How to read the entries: The summaries are produced with AI support from the abstracts and machine-translated; they can contain errors. The original source is always what counts. “Evidence” is an automatic rating of the body of research (high, medium, low), not a treatment verdict. Preprints have not yet been peer reviewed. This is not medical advice: always discuss treatment decisions with your neurologist.
This page shows the entries translated so far (30 of 30). The complete list is on the German page.
Autologous Hematopoietic Transplantation Reduces Brain Inflammatory and Axoglial Damage Biomarkers in Multiple Sclerosis.
A study examined the effects of autologous hematopoietic stem cell transplantation (AHSCT) in 24 participants with severe multiple sclerosis. Over several years, AHSCT led to reduced expression of many pro-inflammatory cytokines, chemokines and neuroinflammatory markers, including neurofilament light chain (NfL), in serum and cerebrospinal fluid. In contrast, cerebrospinal fluid levels of glial fibrillary acidic protein and IL-7 rose after treatment. The results suggest that AHSCT produces long-lasting reductions in markers of inflammation and axo-glial damage, consistent with sustained disease quiescence. The weak correlation between serum and cerebrospinal fluid biomarkers suggests that these samples reflect different immunological processes.
Optimizing the Use of Anti-CD20 Agents in Multiple Sclerosis and Other Autoimmune Central Nervous System Disorders: A Narrative Review.
Anti-CD20 antibodies are core treatments in multiple sclerosis (MS) and other autoimmune diseases of the central nervous system, but cumulative exposure is associated with higher infection risk and hypogammaglobulinemia. Observational studies in MS suggest that extended-interval dosing (EID) of ocrelizumab and rituximab can maintain short-term clinical and radiological disease control in selected stable patients, while potentially reducing the drop in immunoglobulins and improving vaccine response. However, the available evidence is heterogeneous and largely based on retrospective real-world cohorts. In NMOSD, individualized re-infusion strategies might improve the balance between efficacy and safety, while prospective randomized trials to define the safest and most effective dosing approaches are still lacking overall.
Challenging historical associations and reassuring women: an updated meta-analysis of multiple sclerosis relapse risk following assisted reproductive technology.
An updated meta-analysis examined the influence of assisted reproductive technology (ART) on relapse risk in women with multiple sclerosis (MS). The analysis of twelve studies, including four nationwide cohorts, found no significantly increased relapse risk due to ART (95% CI 0.85-1.39). No increased risk was found either in women who were not on disease-modifying therapy during fertility treatment. Women who became pregnant after ART had significantly fewer relapses (aRR 0.50), while an unsuccessful ART attempt showed a non-significant trend towards higher relapse risk. In two studies, ART was not associated with an increased risk of developing MS de novo.
Management of Multiple Sclerosis: Incorporating Recent Advances in Pathophysiology and Diagnosis to Guide Treatment Strategies.
Multiple sclerosis (MS) is a chronic disease for which more than 20 disease-modifying therapies (DMTs) are available. Advances in diagnostic criteria, biomarker development and understanding of the disease enable new individualized treatment strategies. The 2024 McDonald diagnostic criteria broaden the biological definition of MS by including advanced MRI biomarkers, which can support earlier diagnosis and treatment. Aging affects disease pathobiology and the benefit-risk balance of treatment, with implications for treatment initiation, sequencing and discontinuation. New imaging and fluid biomarkers such as neurofilament light chain and GFAP could improve therapeutic decision-making but need further validation.
Infection Risk During Rituximab Therapy in Multiple Sclerosis: Effect of Dosing Interval and Age.
A nationwide observational study in Norway with 3,410 people with MS examined infection risk during rituximab therapy depending on dosing interval and age. Extended rituximab intervals (1 or 2 infusions per 2 years) were associated with a lower risk of any infection than 4 infusions per 2 years. A reduced risk of infections treated in hospital was seen only with one infusion per 2 years, but was not robust in sensitivity analyses. Patients aged 60 and older had a significantly higher risk of infections treated in hospital. The results support cautious interval extension and careful weighing of benefits and risks in older patients.
Risk of infection in ocrelizumab-treated adults with multiple sclerosis aged 55 years and older: a retrospective cohort study.
A retrospective cohort study examined infection risk in 1,600 adults with multiple sclerosis (MS) aged 55 and older, who were either treated with ocrelizumab (800 people) or not exposed to any B-cell-depleting therapy (800 people). Ocrelizumab was associated with a higher rate of infection-related hospital admissions (IRR 1.67; 95% CI 1.15-2.43; p = 0.008) and with a higher infection rate overall (IRR 1.42; 95% CI 1.20-1.68; p < 0.001). In total, 429 infection-related hospital admissions and 4,538 infections were observed; female sex was associated with a higher infection risk (IRR 1.36), mainly due to urinary tract infections.
Living the Masterclass: Multiple Sclerosis Patient Journeys and the Reality of Participatory Medicine.
This reflective article, written by four people with multiple sclerosis (MS) and a representative of the Society for Participatory Medicine, describes experiences from diagnosis to an "optimal life" with the disease. The authors stress how much it matters how a diagnosis is delivered, and finding a suitable doctor who is not only competent but also communicates respectfully. They present an expanded concept of the care team that includes complementary specialists and a personal network alongside medical professionals. The article gives practical advice for people newly diagnosed: take an active part in treatment, build a broad support system, and protect personal decisions that give life meaning.
Bridging Gaps in the Multidimensional Assessment and Management of Overlapping Symptoms in Multiple Sclerosis and Functional Motor Disorders: Prevalence and Rehabilitation Effectiveness
This multicenter prospective study aims to improve the identification, characterization and management of overlapping functional motor disorders (FMD) and multiple sclerosis (MS). Part A is an observational study intended to estimate the prevalence of FMD-MS overlap in 192 adults with MS at two Italian centers. Part B is a randomized pilot study examining the feasibility, safety and preliminary efficacy of an FMD-specific rehabilitation program compared with conventional MS rehabilitation in about 26 participants. The study is meant to provide prospective evidence on the frequency and clinical profile of FMD-MS overlap and preliminary evidence on the effectiveness of a mechanism-specific rehabilitation approach.
Efficacy of Cognitive Behavioral Therapy for Insomnia to Treat Insomnia Symptoms in Individuals With Multiple Sclerosis
In people with multiple sclerosis (MS), the incidence of insomnia is estimated at up to 90%, as insomnia is often underdiagnosed. Sleep problems in people with MS are linked to reduced cognitive performance, physical function, mental well-being and quality of life, and to a higher prevalence of fatigue, pain, depression and anxiety. This study aims to determine how well cognitive behavioral therapy for insomnia (CBT-I) improves insomnia symptoms, fatigue and health-related quality of life in people with MS compared with an active control group. It also aims to identify characteristics that predict improvement in sleep outcomes.
A Study of Orelabrutinib in Patients With Secondary Progressive Multiple Sclerosis
This global phase 3 trial examines the efficacy and safety of orelabrutinib, a CNS-penetrant BTK inhibitor, compared with placebo in people with non-active secondary progressive multiple sclerosis (SPMS). About 990 participants will be treated for 24 to 60 months, with a minimum treatment duration of 12 months. The trial is randomized, double-blind and multicenter.
A Study of Orelabrutinib in Patients With Primary Progressive Multiple Sclerosis
This phase 3 trial examines the efficacy and safety of orelabrutinib, a CNS-penetrant BTK inhibitor, in people with primary progressive multiple sclerosis (PPMS). It is a randomized, double-blind, multicenter trial with about 705 participants worldwide. Patients are treated for 30 to 60 months, with a minimum treatment duration of 12 months. Allocation to orelabrutinib or placebo is 2:1.
A Blood-Based Synaptic Biomarker in Neuronally-Enriched Extracellular Vesicles Predicts Disability Progression in Progressive Multiple Sclerosis
An investigation measured synaptopodin, a postsynaptic protein, in neuronally enriched extracellular vesicles (NEVs) in people with progressive multiple sclerosis (PMS) in two independent cohorts (n=184 and n=268). A higher synaptopodin level at baseline was associated with an approximately 32% lower risk of confirmed disability progression in PMS (p=0.011), with the strongest effect in secondary progressive MS (SPMS; about 57% lower odds, p=0.019). This association in SPMS was replicated in a validation cohort (about 60% lower odds, p=0.009). Higher baseline synaptopodin was also linked to slower future whole-brain atrophy and preserved microstructural integrity on MRI metrics (p=0.007-0.013). Unlike NfL, NEV synaptopodin was associated with confirmed disability progression in PMS participants (HR 0.71 vs 1.12, p=0.007 vs 0.22), identifying NEV synaptopodin as a prognostic and longitudinal blood biomarker of synaptic integrity in PMS, especially SPMS, that complements NfL.
Glucagon-Like Peptide-1 Receptor Agonists in Multiple Sclerosis: A Topical Narrative Review.
This narrative review looks at glucagon-like peptide-1 (GLP-1) receptor agonists in the context of multiple sclerosis. GLP-1 receptor agonists are drugs originally approved to treat type 2 diabetes and obesity. Because people with MS often have comorbidities for which GLP-1 receptor agonists are indicated, they are increasingly taken by people with MS. The review examines the use of these drugs for weight loss in people with MS, their efficacy in approved non-MS indications, and possible pleiotropic effects on the course of MS. It also discusses tolerability and safety of the drugs in people with MS.
Multiple sclerosis and housing insecurity or forcible displacement: A scoping review.
A scoping review examined the situation of people with multiple sclerosis (MS) who are affected by housing insecurity or forced displacement. The number of reports on people with MS in these situations is very small compared with the estimated total number. Among US veterans, homelessness was not significantly more common in those with MS than in matched veterans without MS. Refugees with MS often face unaffordable care, and armed conflict can lead to more relapses and MRI activity as well as interruptions in MS care. The global geographic coverage of these reports is limited, and more data are needed to understand the risks and improve humanitarian care.
Precision cognitive neurorehabilitation: dose, adaptivity, digital therapeutics and implementation.
This review article addresses cognitive deficits that cause long-term impairment in multiple sclerosis and other neurological conditions. Although cognitive neurorehabilitation has an evidence base, its implementation is heterogeneous and the therapeutic parameters are poorly defined. The authors emphasize the importance of dose, frequency, adaptivity, personalization, and digital and technology-assisted interventions. Methodological challenges include heterogeneous protocols and insufficient long-term follow-up. Precision-guided approaches and large pragmatic trials are needed to move the field forward.
Spinal cord imaging in multiple sclerosis: from diagnosis to disease progression.
Involvement of the spinal cord in multiple sclerosis (MS) is common and an important driver of long-term disability. A review summarizes the current understanding of spinal cord involvement in MS, including advances in pathophysiology, imaging and clinical use. It describes characteristic MRI features of MS spinal cord lesions and their role in diagnosis, particularly in light of the 2024 revisions to the McDonald criteria. It highlights the prognostic significance of spinal cord lesions and atrophy, including their link to progression-independent relapse activity. The review also discusses current MRI acquisition strategies and consensus guidelines as well as new quantitative and advanced imaging techniques.
Sleep in caregivers of people with multiple sclerosis: A scoping review.
A scoping review examined sleep in family caregivers of people with multiple sclerosis (MS) and included eight studies. The prevalence of self-reported sleep problems among MS caregivers ranged from 38.6% to 72.1%. In four studies, MS caregivers reported significantly more sleep difficulties than control groups without caregiving duties. Poor sleep quality was linked to higher levels of anxiety and depression. The studies used almost exclusively subjective measures of sleep, and sleep was rarely studied as a primary outcome, so future research is needed to characterize sleep in MS caregivers comprehensively.
Targeting Residual Activity By Precision, Biomarker-Guided Combination Therapies of Multiple Sclerosis (TRAP-MS)
A study is investigating whether signs of inflammation in the cerebrospinal fluid (CSF) can predict how people with multiple sclerosis (MS) respond to different drugs. It explores whether four drugs, given alone or in combination, affect MS biomarkers. People aged 18 and older with progressive MS who already take an MS drug and meet certain mobility criteria can take part. Participants receive one or two study drugs for up to 18 months and are examined twice a year for up to 6 years, including lumbar punctures.
A Study to Evaluate the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of RO7268489 as Add-on Therapy to Ocrelizumab, in Participants With Progressive Forms of Multiple Sclerosis (MS)
This study examines the efficacy of RO7268489 as add-on therapy to ocrelizumab in adults with progressive forms of multiple sclerosis (PMS). The main goal is to assess the effectiveness of this combination. After the double-blind phase ends, eligible participants have the option of an open-label extension study.
Effect of Corticosteroids on Inflammation at the Edge of Acute Multiple Sclerosis Plaques
This randomized trial examines whether short-term high-dose corticosteroid treatment affects the healing of ring-enhancing MS lesions when there are no signs of an MS relapse. Participants are adults aged 18 and older with MS and such a lesion who are already enrolled in another NINDS protocol. Patients are randomly assigned either to no treatment or to a three-day course of corticosteroids (intravenous or oral). Follow-up takes place at 13 and 25 weeks with neurological examinations and MRIs.
Prospective validation of an uncertainty-aware machine learning model for secondary progressive multiple sclerosis classification
A study prospectively evaluated a conformal prediction (CP) model for reproducing clinician-recorded disease course classifications in multiple sclerosis. The model was trained on data from 10,787 people (SMSReg-2022) and validated on 15,719 people (SMSReg-2025). At the level of hospital visits, the model reached accuracies of 92% for RRMS and 95% for SPMS. At the individual level, it showed a sensitivity of 98%, a specificity of 89% and an F1 score of 0.75. Compared with the Lorscheider criteria, the model had higher sensitivity (98% vs. 71%) and a higher F1 score (0.76 vs. 0.69).
Disentangling Age-Related and Disease-Specific Effects on Upper Cervical Cord Area in Patients With Multiple Sclerosis.
This multicenter cross-sectional study examined the upper cervical cord area in 1,295 people with MS and 480 healthy controls. MS-related atrophy of the upper spinal cord exceeded age-related effects, especially in the fifth and sixth decades of life. This disease-specific atrophy was independent of sex. Greater upper spinal cord atrophy correlated with a higher degree of disability and poorer structural MRI measures. The results support the role of upper spinal cord atrophy as a sensitive biomarker of MS-related neurodegeneration.
Multiple sclerosis occurrence with gut microbial metabolites and sex hormones.
This review article looks at the role of gut microbiome metabolites and sex hormones in multiple sclerosis (MS). It describes how specific microbial products influence the immune system, the blood-brain barrier and glial cells. The work also addresses sex differences in MS, including the higher prevalence in women and the more progressive course in men. Based on preclinical and clinical findings from pregnancy, menopause and hormone replacement therapy, it discusses the immunomodulatory, neuroprotective and remyelinating activities of estrogens, progesterone and androgens. The article introduces the concept of the "microgenderome", which describes the interaction between hormones and gut microbiota.
Relaxation interventions in neurological rehabilitation: a scoping review.
A scoping review examined relaxation interventions in neurological rehabilitation and included 63 sources. Relaxation interventions were most often studied in people with multiple sclerosis and stroke. They are generally described as feasible and well accepted, and are often adapted to specific functional needs. The outcomes focused mainly on psychological functions. The authors point to research gaps, such as limited studies in less common conditions and a lack of comparative effectiveness studies.
Beyond Histamine Blockade: Clemastine Fumarate as a Promoter of Myelin Regeneration, Inflammatory Regulation, and Neuroimmune Modulation in CNS Disorders.
This review article examines clemastine fumarate, an antihistamine, as a potential agent for promoting myelin regeneration, regulating inflammation and neuroimmune modulation in diseases of the central nervous system. Experimental studies suggest that clemastine could promote remyelination and reduce neuroinflammation, as observed in animal models of multiple sclerosis and other neurological diseases. For multiple sclerosis, there are first clinical studies that showed modest remyelinating activity, while the evidence for other conditions is mainly preclinical. Challenges include dose optimization, long-term safety and side effects such as sedation. Use beyond multiple sclerosis is still being explored and requires further studies.
Artificial Intelligence for Gadolinium-Sparing Detection of Active Multiple Sclerosis Lesions: A Structured Narrative Review.
This structured narrative review examined the use of artificial intelligence (AI) to detect active MS lesions without gadolinium contrast agent, because of concerns about its deposition and cost. The studies analyzed showed a sensitivity of 72% to 100% and a specificity of 66% to 96% compared with the gadolinium standard. Common limitations were the lack of prospective validation and insufficient assessment of generalizability. The authors conclude that AI-based approaches are feasible but not yet sufficient to replace contrast-enhanced MRI in routine clinical practice. A possible short-term role could be triage, to identify low-risk examinations in which gadolinium can be avoided.
From danger to resolution: targeting purinergic signaling in CNS diseases.
This review article examines purinergic signaling pathways in the central nervous system (CNS), which regulate immune responses, resolution of inflammation and tissue repair. Dysregulation of these pathways is linked to multiple sclerosis and other neurological diseases. Therapeutic strategies targeting purinergic receptors such as A2AR and P2X7 show promising clinical potential for immune modulation and neuroprotection. The authors see new routes to precise immunotherapies for neurological disorders.
Chimeric antigen receptor T cell therapy in autoimmune neurological disease: current status of efficacy and safety.
This scoping review examined 19 clinical studies of CAR-T cell therapy in autoimmune neurological diseases. The therapy showed promising but still preliminary results in multiple sclerosis, while efficacy in myasthenia gravis and neuromyelitis optica spectrum disorder was more consistent. The safety profile was more favorable than in cancer use, but cytopenias, infections and hypogammaglobulinemia remain clinically important. Follow-up was mostly limited to under two years, and the current evidence rests on small, largely uncontrolled studies. Well-powered, longer-term controlled trials are needed before any broader recommendation.
Deconstructing the microbiota-gut-brain axis in multiple sclerosis: from a barrier-immune-metabolic framework to emerging therapeutics.
This narrative review examines the role of the gut microbiota in the pathogenesis of multiple sclerosis (MS) via the gut-brain axis. Dysbiosis of the gut microbiota in MS is linked to impaired gut barrier function, immune dysregulation and altered metabolism. Microbial metabolites such as short-chain fatty acids play an important role as molecular mediators. Although microbiome-targeted interventions show promising therapeutic potential, causal relationships are not yet fully clarified, and further mechanistic validation and well-controlled human studies are needed. The evidence is currently largely associative.
Melatonin supplementation in multiple sclerosis: a systematic review of clinical, imaging, biomarker, and safety outcomes.
A systematic review examined the efficacy and safety of oral melatonin in adults with multiple sclerosis (MS), covering 10 studies with 435 participants. The evidence showed no reduction in relapse activity, disability progression or new MRI activity. Smaller studies suggested possible improvements in sleep, fatigue, pain and other symptoms, but these findings were inconsistent and rarely replicated. Doses of 0.5-25 mg/day were generally well tolerated, but at 300 mg/day three of four participants developed elevated liver transaminases, indicating a significant liver risk at high doses. The current evidence does not support a disease-modifying effect of melatonin in MS, and the certainty of the evidence was low or very low for all outcomes examined.