosis is associated with worse prognosis.
JOURNAL OF NEUROLOGY
(2022)
Article
Hematology
Brian W. Hoeynck, Adam D. Cohen, Edward A. Stadtmauer, Sandra P. Susanibar-Adaniya, Dan T. Vogl, Adam J. Waxman, Mark Bardsley, Samantha Le, Lexis LaMaestra, Alfred L. Garfall
Summary: Progressive multifocal leukoencephalopathy (PML) is a rare and often fatal disease that affects the central nervous system. It is caused by the reactivation of the JC virus in individuals with weakened immune systems such as those with HIV, cancer, or taking immunosuppressive medications. PML has been rarely reported in multiple myeloma patients, and this study describes six cases of PML among multiple myeloma patients treated at a specific institution between 2013 and 2022, including two cases associated with recently developed BCMA-directed immunotherapies.
EUROPEAN JOURNAL OF HAEMATOLOGY
(2023)
Article
Clinical Neurology
Marine Joly, Cecile Conte, Charles Cazanave, Vincent Le Moing, Pierre Tattevin, Pierre Delobel, Agnes Sommet, Guillaume Martin-Blondel
Summary: This study examined the epidemiology and prognosis of progressive multifocal leukoencephalopathy using a large cohort of patients in France. The findings revealed a stable incidence rate of the disease in France, with HIV infection being the main predisposing condition. Male patients had a higher risk of mortality compared to females, and patients with solid neoplasms had the worst prognosis.
Article
Clinical Neurology
Kevin Bigaut, Laurent Kremer, Thibaut Fabacher, Guido Ahle, Mathilde Goudot, Marie Fleury, Claude Gaultier, Sylvie Courtois, Nicolas Collongues, Jerome de Seze
Summary: This study compared the effectiveness of ocrelizumab and fingolimod after natalizumab cessation. The results showed that ocrelizumab had a significantly lower relapse rate at 1 year compared to fingolimod.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Emilio Portaccio, Laura Tudisco, Luisa Pasto, Lorenzo Razzolini, Mattia Fonderico, Angelo Bellinvia, Angelo Ghezzi, Pietro Annovazzi, Mauro Zaffaroni, Lucia Moiola, Vittorio Martinelli, Clara Grazia Chisari, Francesco Patti, Gianluigi Mancardi, Carlo Pozzilli, Laura De Giglio, Rocco Totaro, Alessandra Lugaresi, Valeria Di Tommaso, Damiano Paolicelli, Eleonora Cocco, Maria Giovanna Marrosu, Giancarlo Comi, Massimo Filippi, Maria Trojano, Maria Pia Amato
Summary: The study found that pregnancy in women with relapses in the year before conception increases the risk of long-term disability worsening.
MULTIPLE SCLEROSIS JOURNAL
(2022)
Article
Clinical Neurology
Maria Pia Sormani, Irene Schiavetti, Doriana Landi, Luca Carmisciano, Nicola De Rossi, Cinzia Cordioli, Lucia Moiola, Marta Radaelli, Paolo Immovilli, Marco Capobianco, Vincenzo Brescia Morra, Maria Trojano, Gioacchino Tedeschi, Giancarlo Comi, Mario Alberto Battaglia, Francesco Patti, Yara Dadalti Fragoso, Sedat Sen, Aksel Siva, Roberto Furlan, Marco Salvetti
Summary: The study assessed the relationship between disease-modifying therapy (DMT) and the development of anti-SARS-CoV-2 antibodies in patients with multiple sclerosis (MS), finding that patients treated with anti-CD20 drugs had a lower likelihood of developing antibodies.
MULTIPLE SCLEROSIS JOURNAL
(2022)
Article
Neuroimaging
Alessandro Stasolla, Luca Prosperini, Shalom Haggiag, Francesca R. Pezzella, Alberto Pingi, Valeria Cozzolino, Enrico Pampana, Enrico Cotroneo, Carla Tortorella, Agazio Menniti, Claudio Gasperini
Summary: In the emergency setting, we propose a simple clinical indicator to differentiate non-traumatic acute myelopathies from mimicking conditions. Urgent spinal cord MRI remains essential for discriminating compressive and non-compressive etiologies.
NEURORADIOLOGY JOURNAL
(2022)
Article
Clinical Neurology
Claudio Solaro, Rachele Di Giovanni, Erica Grange, Giampaolo Brichetto, Margit Mueller, Andrea Tacchino, Rita Bertoni, Francesco Patti, Angelo Pappalardo, Luca Prosperini, Letizia Castelli, Rosalba Rosato, Davide Cattaneo, Davide Marengo
Summary: The study aims to evaluate the associations between Manual Ability Measure-36 (MAM-36) and objective measures, including the Nine Hole Peg Test (9-HPT), Box and Block Test (BBT), and Hand Grip Strength (HGS) in people with multiple sclerosis (PwMS). The study found small correlations between MAM-36 and these objective measures, with different correlations seen in different subgroups. Combining 9-HPT and HGS can enhance the assessment of upper limb function in daily activities.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Carlo Pozzilli, Maura Pugliatti, Patrick Vermersch, Nikolaos Grigoriadis, Mona Alkhawajah, Laura Airas, Celia Oreja-Guevara
Summary: This article examines the impact of diagnostic definitions of progressive multiple sclerosis (MS) on clinical research, clinical trial design, and treatment decisions. The results show that inconsistent results in clinical studies of treatments for progressive MS may be attributed to differences in patient characteristics and endpoint definitions. Younger patients with more active disease are likely to benefit the most from available treatments. Therefore, treatment decisions should be based on individual patient's disease progression pattern and parameters, rather than their clinical phenotype. Careful selection of eligibility criteria and study endpoints is necessary for future studies in patients with progressive MS.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Matteo Gastaldi, Thomas Foiadelli, Giacomo Greco, Silvia Scaranzin, Eleonora Rigoni, Stefano Masciocchi, Sergio Ferrari, Chiara Mancinelli, Laura Brambilla, Margherita Mancardi, Thea Giacomini, Diana Ferraro, Marida Della Corte, Antonio Gallo, Massimiliano Di Filippo, Luana Benedetti, Giovanni Novi, Maurizio Versino, Paola Banfi, Raffaele Iorio, Lucia Moiola, Emanuela Turco, Stefano Sartori, Margherita Nosadini, Martino Ruggieri, Salvatore Savasta, Elena Colombo, Elena Ballante, Sven Jarius, Sara Mariotto, Diego Franciotta
Summary: Longitudinal MOG-IgG titres can predict relapses in patients with MOGAD, and the results can be used to guide treatment decisions.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)
Article
Clinical Neurology
Rocco Capuano, Luca Prosperini, Manuela Altieri, Lorena Lorefice, Roberta Fantozzi, Paola Cavalla, Clara Guaschino, Marta Radaelli, Cinzia Cordioli, Viviana Nociti, Laura Boffa, Paolo Ragonese, Maria Di Gregorio, Federica Pinardi, Valentina Torri Clerici, Giovanna De Luca, Alberto Gajofatto, Damiano Paolicelli, Carla Tortorella, Claudio Gasperini, Claudio Solaro, Eleonora Cocco, Alvino Bisecco, Antonio Gallo
Summary: This study aimed to evaluate COVID-19 course and outcomes in patients with multiple sclerosis (pwMS) treated with ocrelizumab (OCR) and fingolimod (FNG) after receiving the third dose of mRNA vaccine against SARS-CoV-2 (mRNA-Vax), and compare it with pwMS on natalizumab (NTZ). The results showed that pwMS who had COVID-19 on OCR and FNG were slightly more symptomatic with higher hospitalization rates compared to those on NTZ, but no fatal cases were observed.
MULTIPLE SCLEROSIS JOURNAL
(2023)
Article
Medicine, General & Internal
Cristiano Scandurra, Laura Rosa, Antonio Carotenuto, Marcello Moccia, Sebastiano Arena, Antonio Ianniello, Agostino Nozzolillo, Mariavittoria Turrini, Lidia Mislin Streito, Gianmarco Abbadessa, Elisabetta Ferraro, Manuela Mattioli, Alessandro Chiodi, Nelson Mauro Maldonato, Simona Bonavita, Marinella Clerico, Cinzia Cordioli, Lucia Moiola, Francesco Patti, Luigi Lavorgna, Massimo Filippi, Giovanna Borriello, Emanuele D'Amico, Carlo Pozzilli, Vincenzo Brescia Morra, Maria Petracca, Roberta Lanzillo
Summary: Despite being a common issue, sexual dysfunction in people with multiple sclerosis (pwMS) is underinvestigated. This study aimed to assess the potential determinants of sexual dysfunction in pwMS by considering its relationship with disease severity, illness perception, and depressive symptoms. The results showed that disease severity indirectly affects sexual dysfunction through illness perception and depressive symptoms. Illness perception plays a more crucial role in sexual dysfunction for pwMS with mild disability. Modulating the effect of illness perception might be a valid approach to mitigate sexual dysfunction symptoms in pwMS.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Biochemistry & Molecular Biology
Costanza Gianni, Claudia Piervincenzi, Daniele Belvisi, Silvia Tommasin, Maria Ilenia De Bartolo, Gina Ferrazzano, Nikolaos Petsas, Giorgio Leodori, Nicoletta Fantoni, Antonella Conte, Alfredo Berardelli, Patrizia Pantano
Summary: This study investigated the microstructural damage of white matter bundles connecting subcortical and cortical regions in patients with cervical dystonia and blepharospasm. The results showed significant differences in diffusion tensor imaging metrics between the patient groups and healthy subjects, suggesting a common pathology in these two types of dystonia.
Article
Biochemistry & Molecular Biology
Claudia Piervincenzi, Antonio Suppa, Nikolaos Petsas, Andrea Fabbrini, Alessandro Trebbastoni, Francesco Asci, Costanza Gianni, Alfredo Berardelli, Patrizia Pantano
Summary: This study used multimodal magnetic resonance imaging to investigate the relationship between parkinsonism and brain structure and function in patients with frontotemporal degeneration (FTD). The results showed that patients with and without parkinsonism exhibited similar patterns of cortical thinning and reduced thalamic volume, but only patients with parkinsonism showed reduced putaminal volume and decreased connectivity between the supplementary motor area and putamen. These findings suggest that FTD patients with parkinsonism have specific neurodegenerative processes in the corticobasal ganglia-thalamocortical motor loops.
Review
Clinical Neurology
Luca Prosperini, Shalom Haggiag, Serena Ruggieri, Carla Tortorella, Claudio Gasperini
Summary: This study evaluated the rate of disease reactivation and associated risk factors after discontinuation of disease-modifying treatments in patients with multiple sclerosis. The findings suggest that discontinuation of treatments may be feasible in selected patients.
Article
Clinical Neurology
Serena Ruggieri, Luca Prosperini, Sarmad Al-Araji, Pietro Osvaldo Annovazzi, Alvino Bisecco, Olga Ciccarelli, Nicola De Stefano, Massimo Filippi, Vinzenz Fleischer, Nikos Evangelou, Christian Enzinger, Antonio Gallo, Afagh Garjani, Sergiu Groppa, Shalom Haggiag, Michael Khalil, Matteo Lucchini, Massimiliano Mirabella, Xavier Montalban, Carlo Pozzilli, Paolo Preziosa, Jordi Rio, Maria A. Rocca, Alex Rovira, Maria L. Stromillo, Mauro Zaffaroni, Carla Tortorella, Claudio Gasperini
Summary: Early relapses and substantial MRI activity in the first year of treatment are associated with worse short-term outcomes in patients treated with some of the oral DMTs.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)
Article
Clinical Neurology
Luca Prosperini, Irene Alcamisi, Maria Esmeralda Quartuccio, Ilaria Rossi, Deborah Fortuna, Serena Ruggieri
Summary: This study found that brain and cognitive reserve can lessen the impact of multiple sclerosis-related tissue damage on balance control. The research found that larger brain volume and higher educational attainment can reduce the adverse effects of MS-related tissue damage on postural sway.
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Luca Prosperini, Shalom Haggiag, Serena Ruggieri, Carla Tortorella, Claudio Gasperini
Summary: Based on real-world studies, we found that dimethyl fumarate (DMF) is slightly more effective than teriflunomide (TRF) in reducing the short-term relapse risk of relapsing-remitting multiple sclerosis. However, there were no significant differences in reducing confirmed disability worsening and treatment discontinuation between the two drugs.
Review
Clinical Neurology
Diego Centonze, Maria Pia Amato, Vincenzo Brescia Morra, Eleonora Cocco, Nicola De Stefano, Claudio Gasperini, Paolo Gallo, Carlo Pozzilli, Maria Trojano, Massimo Filippi
Summary: Multiple sclerosis (MS) is a chronic neurological disease characterized by inflammation, degeneration, and demyelination. Cladribine tablets have been approved as an effective treatment option for highly active relapsing-remitting MS. A group of neurologists has proposed management pathways for patients completing the approved 4-year regimen, based on response to treatment and monitoring of disease activity. Re-treatment decisions should be made based on clinical and radiological assessments, as well as patient eligibility and preference.
THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS
(2023)
