Donzé C, Mekies C, Mouzawak C
… +6 more, Pau D, Civet A, Brechenmacher L, Paillot G, Cohen M, Vermersch P
Mult Scler Relat Disord
· 2026 May · PMID 42276022
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BACKGROUND: Multiple sclerosis (MS) is a leading cause of non-traumatic neurological disability in young adults, with profound implications for personal autonomy, mental health, and social participation. As no Patient-Re...BACKGROUND: Multiple sclerosis (MS) is a leading cause of non-traumatic neurological disability in young adults, with profound implications for personal autonomy, mental health, and social participation. As no Patient-Reported Outcome Measure adequately captures patient autonomy, we developed the Multiple Sclerosis Autonomy Scale (MSAS). The FOCAL-MS 2 study aims to confirm the psychometric properties of the MSAS score. METHODS: Patients included between 01/02/2024 and 19/04/2024 were routinely followed for 12 months throughout France. Health Care Professionals (HCPs) sent patients the 36-item MSAS questionnaire to complete before out-patient visits. Patients also completed the MSAS upon inclusion, 15 (D15), 30 (D30), and 360 (D360) days later. Validation included internal consistency, reliability, unidimensionality, multidimensionality, and construct validity. RESULTS: A total of 199 patients (74.4% females; age 49.7 years) were included. The MSAS presented good internal consistency at inclusion (Cronbach's alpha = 0.845) and good test-retest reliability (intra-class correlation coefficient = 0.72 at D15 and 0.75 at D30). As each dimension was required to maintain consistency, one item was removed to improve the instrument's properties. CONCLUSION: The 35-question MSAS is a valid, consistent, and reliable tool to assess patient autonomy in MS and satisfies patients' and HCPs' needs.
Toksoy CK, Ayaz TB, Emekli AS
… +2 more, Gündüz T, Kürtüncü M
Mult Scler Relat Disord
· 2026 Jun · PMID 42276021
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OBJECTIVES: Somatosensory evoked potentials (SEP) reflect functional integrity of sensory pathways and may predict disability progression in multiple sclerosis (MS). Cervical spinal cord atrophy is thought to reflect neu...OBJECTIVES: Somatosensory evoked potentials (SEP) reflect functional integrity of sensory pathways and may predict disability progression in multiple sclerosis (MS). Cervical spinal cord atrophy is thought to reflect neurodegenerative processes and may contribute to disability in MS. This study aimed to investigate the association between SEP abnormalities, cervical spinal cord atrophy, and disability progression in MS. METHODS: In this retrospective cohort study, MS patients who underwent SEP examination and had at least two cervical spinal MRI scans acquired more than one year apart were included. Cervical spinal cord cross-sectional areas (C2-3, C3-4) were automatically quantified using a validated deep learning segmentation model. SEP and visual evoked potentials (VEPs) were dichotomized as normal or pathological based on institutional normative values. Disability progression was assessed by time to Expanded Disability Status Scale (EDSS) scores of 3 and 6 using Kaplan-Meier survival analysis and Cox proportional hazards models. RESULTS: A total of 47 patients were included. SEP abnormalities were observed in 46.8% of patients. Pathological SEP was associated with higher annual cervical spinal cord atrophy rates and a significantly shorter time to EDSS 3, but not EDSS 6. Pathological SEP was associated with earlier attainment of EDSS 3 (HR 3.4). DISCUSSION: SEP abnormalities are associated with increased cervical spinal cord atrophy and early disability progression in MS, supporting SEP as an electrophysiological biomarker of spinal cord involvement.
Sriram M, Shivarthi T, Anand V
… +6 more, Muppavarapu SC, Radhakrishnan N, Rasheed R, Radhakrishnan S, Kannoth S, Vinayan KP
Mult Scler Relat Disord
· 2026 Jun · PMID 42276020
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BACKGROUND: Demyelinating optic neuritis (ON) is the most common cause of visual loss in children. However, data from a neurological standpoint is limited. AIM: To assess clinical, radiological, immunological, and treatm...BACKGROUND: Demyelinating optic neuritis (ON) is the most common cause of visual loss in children. However, data from a neurological standpoint is limited. AIM: To assess clinical, radiological, immunological, and treatment-related variables in pediatric ON from a neurological perspective. METHODS: All cases of demyelinating optic neuritis in the Pediatric Neurology Department of a tertiary care center from 2014 to 2024 were analyzed. RESULTS: Of 32 patients, 23 were female (71.9 %). The mean age at presentation was 8.9 years (range: 2-16 years), and 18 (56.2 %) showed bilateral involvement. The first symptom at onset in 18 (56.2 %) was visual impairment, although all patients experienced visual impairment during their course. 17 subjects (53.1 %) had a history of recent inflammatory prodrome, and 5 (15.6 %) had fever at the time of presentation. Demyelinating cerebral, infratentorial, or spinal cord MRI lesions were seen in 17 patients (53.1 %). Serum MOG antibody positivity was observed in 13/20 (65 %) patients tested, of which 11 seropositives (84.6 %) were female. Visual status at the latest follow-up was good in all 9 children treated with oral steroids for over 1 month (p = 0.017). Relapses with visual symptoms were noted in 9 patients; children with MOG-ON showed increased risk of relapses (p = 0.033) compared to other diagnoses. CONCLUSION: MOG-ON is the leading cause of pediatric demyelinating ON. In about half of the children with ON, visual impairment may not be the presenting complaint. Extended courses of steroids are better associated with improved visual outcomes.
Aboseif A, Neyal N, Keegan BM
… +7 more, Eckel-Passow JE, Siva A, Lebrun-Frenay C, Okuda DT, Tobin WO, Zeydan B, Kantarci OH
Mult Scler Relat Disord
· 2026 Jun · PMID 42269338
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INTRODUCTION: Tumefactive multiple sclerosis (TMS) is characterized by large brain demyelinating lesions, often with severe, disabling attacks. While MS can be preceded by a radiologically isolated syndrome (RIS), a pre-...INTRODUCTION: Tumefactive multiple sclerosis (TMS) is characterized by large brain demyelinating lesions, often with severe, disabling attacks. While MS can be preceded by a radiologically isolated syndrome (RIS), a pre-symptomatic phase in TMS is not well described. AIM: To characterize pre-symptomatic TMS and compare its frequency and symptomatic evolution to a non-tumefactive MS (nTMS) cohort. METHODS: Adults (≥18 years) with ≥1 tumefactive demyelinating lesion (TDL; ≥2 cm), fulfilling 2024 McDonald Criteria were included. Pre-symptomatic TMS was defined as an incidental TDL fulfilling the 2024 pre-symptomatic MS criteria. The frequency of pre-symptomatic disease and symptomatic MS evolution were compared to a nTMS cohort matched on age at onset, sex, and disease duration, using Fisher's exact test. Among patients with pre-symptomatic MS, time to symptomatic MS conversion was compared using Kaplan-Meier (KM) analysis with log-rank testing. RESULTS: Among 202 TMS patients, seven (4%) were pre-symptomatic with a median age of 51 (IQR 46, 53.5) years. Over 92 (IQR 16.5, 129.5) months, four developed new MRI lesions and one developed symptomatic MS. Four initiated disease-modifying therapy within 13.5 (IQR 1.8, 28.8) months. After matching, the frequency of pre-symptomatic disease was 3.1% (4/129; median age 38 years) in TMS compared to 5.4% (7/129; median age 38 years) in nTMS (p = 0.54). One pre-symptomatic TMS patient (25%) and one (14%) pre-symptomatic nTMS patient evolved to symptomatic MS (p = 1.0). A time-to-event analysis of symptomatic MS evolution across pre-symptomatic TMS and nTMS cohorts yielded a log-rank p = 0.67, although the overall number of observed events were limited. DISCUSSION: A pre-symptomatic phase of TMS mirroring RIS may be underrecognized, warranting consideration when evaluating incidental tumefactive brain lesions. Larger studies are needed to determine whether the temporal pattern of symptomatic evolution differs between presymptomatic TMS and nTMS.
Drobinska N, Sukockiene E, Uginet M
… +2 more, Lalive PH, Lascano AM
Mult Scler Relat Disord
· 2026 May · PMID 42263353
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BACKGROUND: Pain is a common and disabling symptom in multiple sclerosis (MS), yet its pathophysiological mechanisms remain poorly understood. Clinical assessment of neuropathic pain relies largely on subjective screenin...BACKGROUND: Pain is a common and disabling symptom in multiple sclerosis (MS), yet its pathophysiological mechanisms remain poorly understood. Clinical assessment of neuropathic pain relies largely on subjective screening tools such as the DN4 questionnaire. This study aimed to characterize pain phenotype in MS using the DN4 score and to determine its relationship with objective neurophysiological markers of nociceptive and non-nociceptive pathway function assessed by laser-evoked (LEPs) and somatosensory evoked potentials (SEPs). METHODS: Fifty MS patients reporting pain underwent standardized clinical evaluation, including DN4, pain intensity (VAS), fatigue (FSMC), anxiety and depression (HADS), and disability (EDSS). LEPs were recorded after laser stimulation of the hand and foot dorsum, and SEPs following median and tibial nerve stimulation. Neurophysiological parameters were compared between patients with DN4 <4 and ≥4. Logistic regression, non-parametric group comparisons, and correlation analyses were performed. RESULTS: Neuropathic pain phenotype (DN4 ≥4) was identified in 56% of patients. DN4 showed moderate correlation with pain intensity and fatigue, and weakly with anxiety, but showed no significant association with LEPs or SEPs. Logistic regression confirmed that no neurophysiological measure independently predicted DN4 ≥4 status. LEP and SEP abnormalities were not significantly correlated, suggesting dissociated involvement of nociceptive and large-fiber pathways. CONCLUSION: In MS, DN4-defined pain phenotype reflects subjective symptom burden rather than objective sensory pathway dysfunction. Its limited correlation with neurophysiological measures highlights pain's multidimensional nature in MS. LEPs and SEPs provide complementary mechanistic insights, supporting a multimodal, mechanism-oriented approach to pain assessment and management.
Mult Scler Relat Disord
· 2026 Jun · PMID 42263352
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BACKGROUND: Neurogenic bowel dysfunction is a frequent but often underrecognized problem in patients with multiple sclerosis (MS) and may contribute to disability and reduced quality of life. OBJECTIVE: The aim of this s...BACKGROUND: Neurogenic bowel dysfunction is a frequent but often underrecognized problem in patients with multiple sclerosis (MS) and may contribute to disability and reduced quality of life. OBJECTIVE: The aim of this study was to determine the prevalence and severity of bowel dysfunction in patients with MS using the validated Neurogenic Bowel Dysfunction (NBD) score and to evaluate its associations with urinary dysfunction, anxiety, depression, fatigue, cognitive function, sleep quality, and quality of life. METHODS: Patients aged ≥18 years with MS who fulfilled the 2017 revised McDonald criteria were included. This cross-sectional study prospectively collected questionnaire and clinical assessment data, while CSF findings were retrospectively obtained from patient records. Neurogenic bowel dysfunction was assessed using the NBD score. Clinical and psychosocial parameters were evaluated using validated questionnaires. Neurological disability was assessed with the EDSS. RESULTS: A total of 107 patients with MS were included. The mean NBD score was 4.56 ± 5.68, and most patients had very minor bowel dysfunction. Higher NBD scores were significantly associated with older age, higher disability level, urinary symptoms, fatigue severity, and lower physical quality-of-life scores. No significant associations were found with disease duration, anxiety, depression, cognitive function, sleep quality, or the mental health component of quality of life. Patients with progressive MS had significantly higher NBD scores than the relapsing-remitting MS group. CONCLUSION: Neurogenic bowel dysfunction is common in patients with MS, even at mild levels, and is associated with disability, urinary symptoms, fatigue, and reduced physical quality of life. These findings suggest that bowel dysfunction reflects multisystem involvement and should be routinely assessed in the clinical evaluation of patients with MS.
Mohsen E, Haffez H, Ahmed S
… +2 more, Hamed S, El-Mahdy TS
Mult Scler Relat Disord
· 2026 Jun · PMID 42259160
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INTRODUCTION: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the CNS that results from complex interactions between the peripheral and the central immune systems through proinflammatory cytoki...INTRODUCTION: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the CNS that results from complex interactions between the peripheral and the central immune systems through proinflammatory cytokine secretion. AIMS: The present study aimed to 1: estimate the associated risk of single nucleotide polymorphisms (SNPs) in genes regulating the immune responses, namely, Toll like receptor 3 (TLR3), TLR7, and Suppressor of cytokine signaling 3 (SOCS3), with MS incidence, 2: correlate the SNPs frequencies with some patient demographics. MATERIALS AND METHODS: A total of 192 MS patients and 60 healthy controls were recruited. TLR3 (rs3775291), TLR7 (rs3853839), and SOCS3 (rs201763454) SNPs were assayed using the TaqMan genotyping assay. RESULTS: The CT genotype of rs3775291 significantly protects against MS incidence (OR (95% CI) 0.3632 (0.19-0.66), P = 0.001), while the GA genotype of rs201763454 is associated with disease progression. TLR3 rs3775291 wild genotype, higher relapse frequency, IgG index elevation, and male sex were significantly associated with increased expanded disability status scale (EDSS) at disease onset. CONCLUSION: The TLR3 rs3775291 SNP can confer protection against developing MS, whereas the SOCS3 rs201763454 SNP is associated with the progressive form of the disease. Higher relapse frequency, IgG index, and male sex were significantly associated with greater disability.
Zanghì A, Di Filippo PS, Rutigliano C
… +3 more, Moretti MC, Avolio C, D'Amico E
Mult Scler Relat Disord
· 2026 May · PMID 42259159
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BACKGROUND: Subcutaneous (SC) ocrelizumab offers a streamlined alternative to intravenous (IV) infusion in the management of multiple sclerosis (MS). Building on time-and-motion (T&M) methodologies validated in oncology,...BACKGROUND: Subcutaneous (SC) ocrelizumab offers a streamlined alternative to intravenous (IV) infusion in the management of multiple sclerosis (MS). Building on time-and-motion (T&M) methodologies validated in oncology, we conducted a single-center operational study to quantify procedure-level time savings, estimate the resulting care-time dividend, and assess changes in patient flow following SC implementation. METHODS: We employed a cross-sectional observational design in a five-chair day hospital treating ∼600 patients with MS treated with infusive therapies. T&M data were collected for 15 IV ocrelizumab administrations (April 2025) and 15 SC administrations (November 2025), capturing active clinical time across four phases: premedication, administration, observation, and checkout. Service-flow metrics (monthly visit volume, mean waiting time) were extracted from the electronic queue system for May 2025 (early SC implementation) and November 2025 (mature SC adoption). A deterministic operational model projected capacity gains under different SC adoption scenarios. RESULTS: SC ocrelizumab reduced total active clinical time from 320 to 60 min (-81%), driven by administration (210→10 min) and observation (60→15 min) reductions. At 15 SC administrations/month, this translated into 65 clinical hours and 50 chair-hours released-equivalent to 14 IV-equivalent infusion slots. Despite unchanged ocrelizumab volumes, monthly visits increased (+7.9%) and mean waiting time decreased (-30%) from May to November 2025. Scenario modeling projected 100-133 chair-hours released at 30-40 SC administrations/month. CONCLUSIONS: Transitioning from IV to SC ocrelizumab yields substantial procedural efficiencies and frees infusion-unit capacity. The care-time dividend enables expanded access to complex therapies without additional staff or infrastructure, positioning SC ocrelizumab as a structural efficiency tool in MS care.
Tregaskis-Daniels E, Adan HM, Jacobs B
… +2 more, Funston G, Dobson R
Mult Scler Relat Disord
· 2026 May · PMID 42250514
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BACKGROUND AND AIM: Evidence has highlighted the prodromal phase of multiple sclerosis (MS), reflected in increased healthcare usage, hospital admissions and prescriptions. Despite increasing interest in the role of infe...BACKGROUND AND AIM: Evidence has highlighted the prodromal phase of multiple sclerosis (MS), reflected in increased healthcare usage, hospital admissions and prescriptions. Despite increasing interest in the role of infections in MS susceptibility and severity, infections in the prodrome have not been systematically reviewed. We examined how infections are defined and measured within the MS prodrome and synthesised existing evidence. METHODS: We conducted a systematic review of studies investigating infection-related events in the 10 years preceding MS onset. RESULTS: 3523 papers were screened; 40 papers underwent full-text review with eight studies meeting inclusion criteria. MS case definitions varied, ranging from a single diagnostic code to neurologist-confirmed diagnoses. Most papers (75%) examined a five-year period prior to diagnosis. Findings were heterogeneous. One study reported higher self-reported upper respiratory tract infections, while UK and French healthcare data showed increased rates of cystitis and urinary tract infections in people with subsequent MS (P< 0.05). Some infections were less frequent in the MS cohort (e.g., tonsillitis). Higher infection-related healthcare usage was observed in a Canadian administrative cohort compared with controls, whereas no significant differences were found in a clinically defined cohort. CONCLUSION: Differences in how cases are defined, including criteria for the prodrome and infections, limit comparability across studies. While some evidence suggests increased infections prior to MS onset, findings are inconsistent. We highlight the need for further investigation including across MS subtypes and more diverse populations.
Ruiz-Ortiz M, García-Cena C, Hernández-Ramírez R
… +5 more, Labiano-Fontcuberta A, Moreno-García S, Lapeña-Motilva J, Guzmán-Villamarín DE, Benito-León J
Mult Scler Relat Disord
· 2026 Jun · PMID 42250513
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BACKGROUND: Disability monitoring in multiple sclerosis (MS) relies on EDSS and MRI lesion metrics that are often insensitive to cognitive dysfunction and fatigue. OBJECTIVE: To test whether memory-guided saccade (MGS) p...BACKGROUND: Disability monitoring in multiple sclerosis (MS) relies on EDSS and MRI lesion metrics that are often insensitive to cognitive dysfunction and fatigue. OBJECTIVE: To test whether memory-guided saccade (MGS) performance relates to processing speed and fatigue independent of mood symptoms, EDSS, and MRI inflammatory activity. METHODS: Forty-four MS patients completed MGS eye tracking. Error types and Total Task Error Rate were related to the Symbol Digit Modalities Test (SDMT), fatigue impact, mood scales, EDSS, and MRI lesion measures (including 5-year new T2 lesions) using age- and sex-adjusted partial correlations with mood sensitivity analyses. RESULTS: Mean Total Task Error Rate was 21.5% (SD 20.6); delay errors predominated. Lower SDMT scores correlated with more delay errors (r = -0.47, p = 0.002) and higher Total Task Error Rate (r = -0.40, p = 0.008). Greater fatigue correlated with more omissions (r = 0.36, p = 0.018) and higher Total Task Error Rate (r = 0.35, p = 0.022). Associations persisted after mood adjustment. No relationships were observed with EDSS or new T2 lesions (all p > 0.1). CONCLUSIONS: Preliminary, exploratory associations were observed between MGS metrics and measures of processing speed and fatigue in MS, independent of EDSS and MRI lesion activity. These findings should be regarded as hypothesis-generating and support further investigation of MGS as a candidate functional digital biomarker in larger, prospective, controlled studies with longitudinal follow-up and test-retest reliability assessment.
Toman T, Svěráková A, Čapek V
… +15 more, Hanáková P, Němcová L, Píža R, Dostál O, Kašparová H, Ampapa R, Dvořáková L, Procházková L, Glombová M, Munzar P, Kočí P, Peřinová Z, Matek P, Kršek P, Libá Z
Mult Scler Relat Disord
· 2026 May · PMID 42248069
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BACKGROUND: Acquired demyelinating syndromes (ADS) include rare diagnoses of acute disseminated encephalomyelitis (ADEM), clinically isolated syndrome (CIS), multiple sclerosis (MS), neuromyelitis optica spectrum disorde...BACKGROUND: Acquired demyelinating syndromes (ADS) include rare diagnoses of acute disseminated encephalomyelitis (ADEM), clinically isolated syndrome (CIS), multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Their characteristics in the Czech children are currently unknown. OBJECTIVES: To identify the epidemiology, diagnosis, care management, and outcomes of Czech children with ADS. METHODS: Data from a two-year prospective national multicenter study were analyzed. The incidence was calculated for the Czech population (< 18 years of age) per 100,000 per year sourcing data from the Czech Statistical Office. RESULTS: Our study covered 84.1% of the population and included 81 patients. The overall incidence of pediatric ADS was 2.24/100,000 (95% confidence interval [CI] 1.76-2.79). In particular, POMS, CIS, ADEM, and NMOSD had an incidence of 1.19 (0.85-1.62); 0.7 (0.35-1.33); 0.32 (0.16-0.57); and 0.03 (0.0007-0.16), respectively. Myelin oligodendrocyte glycoprotein (MOG) antibodies were present in 19.8% of all patients. Age was associated with diagnoses, MOG antibodies and preceding infections. After the first ADS episode, 6.3% of the children remained severely affected. CONCLUSION: This first comprehensive analysis of pediatric ADS in the Czech Republic provided unique data on ADS incidence, identified a significant proportion of POMS, and highlighted challenges in diagnosis and care.
Gervasoni E, Torchio A, Bonilauri A
… +4 more, Corrini C, Sangiuliano Intra F, Baglio F, Cattaneo D
Mult Scler Relat Disord
· 2026 May · PMID 42248068
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BACKGROUND: Balance impairments are common in people with Multiple Sclerosis (PwMS), yet brain activity during ecologically valid balance tasks is poorly understood. OBJECTIVE: To compare hemodynamic responses and postur...BACKGROUND: Balance impairments are common in people with Multiple Sclerosis (PwMS), yet brain activity during ecologically valid balance tasks is poorly understood. OBJECTIVE: To compare hemodynamic responses and postural control between PwMS and healthy subjects(HS) during a task forcing a greater reliance on vestibular cues. METHODS: In this cross-sectional study, 18 PwMS (median[IQR] age: 44.0(17.5) years, EDSS: 2.0(1.0)) and 18 age-sex-matched HS underwent fNIRS recordings while standing on a foam with eyes closed. Oxy- and deoxyhemoglobin changes were recorded over frontal, occipital, and temporo-parietal cortices, while body sway Area was measured using a stabilometric platform. A linear mixed-effects model tested Group, Brodmann area(BA), hemisphere Side and body sway Area effects. RESULTS: PwMS showed greater sway than HS (1965.9[2027.8]mm²; 1306.7[572.2]mm², p=.04). A significant four-way interaction emerged between Group, BA, Side, and Area (F(df1,df2) =16.76,p<.0001; conditional-R²=0.89). HS exhibited larger responses than PwMS in bilateral BA40 (HS-PwMS; left:0.45±0.14 µM,p=.003; right:0.57±0.14 µM,p=.003), and BA21-22 (left:0.58±0.14 µM,p=.0002; right:0.45±0.14 µM, p=.003). Associations between sway Area and cortical activity were stronger in HS, with significant slopes in BA21-22, BA40 bilaterally and left BA18 (p<.01). CONCLUSIONS: Temporal-parietal activity is a key contributor to maintaining balance control. PwMS showed weaker hemodynamic responses in sensory-challenging conditions less associated to postural instability compared to HS, suggesting altered cortical involvement in balance control. TRIAL REGISTRY: Protocol code: 20190119. Date of ethical approval: 2020/10/19).
Sremec J, Košćak Lukač J, Raifi Z
… +4 more, Bačić Baronica K, Tomić Sremec N, Ruška B, Tomasović S
Mult Scler Relat Disord
· 2026 Jun · PMID 42248066
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BACKGROUND: Despite a significant advance in multiple sclerosis (MS) treatment, the lack of reliable and easily available prognostic biomarkers, even with serum NfL and GFAP now available, is more exposed than ever, as t...BACKGROUND: Despite a significant advance in multiple sclerosis (MS) treatment, the lack of reliable and easily available prognostic biomarkers, even with serum NfL and GFAP now available, is more exposed than ever, as they would enable tailoring the therapeutic approach to an individual. Since we earlier demonstrated a link between antinuclear antibodies (ANA) and soluble apoptotic factors sFas and sFasL, as well as between CXCL8 and CXCL10 chemokine levels and MS relapses, these analytes were deemed suitable for longitudinal assessment in this sense. MATERIALS AND METHODS: Forty-two people with MS (pwMS) were followed for a median of 68 months, and their initial ANA status, as well as concentrations of sFas, sFasL, CXCL8, CXCL10, and CCL20 were assessed in relation to relapses, disability accrual, and therapy usage during follow up. RESULTS: There are fewer pwMS who relapsed amongst those with positive ANA. These subjects had longer relapse-free survival, and lower hazard and odds ratio for relapse compared to ANA-negative pwMS. This was even more pronounced in pwMS with low initial sFasL concentrations, which correlated with higher annualized relapse rate, especially in ANA-negative subjects. CXCL8 concentrations point to a potentially promising sensitivity and specificity for future disability worsening. CONCLUSION: ANA presence, alone or in conjunction with sFasL concentrations, could potentially be developed into a prognostic biomarker in pwMS regarding disease activity, while same is true for CXCL8 regarding disability accrual. However, it should be noted that these are exploratory findings requiring external validation. Further studies, especially those with follow-up started at the time of diagnosis, are warranted.
Hamer R, Allan M, Skvarc D
… +12 more, Friedel E, Giles A, Kulkarni J, Neil J, Rajendran D, Shaw S, Caswell N, Fanning V, Marcon S, Butler E, Grech L, MINDS-MS research team
Mult Scler Relat Disord
· 2026 May · PMID 42241789
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BACKGROUND: Depression and anxiety are often undetected and untreated in individuals with multiple sclerosis (MS), despite a high prevalence of these conditions in this population. This study evaluated the clinical utili...BACKGROUND: Depression and anxiety are often undetected and untreated in individuals with multiple sclerosis (MS), despite a high prevalence of these conditions in this population. This study evaluated the clinical utility, diagnostic accuracy, and acceptability of depression and anxiety screeners and their integration into routine MS clinic appointments. METHODS: Participants with MS (N = 207; age M = 47.3 ± 12.7 years, 77.3% female) were enrolled in this cross-sectional study conducted at an MS clinic in Melbourne, Australia. Consenting participants completed the Patient Reported Questionnaire-9 (PHQ-9) and the Depression, Anxiety and Stress Scale-21 (DASS-21) via an electronic tablet in the clinic waiting room or online for telehealth appointments, and underwent a Structured Clinical Interview for DSM-5 major depressive disorder and generalised anxiety disorder. Sensitivity, specificity, internal consistency, and patient comfort were assessed. RESULTS: The PHQ-9 and DASS-21 depression subscales demonstrated excellent internal consistency (α=0.90-.93) and good diagnostic performance. For anxiety, DASS subscales showed moderate validity, with the stress subscale outperforming the anxiety subscale. Participants rated screening as highly acceptable (mean comfort score=7.7/10). CONCLUSIONS: Among people with MS, self-administered depression and anxiety screening tools are valid and acceptable for routine use at MS clinic appointments. Tablet and online survey administration provide scalable options for integrating mental health assessment into standard care.