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Article ; Online: Post-Stroke Depression in Older Adults: An Overview.

Masuccio, Fabio Giuseppe / Grange, Erica / Di Giovanni, Rachele / Rolla, Martina / Solaro, Claudio Marcello

2024 Volume 41, Issue 4, Page(s) 303–318

Abstract: Detailed data on post-stroke depression (PSD) in older adults are limited in spite of the high vulnerability of this population to stroke. In fact, PSD prevalence in older adults ranges from 16.0 to 43.9%; however, timing and instruments of evaluation ... ...

Abstract	Detailed data on post-stroke depression (PSD) in older adults are limited in spite of the high vulnerability of this population to stroke. In fact, PSD prevalence in older adults ranges from 16.0 to 43.9%; however, timing and instruments of evaluation often differ significantly across all available studies. The etiology, genetic and inflammatory factors, as well as structural brain alterations, are claimed as part of a multifaceted mechanism of action in PSD onset. Thus, the aim of this narrative review was to further elaborate on the prevalence, etiology, diagnosis, consequences and treatment of PSD in older adults. The consequences of PSD in older adults may be devastating, including a poor functional outcome after rehabilitation and lower medication adherence. In addition, lower quality of life and reduced social participation, higher risk of new stroke, rehospitalization, and mortality have been reported. In this scenario, treating PSD represents a crucial step to prevent these complications. Both pharmacological and non-pharmacological therapies are currently available. The pharmacological treatment utilizes antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TAs) and new multimodal antidepressants (NMAs). Non-pharmacological therapies include psychological interventions and non-invasive brain stimulation techniques, while excluding drug administration. In the general population experiencing PSD, SSRIs (sertraline in particular) are the most prescribed, whereas the combination of antidepressants and psychotherapy is underused. Furthermore, about one-third of patients do not receive treatment for PSD. In regard to older adults with PSD, the possibility of more adverse effects or contraindications to antidepressant prescription due to comorbidities may limit the therapeutic window. Although drugs such as citalopram, escitalopram, sertraline, venlafaxine, and vortioxetine are usually well tolerated by older patients with PSD, the few randomized controlled trials (RCTs) specifically considering older adults with PSD have been conducted with fluoxetine, fluvoxamine, reboxetine, citalopram and nortriptyline, often with very small patient samples. Furthermore, data regarding the results of non-pharmacological therapies are scarce. High-quality RCTs recruiting large samples of older adults are needed in order to better manage PSD in this population. In addition, adequate screening and diagnosis instruments, with reliable timing of evaluation, should be applied.
MeSH term(s)	Aged ; Humans ; Antidepressive Agents/therapeutic use ; Citalopram/therapeutic use ; Depression/complications ; Depression/drug therapy ; Depression/epidemiology ; Selective Serotonin Reuptake Inhibitors ; Sertraline/therapeutic use ; Randomized Controlled Trials as Topic
Chemical Substances	Antidepressive Agents ; Citalopram (0DHU5B8D6V) ; Selective Serotonin Reuptake Inhibitors ; Sertraline (QUC7NX6WMB)
Language	English
Publishing date	2024-02-23
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	1075770-3
ISSN	1179-1969 ; 1170-229X
ISSN (online)	1179-1969
ISSN	1170-229X
DOI	10.1007/s40266-024-01104-1
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Article ; Online: Refactory Trigeminal Neuralgia successfully treated by combination therapy (Pregabalin plus Lamotrigine).

Solaro, Claudio Marcello / Ferriero, Giorgio

Multiple sclerosis and related disorders

2018 Volume 25, Page(s) 165–166

Abstract: In MS patients (PwMS), paroxysmal symptoms (PS) are frequently reported and are often the cause of suffering. PS include Trigeminal Neuralgia (TN) that is the most widely recognized neurophatic pain syndrome. TN treatment primarily consists of ... ...

Abstract	In MS patients (PwMS), paroxysmal symptoms (PS) are frequently reported and are often the cause of suffering. PS include Trigeminal Neuralgia (TN) that is the most widely recognized neurophatic pain syndrome. TN treatment primarily consists of antiepileptic medications such as Carbamazepine (CBZ) and Lamotrigine (LTG). CBZ is reported to be not well tolerated by PwMS for its side effects that mimic an MS exacerbation. Pregabalin (PGB) was successfully used in treating paroxysmal symptoms in PwMS. We performed a prospective open-label pilot study of PGB in combination with LTG in a group of MS patients with TN to evaluate the efficacy and tolerability of the two medications in subjects who were no-responsive or intolerant to conventional treatment. The combination of PGB and LTG may prove effective in the treatment of TN in PwMS, at small dosages, along with the possibility of minimizing adverse effects, while significantly improving pain control.
MeSH term(s)	Aged ; Anticonvulsants/therapeutic use ; Drug Therapy, Combination/methods ; Female ; Humans ; Lamotrigine/therapeutic use ; Male ; Middle Aged ; Pregabalin/therapeutic use ; Treatment Outcome ; Trigeminal Neuralgia/drug therapy
Chemical Substances	Anticonvulsants ; Pregabalin (55JG375S6M) ; Lamotrigine (U3H27498KS)
Language	English
Publishing date	2018-07-27
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-0356
ISSN (online)	2211-0356
DOI	10.1016/j.msard.2018.07.027
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Article ; Online: The administration of the paper and electronic versions of the Manual Ability Measure-36 (MAM-36) and Fatigue Severity Scale (FSS) is equivalent in people with multiple sclerosis.

Tacchino, Andrea / Di Giovanni, Rachele / Grange, Erica / Spirito, Maria Marcella / Ponzio, Michela / Battaglia, Mario Alberto / Brichetto, Giampaolo / Solaro, Claudio Marcello

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2023 Volume 45, Issue 3, Page(s) 1155–1162

Abstract: Background: The mobile device diffusion has increasingly highlighted the opportunity to collect patient-reported outcomes (PROs) through electronic patient-reported outcomes measurements (ePROMs) during the clinical routine. Despite the ePROMs promises ... ...

Abstract	Background: The mobile device diffusion has increasingly highlighted the opportunity to collect patient-reported outcomes (PROs) through electronic patient-reported outcomes measurements (ePROMs) during the clinical routine. Despite the ePROMs promises and advantages, the equivalence when a PRO measure is moved from the original paper-and-pencil to the electronic version is still little investigated. This study aims at evaluating equivalence between PROMs and ePROMs self-administration in people with multiple sclerosis (PwMS); in addition, preference of self-administration type was evaluated. Methods: The Manual Ability Measure-36 (MAM-36) and Fatigue Severity Scale (FSS) were selected for the equivalence test. The app ABOUTCOME was developed through a user-centered design approach to administer the questionnaires on tablet. Both paper-and-pencil and electronic versions were randomly self-administered. Intrarater reliability between both versions was evaluated through the intraclass correlation coefficient (ICC, excellent for values ≥ 0.75). Results: Fifty PwMS (35 females) participated to the study (mean age: 54.7±11.0 years, disease course: 27 relapsing-remitting and 23 progressive; mean EDSS: 4.7±1.9; mean disease duration: 13.3±9.5 years). No statistically significant differences were found for the means total scores of MAM-36 (p = 0.61) and FSS (p = 0.78). The ICC value for MAM-36 and FSS was excellent (0.98 and 0.94, respectively). Most of participants preferred the tablet version (84%). Conclusion: The results of the study provide evidence about the equivalence between the paper-and-pencil and electronic versions of PROs administration. In addition, PwMS prefer electronic methods rather than paper because the information can be provided more efficiently and accurately. The results could be easily extended to other MS PROs.
MeSH term(s)	Female ; Humans ; Adult ; Middle Aged ; Aged ; Reproducibility of Results ; Multiple Sclerosis/diagnosis ; Multiple Sclerosis/complications ; Surveys and Questionnaires ; Fatigue/diagnosis ; Fatigue/etiology ; Tablets
Chemical Substances	Tablets
Language	English
Publishing date	2023-10-12
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-023-07103-1
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Zs.A 1877: Show issues

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Article ; Online: Exergames for balance dysfunction in neurological disability: a meta-analysis with meta-regression.

Prosperini, Luca / Tomassini, Valentina / Castelli, Letizia / Tacchino, Andrea / Brichetto, Giampaolo / Cattaneo, Davide / Solaro, Claudio Marcello

Journal of neurology

2020 Volume 268, Issue 9, Page(s) 3223–3237

Abstract: Objective: To evaluate systematically the efficacy of exergames for balance dysfunction in neurological conditions and to identify factors of exergaming protocols that may influence their effects.: Methods: We searched electronic databases for ... ...

Abstract	Objective: To evaluate systematically the efficacy of exergames for balance dysfunction in neurological conditions and to identify factors of exergaming protocols that may influence their effects. Methods: We searched electronic databases for randomized clinical trials investigating the effect of commercial exergames versus alternative interventions on balance dysfunction as assessed by standard clinical scales in adults with acquired neurological disabilities. Standardized mean differences (Hedge's g) were calculated with random-effects models. Subgroup analyses and meta-regression were run to explore potential modifiers of effect size. Results: Out of 106 screened articles, 41 fulfilled criteria for meta-analysis, with a total of 1223 patients included. Diseases under investigation were stroke, Parkinson's disease, multiple sclerosis, mild cognitive impairment or early Alzheimer's disease, traumatic brain injury, and myelopathy. The pooled effect size of exergames on balance was moderate (g = 0.43, p < 0.001), with higher frequency (number of sessions per week) associated with larger effect (β = 0.24, p = 0.01). There was no effect mediated by the overall duration of the intervention and intensity of a single session. The beneficial effect of exergames could be maintained for at least 4 weeks after discontinuation, but their retention effect was specifically explored in only 11 studies, thus requiring future investigation. Mild to moderate adverse events were reported in a minority of studies. We estimated a low risk of bias, mainly attributable to the lack of double-blindness and not reporting intention-to-treat analysis. Conclusions: The pooled evidence suggests that exergames improve balance dysfunction and are safe in several neurological conditions. The findings of high-frequency interventions associated with larger effect size, together with a possible sustained effect of exergaming, may guide treatment decisions and inform future research.
MeSH term(s)	Adult ; Bias ; Exercise ; Humans ; Nervous System Diseases/therapy ; Parkinson Disease
Language	English
Publishing date	2020-05-23
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	187050-6
ISSN	1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
ISSN (online)	1432-1459
ISSN	0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
DOI	10.1007/s00415-020-09918-w
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Article ; Online: Induction Versus Escalation in Multiple Sclerosis: A 10-Year Real World Study.

Prosperini, Luca / Mancinelli, Chiara Rosa / Solaro, Claudio Marcello / Nociti, Viviana / Haggiag, Shalom / Cordioli, Cinzia / De Giglio, Laura / De Rossi, Nicola / Galgani, Simonetta / Rasia, Sarah / Ruggieri, Serena / Tortorella, Carla / Capra, Ruggero / Mirabella, Massimiliano / Gasperini, Claudio

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics

2020 Volume 17, Issue 3, Page(s) 994–1004

Abstract: In this independent, multicenter, post-marketing study, we directly compare induction immunosuppression versus escalation strategies on the risk of reaching the disability milestone of Expanded Disability Status Scale (EDSS) ≥ 6.0 over 10 years in ... ...

Abstract	In this independent, multicenter, post-marketing study, we directly compare induction immunosuppression versus escalation strategies on the risk of reaching the disability milestone of Expanded Disability Status Scale (EDSS) ≥ 6.0 over 10 years in previously untreated patients with relapsing-remitting multiple sclerosis. We collected data of patients who started interferon beta (escalation) versus mitoxantrone or cyclophosphamide (induction) as initial treatment. Main eligibility criteria included an EDSS score ≤ 4.0 at treatment start and either ≥ 2 relapses or 1 disabling relapse with evidence of ≥ 1 gadolinium-enhancing lesion at magnetic resonance imaging scan in the pre-treatment year. Since patients were not randomized to treatment group, we performed a propensity score (PS)-based matching procedure to select individuals with homogeneous baseline characteristics. Comparisons were then conducted using Cox models stratified by matched pairs. Overall, 75 and 738 patients started with induction and escalation, respectively. Patients in the induction group were older and more disabled than those in the escalation group (p < 0.05). The PS-matching procedure retained 75 patients per group. In the re-sampled population, a lower proportion of patients reached the outcome after induction (21/75, 28.0%) than escalation (29/75, 38.7%) (hazard ratio = 0.48; p = 0.024). Considering the whole sample, serious adverse events occurred more frequently after induction (8/75, 10.7%) than escalation (18/738, 2.4%) (odds ratio = 3.36, p = 0.015). These findings suggest that, in patients with poor prognostic factors, induction was more effective than escalation in reducing the risk of reaching the disability milestone, albeit with a worse safety profile. Future studies are warranted to explore if newer induction agents may provide a more advantageous long-lasting risk:benefit profile.
MeSH term(s)	Adult ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/administration & dosage ; Male ; Multiple Sclerosis, Relapsing-Remitting/diagnosis ; Multiple Sclerosis, Relapsing-Remitting/drug therapy ; Multiple Sclerosis, Relapsing-Remitting/immunology ; Product Surveillance, Postmarketing/methods ; Remission Induction/methods ; Retrospective Studies ; Time Factors ; Young Adult
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2020-03-02
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Pragmatic Clinical Trial
ZDB-ID	2316693-9
ISSN	1878-7479 ; 1933-7213
ISSN (online)	1878-7479
ISSN	1933-7213
DOI	10.1007/s13311-020-00847-0
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Article ; Online: Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review.

Bressi, Federica / Cricenti, Laura / Campagnola, Benedetta / Bravi, Marco / Miccinilli, Sandra / Santacaterina, Fabio / Sterzi, Silvia / Straudi, Sofia / Agostini, Michela / Paci, Matteo / Casanova, Emanuela / Marino, Dario / La Rosa, Giuseppe / Giansanti, Daniele / Perrero, Luca / Battistini, Alberto / Filoni, Serena / Sicari, Monica / Petrozzino, Salvatore /

NeuroRehabilitation

2022 Volume 51, Issue 4, Page(s) 541–558

Abstract: Background: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has ... ...

Abstract	Background: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies. Objective: To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients. Methods: The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021. Results: Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes. Conclusion: Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation.
MeSH term(s)	Humans ; Stroke/complications ; Stroke/therapy ; Stroke Rehabilitation ; Activities of Daily Living ; Upper Extremity ; Cognition ; Recovery of Function
Language	English
Publishing date	2022-12-02
Publishing country	Netherlands
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1087912-2
ISSN	1878-6448 ; 1053-8135
ISSN (online)	1878-6448
ISSN	1053-8135
DOI	10.3233/NRE-220149
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Zs.A 3328: Show issues

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Article: Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review.

Morone, Giovanni / de Sire, Alessandro / Martino Cinnera, Alex / Paci, Matteo / Perrero, Luca / Invernizzi, Marco / Lippi, Lorenzo / Agostini, Michela / Aprile, Irene / Casanova, Emanuela / Marino, Dario / La Rosa, Giuseppe / Bressi, Federica / Sterzi, Silvia / Giansanti, Daniele / Battistini, Alberto / Miccinilli, Sandra / Filoni, Serena / Sicari, Monica /

Brain sciences

2021 Volume 11, Issue 12

Abstract: The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement ...

Abstract	The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.
Language	English
Publishing date	2021-12-10
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci11121630
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Article ; Online: Systematic review of guidelines to identify recommendations for upper limb robotic rehabilitation after stroke.

Morone, Giovanni / Palomba, Angela / Martino Cinnera, Alex / Agostini, Michela / Aprile, Irene / Arienti, Chiara / Paci, Matteo / Casanova, Emanuela / Marino, Dario / LA Rosa, Giuseppe / Bressi, Federica / Sterzi, Silvia / Gandolfi, Marialuisa / Giansanti, Daniele / Perrero, Luca / Battistini, Alberto / Miccinilli, Sandra / Filoni, Serena / Sicari, Monica /

European journal of physical and rehabilitation medicine

2021 Volume 57, Issue 2, Page(s) 238–245

Abstract: Introduction: Upper limb motor impairment is one of the most frequent stroke consequences. Robot therapy may represent a valid option for upper limb stroke rehabilitation, but there are still gaps between research evidence and their use in clinical ... ...

Abstract	Introduction: Upper limb motor impairment is one of the most frequent stroke consequences. Robot therapy may represent a valid option for upper limb stroke rehabilitation, but there are still gaps between research evidence and their use in clinical practice. The aim of this study was to determine the quality, scope, and consistency of guidelines clinical practice recommendations for upper limb robotic rehabilitation in stroke populations. Evidence acquisition: We searched for guideline recommendations on stroke published between January 1st, 2010 and January 1st, 2020. Only the most recent guidelines for writing group were selected. Electronic databases (N.=4), guideline repertories and professional rehabilitation networks (N.=12) were searched. We systematically reviewed and assessed guidelines containing recommendation statements about upper limb robotic rehabilitation for adults with stroke (PROSPERO registration number: CRD42020173386). Evidence synthesis: Four independent reviewers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, and textual syntheses were used to appraise and compare recommendations. From 1324 papers that were screened, eight eligible guidelines were identified from six different regions/countries. Half of the included guidelines focused on stroke management, the other half on stroke rehabilitation. Rehabilitation assisted by robotic devices is generally recommended to improve upper limb motor function and strength. The exact characteristics of patients who could benefit from this treatment as well as the correct timing to use it are not known. Conclusions: This systematic review has identified many opportunities to modernize and otherwise improve stroke patients' upper limb robotic therapy. Rehabilitation assisted by robot or electromechanical devices for stroke needs to be improved in clinical practice guidelines in particular in terms of applicability.
MeSH term(s)	Combined Modality Therapy ; Guidelines as Topic ; Humans ; Robotics/methods ; Stroke Rehabilitation/instrumentation ; Stroke Rehabilitation/methods ; Upper Extremity/physiopathology
Language	English
Publishing date	2021-01-25
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	2426908-6
ISSN	1973-9095 ; 1973-9087
ISSN (online)	1973-9095
ISSN	1973-9087
DOI	10.23736/S1973-9087.21.06625-9
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Article ; Online: Defining the course of tumefactive multiple sclerosis: A large retrospective multicentre study.

Di Gregorio, Maria / Torri Clerici, Valentina Liliana Adriana / Fenu, Giuseppe / Gaetani, Lorenzo / Gallo, Antonio / Cavalla, Paola / Ragonese, Paolo / Annovazzi, Pietro / Gajofatto, Alberto / Prosperini, Luca / Landi, Doriana / Nicoletti, Carolina Gabri / Di Carmine, Caterina / Totaro, Rocco / Nociti, Viviana / De Fino, Chiara / Ferraro, Diana / Tomassini, Valentina / Tortorella, Carla /

Righini, Isabella / Amato, Maria Pia / Manni, Alessia / Paolicelli, Damiano / Iaffaldano, Pietro / Lanzillo, Roberta / Moccia, Marcello / Buttari, Fabio / Fantozzi, Roberta / Cerqua, Raffaella / Zagaglia, Sara / Farina, Deborah / De Luca, Giovanna / Buscarinu, Maria Chiara / Pinardi, Federica / Cocco, Eleonora / Gasperini, Claudio / Solaro, Claudio Marcello / Di Filippo, Massimiliano

European journal of neurology

2021 Volume 28, Issue 4, Page(s) 1299–1307

Abstract: Background and purpose: Tumefactive multiple sclerosis (TuMS) (i.e., MS onset presenting with tumefactive demyelinating lesions [TDLs]) is a diagnostic and therapeutic challenge. We performed a multicentre retrospective study to describe the clinical ... ...

Abstract	Background and purpose: Tumefactive multiple sclerosis (TuMS) (i.e., MS onset presenting with tumefactive demyelinating lesions [TDLs]) is a diagnostic and therapeutic challenge. We performed a multicentre retrospective study to describe the clinical characteristics and the prognostic factors of TuMS. Methods: One hundred two TuMS patients were included in this retrospective study. Demographic, clinical, magnetic resonance imaging (MRI), laboratory data and treatment choices were collected. Results: TuMS was found to affect women more than men (female:male: 2.4), with a young adulthood onset (median age: 29.5 years, range: 11-68 years, interquartile range [IQR]: 38 years). At onset, 52% of TuMS patients presented with the involvement of more than one functional system and 24.5% of them with multiple TDLs. TDLs most frequently presented with an infiltrative MRI pattern (38.7%). Cerebrospinal fluid immunoglobulin G oligoclonal bands were often demonstrated (76.6%). In 25.3% of the cases, more than one acute-phase treatment was administered, and almost one-half of the patients (46.6%) were treated with high-efficacy treatments. After a median follow-up of 2.3 years (range: 0.1-10.7 years, IQR: 3.4 years), the median Expanded Disability Status Scale (EDSS) score was 1.5 (range: 0-7, IQR: 2). Independent risk factors for reaching an EDSS score ≥3 were a higher age at onset (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.03-1.14, p < 0.01), a higher number of TDLs (OR: 1.67, 95% CI: 1.02-2.74, p < 0.05) and the presence of infiltrative TDLs (OR: 3.34, 95% CI: 1.18-9.5, p < 0.001) at baseline. Conclusions: The management of TuMS might be challenging because of its peculiar characteristics. Large prospective studies could help to define the clinical characteristics and the best treatment algorithms for people with TuMS.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Demyelinating Diseases ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multiple Sclerosis/diagnostic imaging ; Oligoclonal Bands ; Prospective Studies ; Retrospective Studies ; Young Adult
Chemical Substances	Oligoclonal Bands
Language	English
Publishing date	2021-01-12
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1280785-0
ISSN	1468-1331 ; 1351-5101 ; 1471-0552
ISSN (online)	1468-1331
ISSN	1351-5101 ; 1471-0552
DOI	10.1111/ene.14672
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Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito