Multiple Sclerosis: Diagnosis, Management, and Future Opportunities

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (20 June 2022) | Viewed by 29338

Special Issue Editor


E-Mail Website
Guest Editor
Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
Interests: digital health; remote monitoring; digital therapeutics; telemedicine; e-health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Multiple sclerosis is characterized by the need to find new solutions for its management both from an epidemiological point of view and for progress in the field of pharmacological, symptomatic, and rehabilitative therapies. We have been diagnosing so-called millennials with MS for some years now, and it is therefore the duty of science to explore new tools for diagnosis, management, and future approaches—which is precisely the goal of this Special Issue on “Multiple Sclerosis: Diagnosis, Management, and Future Opportunities”. We look forward to your contributions.

Dr. Luigi Lavorgna
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Multiple Sclerosis
  • Digital health
  • e-health
  • Remote monitoring
  • Digital therapeutics
  • e-health
  • Robotics Machine learning
  • Artificial Intelligence

Published Papers (13 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Editorial

Jump to: Research, Other

5 pages, 203 KiB  
Editorial
Multiple Sclerosis: Diagnosis, Management, and Future Opportunities
by Elisabetta Maida and Luigi Lavorgna
J. Clin. Med. 2023, 12(14), 4558; https://doi.org/10.3390/jcm12144558 - 08 Jul 2023
Cited by 1 | Viewed by 712
Abstract
Multiple sclerosis (MS) is one of the most common inflammatory neurological diseases which leads to a highly heterogeneous set of symptoms and signs due to the differential involvement of the motor, sensory, visual, and autonomic systems [...] Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)

Research

Jump to: Editorial, Other

7 pages, 414 KiB  
Article
Quality of Life Changes in Early-Onset Multiple Sclerosis: A 4-Year Follow-Up Study
by Laura Rosa, Maria Petracca, Antonio Carotenuto, Pasquale Dolce, Kyrie Piscopo, Francesca Dicé, Francesca Lauro, Antonio Luca Spiezia, Marcello Moccia, Luigi Lavorgna, Carmine Iacovazzo, Giuseppe Servillo, Nelson Mauro Maldonato, Alessandro Chiodi, Vincenzo Brescia Morra and Roberta Lanzillo
J. Clin. Med. 2022, 11(17), 5226; https://doi.org/10.3390/jcm11175226 - 04 Sep 2022
Cited by 3 | Viewed by 1247
Abstract
This study investigates longitudinal changes in health-related quality of life (HRQoL) in early-onset multiple sclerosis (MS) patients and explores the impact of disease activity (relapses) on such changes. People with MS (PwMS) onset between 12 and 25 years of age were followed longitudinally. [...] Read more.
This study investigates longitudinal changes in health-related quality of life (HRQoL) in early-onset multiple sclerosis (MS) patients and explores the impact of disease activity (relapses) on such changes. People with MS (PwMS) onset between 12 and 25 years of age were followed longitudinally. At baseline and at year 4, patients were asked to fill the Paediatric Quality of life inventory (PedsQL). Demographic and clinical features were collected at both time points. Longitudinal within-group comparison of HRQoL total score and sub-scores was performed via paired samples t-test. The effect of relapses on the HRQoL changes over time was explored via linear mixed-effects analysis. No longitudinal changes were observed in the overall PedsQL score, nor in the physical, school and psychological functioning. An increase in the social functioning subscale (p < 0.001) and a decrease in the emotional subscale (p = 0.006) were observed. The change in social functioning, but not the one in the emotional subscale, was affected by the occurrence of relapses (p = 0.044). In conclusion, stimulating the patients to accept their emotional responses to health-related limitations, while preserving their social and relational resources seems key to the preservation of an adequate QoL over time in juvenile-onset MS. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

11 pages, 4625 KiB  
Article
Symptom-Level Disability Status Assessed with an Electronic Unsupervised Patient-Reported Expanded Disability Status Scale (ePR-EDSS) in Multiple Sclerosis Patients—The Example of Croatia
by Ana Jerković, Sanda Pavelin, Joško Šoda, Igor Vujović and Maja Rogić Vidaković
J. Clin. Med. 2022, 11(14), 4081; https://doi.org/10.3390/jcm11144081 - 14 Jul 2022
Cited by 1 | Viewed by 1787
Abstract
The present study aimed to apply an electronic, unsupervised patient-reported Expanded Disability Status Scale (ePR-EDSS) to investigate disability severity in people with multiple sclerosis (pwMS) as a case study in Croatia in 2021, including demographic and comorbidity characteristics and multiple sclerosis (MS) disease-related [...] Read more.
The present study aimed to apply an electronic, unsupervised patient-reported Expanded Disability Status Scale (ePR-EDSS) to investigate disability severity in people with multiple sclerosis (pwMS) as a case study in Croatia in 2021, including demographic and comorbidity characteristics and multiple sclerosis (MS) disease-related factors. The cross-sectional study was conducted as an online survey from 4 October 2021 to 31 December 2021. Symptom-level disability status was assessed with ePR-EDSS for MS capturing MS-related disability across the spectrum of severity.The study enrolled 147 pwMS patients, of which 84% were women. The mean age ± standard deviation in the sample was 41.1 ± 11.3, and the mean disease duration was 8.5 ± 7.4 years, with a median EDSS score of 3.0 (range, 0–8). The distribution of the participants according to clinical forms of MS was as follows: 71% had relapsing-remitting MS, 13% had primary progressive MS, 4% had secondary progressive PMS, and 12% did not provide information on their MS type. Twenty-nine point two percent (29.2%) of the participants had comorbidities in addition to MS. EDSS scores indicate significant differences with regard to age (t = −3.51, p < 0.001), gender (χ2 = 8.04, p < 0.01), and immunomodulatory drug use (χ2 = 5.89, p < 0.05). An ePR-EDSS analysis of disability symptoms showed a significant difference in symptoms with regard to strength, sensation, coordination, vision, fatigue, mobility, and overall wellness among MS types. Participants with PPMS and SPMS were older on average, had higher EDSS, and had more pronounced symptoms of disability measured with ePR-EDSS compared to those with RRMS. Application of ePR-EDSS shows it to be a reliable eHealth tool for clinical assessment of pwMS disability status, and future studies should correlate it with standard self-report scales capturing MS symptoms such as fatigue, depression, anxiety, and stress. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

8 pages, 574 KiB  
Article
Effect of Rituximab Compared with Natalizumab and Fingolimod in Patients with Relapsing–Remitting Multiple Sclerosis: A Cohort Study
by Martha Rocio Hernández-Preciado, Jazmin Marquez-Pedroza, Nayeli Alejandra Sánchez-Rosales, José de Jesús García-Rivera, Antonio Kobayashi-Gutiérrez, Blanca Miriam Torres-Mendoza, Efraín Chavarría-Avila, Raúl Alejandro Montaño-Serrano, Fernando Cortes-Enriquez and Mario Alberto Mireles-Ramírez
J. Clin. Med. 2022, 11(13), 3584; https://doi.org/10.3390/jcm11133584 - 22 Jun 2022
Cited by 4 | Viewed by 1805
Abstract
The objective of this study was to evaluate the clinical files of patients with RRMS who started rituximab (RTX) compared with a second-line treatment (natalizumab (NTZ) or fingolimod (FTY)). This was a historical cohort study. We compared the effect according to the Expanded [...] Read more.
The objective of this study was to evaluate the clinical files of patients with RRMS who started rituximab (RTX) compared with a second-line treatment (natalizumab (NTZ) or fingolimod (FTY)). This was a historical cohort study. We compared the effect according to the Expanded Disability Status Scale (EDSS) and the number of relapses in RRMS patients receiving these treatments after a mean period of 12 months. We found a statistically significant difference (p < 0.001) when comparing the EDSS scores and the annual relapse rates of patients receiving RTX with those receiving NTZ or FTY. This study is essential for our clinical practice, since patients with limited treatment options represent a challenge with regard to the management of their medical care. However, clinical trials and prospective studies with long follow-up periods are necessary to provide sufficient evidence on the efficacy of RTX and thus include this treatment in the therapeutic profile of patients with MS. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

12 pages, 2806 KiB  
Article
PECAM-1 Is Down-Regulated in γδT Cells during Remission, but Up-Regulated in Relapse of Multiple Sclerosis
by Michał K. Zarobkiewicz, Izabela Morawska, Wioleta Kowalska, Paweł Halczuk, Jacek Roliński and Agnieszka A. Bojarska-Junak
J. Clin. Med. 2022, 11(11), 3210; https://doi.org/10.3390/jcm11113210 - 04 Jun 2022
Cited by 2 | Viewed by 1393
Abstract
Introduction. PECAM-1 and NKRP1A are both involved in the vascular transmigration of T lymphocytes. Vascular transmigration is a crucial process in multiple sclerosis pathogenesis. Methods and aim. The current paper presents an analysis of PECAM-1 and NKRP1A expression on γδ T [...] Read more.
Introduction. PECAM-1 and NKRP1A are both involved in the vascular transmigration of T lymphocytes. Vascular transmigration is a crucial process in multiple sclerosis pathogenesis. Methods and aim. The current paper presents an analysis of PECAM-1 and NKRP1A expression on γδ T cells. Expression of PECAM-1 and NKRP1A on subsets of γδ T cells was performed with flow cytometry. Results. Based on the flow cytometry data, PECAM1 was slightly differentially modulated on γδ T cells—it was up-regulated during relapse, but down-regulated during remission. Moreover, a significant downregulation of CD3 expression was noted on γδ T cells from MS patients, most notably during relapse. Conclusions. This may be a sign of the overall activation of γδ T cells in the course of multiple sclerosis. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

9 pages, 1180 KiB  
Article
Prognostic Markers of Ocrelizumab Effectiveness in Multiple Sclerosis: A Real World Observational Multicenter Study
by Roberta Lanzillo, Antonio Carotenuto, Elisabetta Signoriello, Rosa Iodice, Giuseppina Miele, Alvino Bisecco, Giorgia Teresa Maniscalco, Leonardo Sinisi, Felice Romano, Maria Di Gregorio, Luigi Lavorgna, Francesca Trojsi, Marcello Moccia, Mario Fratta, Nicola Capasso, Raffaele Dubbioso, Maria Petracca, Antonio Luca Spiezia, Antonio Gallo, Martina Petruzzo, Marcello De Angelis, Simona Bonavita, Giacomo Lus, Gioacchino Tedeschi and Vincenzo Brescia Morraadd Show full author list remove Hide full author list
J. Clin. Med. 2022, 11(8), 2081; https://doi.org/10.3390/jcm11082081 - 07 Apr 2022
Cited by 6 | Viewed by 2197
Abstract
Pivotal trials showed the effectiveness of the monoclonal antibody ocrelizumab in relapsing and progressive multiple sclerosis (MS). However, data on everyday practice in MS patients and markers of treatment effectiveness are scarce. We aimed to collect real-world data from ocrelizumab-treated MS patients, relapsing-remitting [...] Read more.
Pivotal trials showed the effectiveness of the monoclonal antibody ocrelizumab in relapsing and progressive multiple sclerosis (MS). However, data on everyday practice in MS patients and markers of treatment effectiveness are scarce. We aimed to collect real-world data from ocrelizumab-treated MS patients, relapsing-remitting (RR) and progressive MS patients (PMS), including active secondary progressive MS (aSPMS) and primary progressive MS (PPMS) patients, and to explore potential prognostic factors of clinical outcome. Patients were enrolled at MS centres in the Campania region, Italy. We collected clinic-demographic features retrospectively one year before ocrelizumab start (T−1), at ocrelizumab start (T0), and after one year from ocrelizumab start (T1). We explored possible clinical markers of treatment effectiveness in those patients receiving ocrelizumab treatment for at least one year using multilevel-mixed models. We included a total of 383 MS patients (89 RRMS and 294 PMS; 205 females, mean age: 45.8 ± 11.2, disease duration: 12.7 ± 11.6 years). Patients had a mean follow-up of 12.4 ± 8.2 months, and 217 patients completed one-year ocrelizumab treatment. Overall, EDSS increased from T−1 to T0 (coeff. = 0.30, 95% coefficient interval [CI] = 0.19–0.41, p < 0.001) without a further change between T0 and T1 (p = 0.61). RRMS patients did not show an EDSS change between T−1 and T0 nor between T0 and T1. Conversely, PMS patients showed EDSS increase from T−1 to T0 (coeff. = 0.34, 95% CI = 0.22–0.45, p < 0.001) without a further change between T0 and T1 (p = 0.21). PMS patients with a time from conversion shorter than 2 years showed increased EDSS from T−1 to T0 (coeff. = 0.63, 95% CI = 0.18–1.08, p = 0.006) without a further change between T0 and T1 (p = 0.94), whereas PMS patients with a time from conversion longer than 2 years showed increased EDSS from T0 to T1 (coeff. = 0.30, 95% CI = 0.11–0.49, p = 0.002). Naïve patients showed an EDSS decrease between T0 and T1 (coeff. = −0.30, 95% CI = −0.50–−0.09, p = 0.004). In conclusion, our study highlighted that early ocrelizumab treatment is effective in modifying the disability accrual in MS patients. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

8 pages, 599 KiB  
Article
The Timing of Kinematic and Kinetic Parameters during Gait Cycle as a Marker of Early Gait Deterioration in Multiple Sclerosis Subjects with Mild Disability
by Francisco Molina-Rueda, Diego Fernández-Vázquez, Víctor Navarro-López, Juan Carlos Miangolarra-Page and María Carratalá-Tejada
J. Clin. Med. 2022, 11(7), 1892; https://doi.org/10.3390/jcm11071892 - 29 Mar 2022
Cited by 6 | Viewed by 1589
Abstract
This study aimed to evaluate walking in multiple sclerosis (MS) patients with mild disability. A case control study with 8 mild disability MS patients and 10 controls was conducted. This study analyzed spatiotemporal, kinematic, and kinetic parameters. We also analyzed the timing of [...] Read more.
This study aimed to evaluate walking in multiple sclerosis (MS) patients with mild disability. A case control study with 8 mild disability MS patients and 10 controls was conducted. This study analyzed spatiotemporal, kinematic, and kinetic parameters. We also analyzed the timing of these parameters, as a percentage of the gait cycle. The MS patients and controls walked with a similar gait pattern. However, there were differences in the timing of the biomechanical parameters. The timing of toe-off was at 62–63% of gait cycle in MS subjects while in controls it was at 59.94% (p = 0.009 to 0.027 vs. to controls). The peak of knee flexion during swing was at 74–76% of gait cycle in MS subjects while in controls was at 72% (p = 0.027 to 0.034). While the peak of ankle dorsiflexion during stance occurred at 48–50% in MS subjects, while in controls it was at 46% (p = 0.001 to 0.009), and the peak of plantar flexion during pre-swing was at 66% in MS subjects vs. 64% in controls (p = 0.001). At the kinetic pattern, the first peak of the vertical ground reaction force occurred at 14% of gait cycle in controls while in MS patients it was at 17–20% (p = 0.012 to 0.021). MS subjects with mild disability walked with similar spatiotemporal parameters, joint angles and moments compared to controls. However, our results suggest that those changed the temporal occurrences, expressed as percentage of the gait cycle, of the kinematic and kinetic parameters. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

12 pages, 937 KiB  
Article
Reflex Locomotion Therapy for Balance, Gait, and Fatigue Rehabilitation in Subjects with Multiple Sclerosis
by María Carratalá-Tejada, Alicia Cuesta-Gómez, Rosa Ortiz-Gutiérrez, Francisco Molina-Rueda, Laura Luna-Oliva and Juan Carlos Miangolarra-Page
J. Clin. Med. 2022, 11(3), 567; https://doi.org/10.3390/jcm11030567 - 23 Jan 2022
Cited by 6 | Viewed by 3544
Abstract
This study evaluates the effects of a rehabilitation program based on reflex locomotion therapy (RLT) on balance, gait, and fatigue in patients with multiple sclerosis (MS). Twenty-three patients diagnosed with MS participated in this study. Reversal design was carried out. The assessment tools [...] Read more.
This study evaluates the effects of a rehabilitation program based on reflex locomotion therapy (RLT) on balance, gait, and fatigue in patients with multiple sclerosis (MS). Twenty-three patients diagnosed with MS participated in this study. Reversal design was carried out. The assessment tools included the Berg Balance Scale (BBS), the Performance Oriented Mobility Assessment (POMA), the Fatigue Severity Scale (FSS) and the instrumental analysis of the gait recorded by Vicon Motion System®. We analyzed spatio-temporal parameters and kinematic variables of the hip, knee, and ankle joints. Additionally, the Client Satisfaction Questionnaire (CSQ-8) was administrated. We did find a significant improvement in balance and gait tools after the RLT period. Regarding instrumental analysis, the statistical analysis of spatio-temporal parameters showed a significant improvement in stride length, double support, and velocity after the RLT period. Concerning kinematic parameters, the analysis showed improvements in hip and knee range of motion (ROM) after RLT period. RLT could improve gait and balance in patients with MS. The patients reported a high level of satisfaction with the therapy received. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

16 pages, 1113 KiB  
Article
Diagnostic Value of JC Polyomavirus Viruria, Viremia, Serostatus and microRNA Expression in Multiple Sclerosis Patients Undergoing Immunosuppressive Treatment
by Carla Prezioso, Marco Ciotti, Gabriele Brazzini, Francesca Piacentini, Sara Passerini, Alfonso Grimaldi, Doriana Landi, Carolina Gabri Nicoletti, Maria Antonella Zingaropoli, Marco Iannetta, Marta Altieri, Antonella Conte, Dolores Limongi, Girolama Alessandra Marfia, Maria Rosa Ciardi, Claudio Maria Mastroianni, Anna Teresa Palamara, Ugo Moens and Valeria Pietropaolo
J. Clin. Med. 2022, 11(2), 347; https://doi.org/10.3390/jcm11020347 - 11 Jan 2022
Cited by 4 | Viewed by 1813
Abstract
Markers of JC polyomavirus (JCPyV) activity can be used to evaluate the risk of progressive multifocal leukoencephalopathy (PML) in treated multiple sclerosis (MS) patients. The presence of JCPyV DNA and microRNA (miR-J1-5p), the anti-JCV index and the sequence of the non-coding control region [...] Read more.
Markers of JC polyomavirus (JCPyV) activity can be used to evaluate the risk of progressive multifocal leukoencephalopathy (PML) in treated multiple sclerosis (MS) patients. The presence of JCPyV DNA and microRNA (miR-J1-5p), the anti-JCV index and the sequence of the non-coding control region (NCCR) in urine and plasma were determined in 42 MS subjects before treatment (T0), 6 months (T6) and 12 months (T12) after natalizumab, ocrelizumab, fingolimod or dimethyl-fumarate administration and in 25 healthy controls (HC). The number of MS patients with viruria increased from 43% at T0 to 100% at T12, whereas it remained similar for the HC group (35–40%). Viremia first occurred 6 months after treatment in MS patients and increased after 12 months, whereas it was absent in HC. The viral load in urine and plasma from the MS cohort increased over time, mostly pronounced in natalizumab-treated patients, whereas it persisted in HC. The archetypal NCCR was detected in all positive urine, whereas mutations were observed in plasma-derived NCCRs resulting in a more neurotropic variant. The prevalence and miR-J1-5p copy number in MS urine and plasma dropped after treatment, whereas they remained similar in HC specimens. Viruria and miR-J1-5p expression did not correlate with anti-JCV index. In conclusion, analyzing JCPyV DNA and miR-J1-5p levels may allow monitoring JCPyV activity and predicting MS patients at risk of developing PML. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

17 pages, 6066 KiB  
Article
Potential Contribution of IL-27 and IL-23 Gene Polymorphisms to Multiple Sclerosis Susceptibility: An Association Analysis at Genotype and Haplotype Level
by Ioana S. Barac, Mihaela Iancu, Vitalie Văcăraș, Angela Cozma, Vasile Negrean, Dorel Sâmpelean, Dafin F. Mureșanu and Lucia M. Procopciuc
J. Clin. Med. 2022, 11(1), 37; https://doi.org/10.3390/jcm11010037 - 22 Dec 2021
Cited by 5 | Viewed by 2585
Abstract
(1) Background: interleukin 23 (IL-23) and interleukin 27 (IL-27) modulate the activity of T helper 17 cells (Th17) with critical roles in autoimmune diseases and multiple sclerosis (MS). The genes responsible for cytokine generation are highly influenced by the presence of single nucleotide [...] Read more.
(1) Background: interleukin 23 (IL-23) and interleukin 27 (IL-27) modulate the activity of T helper 17 cells (Th17) with critical roles in autoimmune diseases and multiple sclerosis (MS). The genes responsible for cytokine generation are highly influenced by the presence of single nucleotide polymorphisms (SNP) in main regions such as regulatory sequences or in promoter regions, contributing to disease susceptibility and evolution. The present study analyzed the associations of IL-23 and IL-27 SNPs with susceptibility to multiple sclerosis. (2) Methods: We performed a case-control study including 252 subjects: 157 patients diagnosed with MS and 95 controls. We used polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to determine the genotypes for IL-27 T4730C (rs 181206), IL-27 A964G (rs 153109), and IL-23 receptor gene (IL-23R) G1142A (rs 11209026). (3) Results: The IL27-T4730C gene polymorphism was significantly associated with an increased odds of MS under the dominant genetic model (TC + CC variant genotypes, adjusted odds ratio OR = 4.06, 95% CI: 2.14–7.83, p-value = 0.000007, Q-value = 0.000063). Individuals carrying the IL-27 A924G variant (AG + GG) genotype presented higher odds of MS compared to non-carriers under the dominant model (adjusted OR = 1.93, 95% CI: 1.05–3.51, p-value = 0.0324, Q-value = 0.05832) and the allelic genetic model (unadjusted p-value = 0.015, OR = 1.58, 95% CI: 1.09–2.28), while IL-23-R381Q SNP conferred a decreased odds of MS under a codominant model of inheritance (adjusted OR = 0.26, 95% CI: 0.08–0.92, p-value = 0.0276, Q-value = 0.058) and an allelic model (unadjusted p-value = 0.008, OR = 0.23, 95% CI: 0.07–0.75). In an additive model with adjustment for age group (≤40 years vs. >40 years), sex and smoking, patients carrying the G-C (A964G, T4730C) haplotype had a 3.18 increased risk (95% CI: 1.74–5.81, p < 0.001) to develop multiple sclerosis. (4) Conclusions: The results of the current study showed a significant relationship of IL-27-A964G and IL-27-T4730C polymorphisms with increased risk of MS, and also the protective role of the IL-23-R381Q polymorphism. Moreover, the haplotype-based analysis proposed the mutant G-C (A924G, T4730C) as a significant risk haplotype for the development of MS. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

10 pages, 263 KiB  
Article
Characteristic Personality Traits of Multiple Sclerosis Patients—An Unicentric Prospective Observational Cohort Study
by Eugenia Irene Davidescu, Irina Odajiu, Delia Tulbă, Camelia Cucu and Bogdan Ovidiu Popescu
J. Clin. Med. 2021, 10(24), 5932; https://doi.org/10.3390/jcm10245932 - 17 Dec 2021
Cited by 5 | Viewed by 5859
Abstract
Background and objectives: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. Methods [...] Read more.
Background and objectives: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. Methods and materials: Patients with relapsing–remitting MS along with a sex- and age-matched control group were included. All subjects completed the DECAS Personality Inventory and an additional form including demographic characteristics. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed using SPSS. Results: 122 subjects were included, out of which 61 were in the patient group, mostly females (71.31%) with a mean age of 42.06 ± 10.46 years. Mean duration of disease was 10.18 ± 5.53 years and mean EDSS score was 2.09; 36% of patients were treated with Interferon-beta 1a. Subjects in the patient group presented significantly lower scores for extraversion (p = 0.036), specifically those with higher EDSS score, even after adjusting for possible confounders (age, sex, marital status, early retirement, alcohol, and tobacco consumption). Additionally, regarding orientation in life, MS patients were more often philosophers (p = 0.001), especially young males, whereas the dominant emotional feeling was less common, the actor profile (p = 0.022). Regarding task involvement, MS patients were often passive and compassionate concerning other people. Higher EDSS score also correlated with avoidant (p = 0.006) and melancholic (p = 0.043) personality traits. Subjects with higher education associated more often pragmatic, experimenter, popular, and optimist traits, whereas the elderly had actor, authoritarian, and experimenter profiles. Conclusions: Some MS patients may have reduced levels of extraversion and specific personality traits compared to age- and sex-matched subjects. Determining the exact personality profile might help the neurologist to establish a better therapeutic alliance and to apply specific interventions. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)

Other

Jump to: Editorial, Research

5 pages, 192 KiB  
Case Report
Disease Reactivation in Secondary Progressive Multiple Sclerosis Patients Switching from Fingolimod to Siponimod: A Case Series
by Gianmarco Abbadessa, Elisabetta Maida, Giuseppina Miele, Floriana Bile, Luigi Lavorgna and Simona Bonavita
J. Clin. Med. 2022, 11(20), 6033; https://doi.org/10.3390/jcm11206033 - 13 Oct 2022
Cited by 3 | Viewed by 1372
Abstract
Siponimod, a selective modulator of sphingosine 1-phosphate receptors 1 (S1P1) and 5 (S1P5), has recently been marketed for patients with Secondary Progressive Multiple Sclerosis (SPMS). Herein, we report three SPMS patients presenting disease reactivation in the first three months after switching from fingolimod [...] Read more.
Siponimod, a selective modulator of sphingosine 1-phosphate receptors 1 (S1P1) and 5 (S1P5), has recently been marketed for patients with Secondary Progressive Multiple Sclerosis (SPMS). Herein, we report three SPMS patients presenting disease reactivation in the first three months after switching from fingolimod to siponimod. Fingolimod binds to S1P1, S1P3, S1P4 and S1P5 receptors. S1P3 holds a central role in eliciting central proinflammatory responses, thus it has been hypothesized that upregulation of S1P3 may be the mechanism behind relapses after switching from fingolimod to siponimod. Further studies are needed to investigate the safety and efficacy of this treatment sequencing. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
9 pages, 1057 KiB  
Case Report
Cutaneous Adverse Reactions Associated with Monoclonal Antibodies Treatment in Multiple Sclerosis: Case Reports and Short Literature Review
by Carmen Adella Sirbu, Raluca Ivan, Titus Mihai Vasile, Lucian George Eftimie and Daniel Octavian Costache
J. Clin. Med. 2022, 11(13), 3702; https://doi.org/10.3390/jcm11133702 - 27 Jun 2022
Cited by 2 | Viewed by 1834
Abstract
Background and aims. Multiple sclerosis is a disease of the central nervous system, whose treatment often involves the use of monoclonal antibodies. This can lead to a series of complications that the clinician should pay attention to and accordingly adjust the therapy. We [...] Read more.
Background and aims. Multiple sclerosis is a disease of the central nervous system, whose treatment often involves the use of monoclonal antibodies. This can lead to a series of complications that the clinician should pay attention to and accordingly adjust the therapy. We aim to emphasize real-life experiences with adverse cutaneous reactions to monoclonal antibodies by presenting a series of two cases from our clinic. Methods. In the first case, a female patient was treated with natalizumab for eight years and developed relapsing-remitting cutaneous lesions following the monthly administration of the treatment. The second case is of a male patient treated with ocrelizumab, who developed plaque-like lesions following the fifth administration. We analyzed the biological parameters and performed investigations, dermatological evaluation and skin biopsies. Results. The result of the skin biopsy for the natalizumab patient showed a chronic spongiotic dermatitis, with the anti-natalizumab antibodies being negative. The patient who received ocrelizumab developed nummular eczema, disseminated on his trunk and limbs. Conclusions. Given the fact that these therapies are frequently used in multiple sclerosis patients, and their skin adverse reactions are known, we described some particularities and a brief review of the literature with practical implications. Further studies need to be conducted to establish a firm association between monoclonal antibodies therapy and adverse cutaneous reactions, but the clinician should be aware of their existence. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis, Management, and Future Opportunities)
Show Figures

Figure 1

Back to TopTop