Perceived pain during isometric exercise and neuromuscular fatigability in individuals with multiple sclerosis.

Impact of a short-term stress management protocol on physiologic biofeedback measures of stress and mood in people with multiple sclerosis.

Theory of mind in multiple sclerosis: Three-month follow-up effects after double-blind tDCS and video-training, a pilot study.

Polypharmacy prevalence, associated factors, and changes over time in Australians with multiple sclerosis.

Revealing the clinical significance of PASAT rejection in multiple sclerosis: Insights from patient-reported and clinician-assessed outcomes.

Safe to stay: A longitudinal evaluation of the sequential relationship between psychological safety, work self-efficacy, fatigue, and employment exit intentions of employees with multiple sclerosis.

Biological age may better capture differences in disease course among people with multiple sclerosis (PwMS) of identical chronological age. We investigated biological age acceleration through metabolomic age (mAge) in PwMS and its association with social determinants of health (SDoH) measured by area deprivation index (ADI). mAge was calculated for two cohorts: 323 PwMS and 66 healthy controls (HCs); 101 HCs and 71 DMT-naïve PwMS, using an aging clock derived from 11,977 healthy adults. mAge acceleration, the difference between mAge and chronological age, was compared between groups using generalized linear and mixed-effects models, and its association with ADI was assessed via linear regression. Estimated mAge showed a modest correlation with chronological age (R2≈0.20-0.25). Cross-sectionally, PwMS had higher age acceleration than HCs: 9.77 years in adult PwMS (95% CI: 6.57-12.97, p = 5.3e-09), and 4.90 years in adult DMT-naïve PwMS (95% CI: 0.85-9.01, p = 0.02). Longitudinally, PwMS aged 1.19 mAge years per chronological year (95% CI: 0.18-2.20; p = 0.02), faster than HCs. In PwMS, a 10-percentile increase in ADI was associated with a 0.63-year (95% CI: 0.10-1.18; p = 0.02) increase in age acceleration. We demonstrated accelerated mAge in PwMS and its association with social disadvantage.

Information processing speed (IPS) is a core cognitive deficit in people with multiple sclerosis (PwMS). Previous efforts have associated IPS performance to frontal regions, but were constrained by limited temporal resolution. In this work, we employed a data-driven method, the time delay embedded-hidden Markov model (TDE-HMM), to identify task-specific states that are spectrally defined with distinct temporal and spatial profiles. We used magnetoencephalographic (MEG) data recorded while healthy controls and PwMS performed a cognitive task designed to capture IPS, the Symbol Digit Modalities Test (SDMT). The TDE-HMM identified five task-relevant states, supporting a tri-factor contribution to IPS: sensory speed (occipital visual detection and processing), cognitive speed (prefrontal executive and frontoparietal attention shift), and motor speed (sensorimotor). We observed reduced prefrontal activation in PwMS, while peak features across prefrontal, frontoparietal, and occipital networks were associated with task reaction time and clinical SDMT performance. This work can drive future research for MS treatments targeting IPS improvements.

Using cognitive testing to predict employment status in multiple sclerosis: A comparative study of the SDMT and a computerized cognitive assessment tool.

Background/Objectives: Multiple sclerosis (MS)-related optic neuritis (ON) results in thinning of the peripapillary nerve fiber layer (pRNFL) which tends to be temporal quadrant-predominant. Optical coherence tomography angiography (OCTA) enables visualization of the retinal vasculature. Prior studies have shown reduced peripapillary vessel density (VD) in MS but data on the quadrantic pattern of peripapillary VD loss are limited. Our objective was to investigate the pattern of OCTA-derived peripapillary VD reduction in MS. Methods: People with MS (PwMS) and healthy controls (HC) underwent optic disc OCTA scans (Solix, Optovue) and VD was derived for the peripapillary region and quadrants. Eyes with ON within six months were excluded. Analyses were performed with generalized estimating equations models and standardized coefficients are presented. Results: We included 50 eyes from 29 PwMS (12 ON, 38 non-ON) and 12 eyes from 6 HC. VD in the peripapillary region was lower in MS ON eyes compared to HC with the largest effect size observed in the temporal quadrant (average: -1.47, p < 0.001; superior: -1.08, p = 0.006; inferior: -0.94; p = 0.017; temporal: -1.55; p < 0.001; nasal: -1.06, p = 0.007). In MS non-ON eyes, only temporal VD was significantly lower compared to HC eyes (temporal: -0.77, p = 0.004). Moderate to strong correlations were observed between OCT and corresponding OCTA metrics from the same regions. Conclusions: Our findings suggest that vascular alterations in the peripapillary region may exhibit a temporal quadrant predominant pattern. Larger studies are needed to further characterize the patterns and temporal evolution of retinal peripapillary vascular injury in MS.

Prevalence and factors associated with polypharmacy among people with multiple sclerosis (PwMS) receiving outpatient rehabilitation: A cross-sectional study.

Neurocognitive outcomes in older adults with multiple sclerosis: Evidence from a cross-sectional cohort.

The effects of trunk rehabilitation on balance, gait, falls, and community mobility in patients with multiple sclerosis: A single-blind randomized controlled trial.

Description of automatic-voluntary dissociation of breathing in multiple sclerosis.

Psychological resilience as a mediator between depression and health-related quality of life in relapsing-remitting multiple sclerosis patients.

Dual-tasking is an emerging topic of study within the field of multiple sclerosis (MS) rehabilitation. Past research on dual-task performance among people with MS (PwMS) is limited by methodological differences and minimal consideration of underlying neurophysiology. Related studies suggest that changes in inhibitory neural activity in the motor cortex may support dual-task performance in healthy adults, as assessed using transcranial magnetic stimulation (TMS). Other TMS work indicates that MS alters corticospinal inhibition, but how and whether it is modulated during dual-tasking in PwMS is unknown. The objective of this exploratory, cross-sectional small-N study was to explore whether changes in corticospinal inhibition that occur during dual-tasking may be different in PwMS compared to non-MS controls. Six PwMS (4F; 45.17 ± 15.74 years) and three non-MS controls (2F; 42.33 ± 16.62 years) performed motor and cognitive tasks under single- and dual-task conditions. Each dual-task included a core motor task, which involved maintaining a steady pinch grip force. Performance of this core motor task allowed for assessment of corticospinal inhibition during task performance via measurement of the cortical silent period elicited by TMS. Tasks combined with the core motor task included holding a string of numbers and/or number letter combinations in working memory and a toe-tapping task. Several versions of the tasks were presented alongside the core motor task, each providing different levels of novelty and complexity. Dual-task performance was measured as dual-task cost, considering task performance and cortical silent period duration. Analyses included descriptive statistics and, in line with a small-N study design, examination of individual data. There was no evidence of greater cognitive-motor interference in PwMS relative to non-MS controls. Task novelty and complexity effects between PwMS and non-MS controls were similar. Despite behavioral similarities, PwMS displayed greater changes in cortical silent period under dual-task conditions compared to non-MS controls that were accentuated under motor-motor dual-task conditions. Findings suggest that while PwMS and non-MS controls may perform similarly during dual-tasking, the neurophysiological mechanisms involved may be different. Further work is needed to elucidate the impact of MS-related changes in the corticospinal system on dual-tasking.

Quality of Life, Self-Reported Cognitive Difficulties, and Performance-Based Cognitive Problems in Multiple Sclerosis: What's Sleep Got to Do With It?

Depending on the methodology used, the prevalence of restless legs syndrome (RLS) in people with multiple sclerosis (PwMS) ranges from 13 to 65%. This study aimed to evaluate the prevalence of RLS in PwMS using a case-control design, with each case confirmed by a sleep disorder specialist. Prevalence of RLS was analyzed in a hospital cohort of 440 PwMS and 241 age- and sex-matched control subjects. Cases were identified through two interviews. First, participants answered to a structured questionnaire, and second, those who met the criteria for any cardinal RLS symptoms were interviewed by a sleep disorder specialist to confirm the diagnosis. Multivariate regression was used to analyze the clinical and radiological characteristics of MS associated with RLS. Of the 86 PwMS who tested positive for RLS using the questionnaire, 67 were diagnosed by a sleep specialist, corresponding to a prevalence of 15.23% (95% CI 11.80-19.34) compared to 19.55% (95% CI 15.63-24.14) based solely on the questionnaire (false positive: 22.09%). PwMS were twice as likely to suffer from this syndrome as the control group (OR 2.148, 95% CI 1.218-3.788, p = 0.008). Family history of RLS (OR 5.291, 95% CI 2.407-11.629, p < 0.0001) and pyramidal tract involvement (OR 4.208 95% CI 1.940-9.128, p < 0.0001) were the only factors associated with RLS. PwMS are twice as likely to develop RLS as the general population. Pyramidal tract involvement appears to be a risk factor for developing RLS in this disease.

Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder that is frequently associated with psychiatric comorbidities, particularly obsessive-compulsive disorder (OCD). OCD may increase psychological burden, reduce quality of life, and exacerbate disease activity in people with MS (PwMS). However, the frequency of OCD in PwMS and its association with MS remain mostly uncertain. This review aimed to estimate the overall prevalence of OCD in PwMS and to evaluate the association between MS and OCD. A comprehensive search of PubMed, Scopus, Embase, and Web of Science was conducted up to January 2025 to identify studies that assessed the frequency rate of OCD in PwMS or explored the relationship between MS and OCD. The meta-analysis was performed using a random-effects model in R version 4.4.0. Ten studies on 1024 PwMS and 172 healthy controls met the inclusion criteria. The pooled prevalence of OCD among PwMS was 10.7% (95% CI: 5.6% to 15.9%, I2 = 67%). Meta-analysis on three studies indicated that the odds of OCD was significantly increased in PwMS (OR = 3.25, 95% CI: 1.13 to 9.36, p-value = 0.03). Although moderate to high heterogeneity was observed, sensitivity analyses confirmed the robustness of the results, and no significant evidence of publication bias was identified. This review indicated that the overall frequency 10.7% of OCD increased risk (3.2-fold) of OCD among PwMS. Screening and targeted interventions for OCD may enhance clinical outcomes and quality of life of PwMS.

ABSTRACT Introduction Information processing speed (IPS) is frequently impaired in people with multiple sclerosis (PwMS) and can potentially interfere with functioning in other cognitive domains. A relationship between IPS and visuospatial memory has been shown, but the impact of IPS on the separate components of visuospatial memory remains unclear. In this study, we aim to investigate the association between IPS impairment and encoding, active and passive retrieval, and learning indices of visuospatial memory in PwMS. Methods Cross-sectional data from 92 PwMS with cognitive complaints and 29 matched healthy controls (HCs) were retrospectively analyzed. IPS and visuospatial memory were measured using the Symbol Digit Modalities Test (SDMT) and the Brief Visuospatial Memory Test – Revised (BVMT-R), respectively. Hierarchical regression analyses were performed to assess the predictive value of IPS impairment (z-score ≤-1.5) for visuospatial encoding, active and passive retrieval, as well as learning indices scores. Results In total, 47.8% of PwMS were impaired on the SDMT. IPS impairment significantly predicted lower performance on the second (ß = −0.26, p = 0.011) and third (ß = −0.29, p = 0.003) learning trials, active retrieval (ß = −0.33, p < 0.001), and learning index (ß = −0.28, p = 0.003) of the BVMT-R in PwMS. No significant association was found between IPS impairment and the initial learning and passive retrieval scores. In HCs, no association between IPS and BVMT-R performance was found. Conclusion PwMS with IPS impairment perform worse on visuospatial learning and memory, particularly in the later encoding phases and active retrieval of information. These findings highlight the importance of taking IPS impairment into account when interpreting visuospatial memory performance in MS.