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Increasing Neurofilament and Glial Fibrillary Acidic Protein After Treatment Discontinuation Predicts Multiple Sclerosis Disease Activity
In this study, sNfL and sGFAP levels in stable patients were evaluated before and after treatment discontinuation to determine association with disease activity. Methods This observational study included patients enrolled in the Comprehensive Longitudinal Investigation in MS at the Brigham and Women's Hospital who discontinued treatment after >2 years disease activity–free. Two serum samples within 2 years, before and after treatment stop, were sent for sNfL and sGFAP measurements by single-molecule array. Biannual neurologic examinations and yearly MRI scans determined disease activity by 3 time-to-event outcome...
Source: Neurology Neuroimmunology and Neuroinflammation - October 9, 2023 Category: Neurology Authors: Bose, G., Healy, B. C., Saxena, S., Saleh, F., Glanz, B. I., Bakshi, R., Weiner, H. L., Chitnis, T. Tags: MRI, Multiple sclerosis, Cohort studies Research Article Source Type: research

Multiple Sclerosis, Disease-Modifying Therapies, and Infections
Discussion Patients with MS have higher risks of outpatient and serious infections compared with patients without MS. The risk of outpatient infections was similarly increased by rituximab and fingolimod and serious infections by rituximab and natalizumab compared with IFN/GLAT. Steps to minimize risks include optimizing bladder care, comorbidity prevention, varicella vaccination, and considering discontinuing or avoiding DMT use in patients with advanced disability and/or previous hospitalizations for infections. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - October 9, 2023 Category: Neurology Authors: Langer-Gould, A. M., Smith, J. B., Gonzales, E. G., Piehl, F., Li, B. H. Tags: Multiple sclerosis Research Article Source Type: research

Natalizumab Treatment Induces Proinflammatory CD4 T Cells Preferentially in the Integrin {beta}7+ Compartment
Discussion Our study shows that circulating integrin β7+ memory CD4 T cells of patients with relapsing-remitting MS under natalizumab are enriched in proinflammatory cells supporting the hypothesis that integrin β7+ memory CD4 T cells could play a pathogenic role in the disease rebound observed at natalizumab discontinuation. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - September 22, 2023 Category: Neurology Authors: Nguyen Ky, M., Duran, A., Hasantari, I., Bru, A., Deloire, M., Brochet, B., Ruet, A., Schmitt, N. Tags: All Immunology, Multiple sclerosis Research Article Source Type: research

Prevalence, Clinical Profiles, and Prognosis of Stiff-Person Syndrome in a Japanese Nationwide Survey
This study provides the current epidemiologic and clinical status of SPS in Japan. The symptom onset to the diagnosis of SPS was longer in patients with high-titer GAD65 antibodies than in those with low-titer GAD65 antibodies. The outcome of patients with SPS was generally favorable, but more aggressive immunotherapies are necessary for GAD65-positive patients with SPS. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - September 22, 2023 Category: Neurology Authors: Matsui, N., Tanaka, K., Ishida, M., Yamamoto, Y., Matsubara, Y., Saika, R., Iizuka, T., Nakamura, K., Kuriyama, N., Matsui, M., Arisawa, K., Nakamura, Y., Kaji, R., Kuwabara, S., Izumi, Y., for the Japanese SPS Study Tags: Autoimmune diseases, Clinical neurology examination, Cohort studies, Prevalence studies Research Article Source Type: research

mRNA COVID-19 Vaccination Does Not Exacerbate Symptoms or Trigger Neural Antibody Responses in Multiple Sclerosis
In this study, mRNA COVID-19 vaccination was safe and did not exacerbate the autoimmune disease nor triggered neural autoantibodies or immune-mediated neurologic disorders. The outcome of patients who developed SARS-CoV-2 infection was favorable. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - September 7, 2023 Category: Neurology Authors: Blanco, Y., Escudero, D., Lleixa, C., Llufriu, S., Egri, N., Garcia, R. R., Alba, M., Aguilar, E., Artola, M., Aldea Novo, M., Alvarez, S., Caballero, E., Cabrera-Maqueda, J. M., Fonseca, E., Guasp, M., Hernando, A., Martinez-Hernandez, E., Olive-Cirera, Tags: All Immunology, Autoimmune diseases, COVID-19, Multiple sclerosis Research Article Source Type: research

A 28-Year-Old Woman With Left-Sided Weakness and Atypical MRI Lesions: From the National Multiple Sclerosis Society Case Conference Proceedings
A 28-year-old woman presented with subacute relapsing left-sided weakness. MRI demonstrated both enhancing C3-C6 and nonenhancing T2-T4 lesions. Initial provisional diagnosis was inflammatory/autoimmune. Her left-sided weakness progressed despite immunosuppressive therapies. We reassessed our original suspected diagnosis because of an atypical clinicoradiologic course, leading to biopsy and a definitive diagnosis. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - September 6, 2023 Category: Neurology Authors: Safadi, A. L., Osborne, B., Chitnis, T., Graves, J. S., Newsome, S. D., Zamvil, S. S., Solomon, I. H., Shin, R. K. Tags: All Immunology, Spinal cord tumor, All Spinal Cord, All Demyelinating disease (CNS), Transverse myelitis Diagnostic [amp ] Treatment Challenges Source Type: research

Peptides From the Variable Domain of Immunoglobulin G as Biomarkers in Chronic Inflammatory Demyelinating Polyradiculoneuropathy
This study provides Class III evidence that the pattern of serum IgG-derived peptide clusters may help differentiate between patients with CIDP and those with other peripheral neuropathies. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - August 28, 2023 Category: Neurology Authors: Godelaine, J., Chitale, Y., De Moor, B., Mathieu, C., Ancheva, L., Van Damme, P., Claeys, K. G., Bossuyt, X., Carpentier, S., Poesen, K. Tags: Autoimmune diseases, Peripheral neuropathy, Chronic inflammatory demyelinating polyneuropathy, Class III Research Article Source Type: research

Immunotherapy-Responsive Neuropathic Pain and Allodynia in a Patient With Glycine Receptor Autoantibodies: A Case Report
We describe the case of a previously well adult presenting with severe neuropathic pain and allodynia as part of an autoimmune brainstem and spinal syndrome with glycine receptor autoantibodies. Results Our patient experienced a severe illness, including marked neuropathic pain and allodynia, hypoventilation, tetraparesis, and ophthalmoplegia. A diagnosis of progressive encephalomyelitis with rigidity and myoclonus was made. Neuropathic pain was characterized with validated instruments and responded promptly to cause-directed immunotherapy. Discussion A detailed longitudinal phenotyping, using validated pain measurement ...
Source: Neurology Neuroimmunology and Neuroinflammation - August 28, 2023 Category: Neurology Authors: Soleimani, B., Board, C., Yu, T., Tracey, I., Irani, S. R., Foley, P. Tags: Autoimmune diseases, All Clinical Neurology, Central pain, Neuropathic pain Clinical/Scientific Note Source Type: research

Kappa Free Light Chain Index Predicts Disease Course in Clinically and Radiologically Isolated Syndromes
This study provides evidence that the K-index predicts new T2L in CIS and RIS but also clinical attack in patients with CIS. We suggest adding the K-index in the further MS diagnosis criteria revisions as a dissemination-in-time biomarker. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - August 28, 2023 Category: Neurology Authors: Levraut, M., Gavoille, A., Landes-Chateau, C., Cohen, M., Bresch, S., Seitz-Polski, B., Mondot, L., Lebrun-Frenay, C. Tags: All Immunology, Prognosis, Cerebrospinal Fluid, Multiple sclerosis, Cohort studies Research Article Source Type: research

SARS-CoV-2-Specific Immune Responses in Patients With Postviral Syndrome After Suspected COVID-19
Discussion Antibody and T-cell assays showed evidence of prior SARS-CoV-2 exposure in approximately 40% of the PVS group. Three-quarters of patients with PVS+ had detectable anti-Nucleocapsid and one-half anti-Spike responses, highlighting the importance of multitargeted COVID-19 immunologic evaluation and the limitations of commercially available diagnostic tests. Despite their persistent symptoms, lack of COVID-19 diagnosis likely delayed clinical care in patients with PVS. Our data suggest that millions of Americans presenting with PVS resembling Neuro-PASC were indeed exposed to SARS-CoV-2 at the beginning of the pande...
Source: Neurology Neuroimmunology and Neuroinflammation - August 23, 2023 Category: Neurology Authors: Orban, Z. S., Visvabharathy, L., Perez Giraldo, G. S., Jimenez, M., Koralnik, I. J. Tags: All Immunology, Post-infectious, COVID-19 Research Article Source Type: research

Trigeminal Nerve Involvement in Bulbar-Onset Anti-IgLON5 Disease
We report 2 cases of atypical trigeminal neuropathy in bulbar-onset IgLON5-D. Methods Trigeminal nerve involvement was assessed using comprehensive clinical, laboratory, electrophysiologic, and MRI workup. Results Both patients were referred for progressive dysphagia, sialorrhea, and hoarseness. They were treated with bilevel positive airway pressure for nocturnal hypoventilation. Patient 1 complained of continuous facial burning pain with allodynia, exacerbated by mastication and prolonged speech. Patient 2 reported no facial pain. Anti-IgLON5 autoantibodies (IgLON5-Abs) were positive in serum for both patients and CSF ...
Source: Neurology Neuroimmunology and Neuroinflammation - August 22, 2023 Category: Neurology Authors: Cluse, F., Hermier, M., Demarquay, G., Rogemond, V., Mallaret, M., Svahn, J., Pegat, A., Honnorat, J., Bernard, E. Tags: MRI, Autoimmune diseases, Anterior nerve cell disease, Trigeminal neuralgia, All clinical neurophysiology Clinical/Scientific Note Source Type: research

Cenobamate and Clobazam Combination as Personalized Medicine in Autoimmune-Associated Epilepsy With Anti-Gad65 Antibodies
Discussion Treatment with the combination CNB + CLB could be a type of personalized medicine in patients with AAE with anti-GAD65. Our preliminary data will need to be endorsed with new prospective and controlled studies. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - August 22, 2023 Category: Neurology Authors: Serrano-Castro, P. J., Rodriguez-Uranga, J. J., Cabezudo-Garcia, P., Garcia-Martin, G., Romero-Godoy, J., Estivill-Torrus, G., Ciano-Petersen, N. L., Oliver, B., Ortega-Pinazo, J., Lopez-Moreno, Y., Aguilar-Castillo, M. J., Gutierrez-Cardo, A. L., Ramirez Tags: Autoimmune diseases, All Epilepsy/Seizures, Antiepileptic drugs Research Article Source Type: research

Efficacy of Rituximab Outlasts B-Cell Repopulation in Multiple Sclerosis: Time to Rethink Dosing?
Discussion The efficacy of RTX outlasted substantial reconstitution of circulating B cells in PwMS, which suggests that renewal of the immune system underlies the prolonged effect of RTX in MS. These findings suggest that extended interval dosing of RTX that leads to a significant reconstitution of circulating B cells is safe in PwMS, could reduce the risk of infection, and could improve vaccine efficacy. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - August 21, 2023 Category: Neurology Authors: Claverie, R., Perriguey, M., Rico, A., Boutiere, C., Demortiere, S., Durozard, P., Hilezian, F., Dubrou, C., Vely, F., Pelletier, J., Audoin, B., Maarouf, A. Tags: All Clinical Neurology, Multiple sclerosis Research Article Source Type: research

Electrolyte Imbalance in Anti-LGI1 Encephalitis: It Is Not All in Your Head
Discussion Hyponatremia in patients with anti-LGI1 antibody encephalitis is due to SIADH as previously assumed. Other electrolyte abnormalities such as hypomagnesemia and hypophosphatemia occur in at least 40% of patients and may be another clue for the diagnosis of anti-LGI1 antibody encephalitis. Because we failed to demonstrate LGI1 expression in the kidney, the results of our study suggest that renal losses lead to these disturbances, most probably due to SIADH. (Source: Neurology Neuroimmunology and Neuroinflammation)
Source: Neurology Neuroimmunology and Neuroinflammation - August 17, 2023 Category: Neurology Authors: Gadoth, A., Nisnboym Ziv, M., Alcalay, Y., Zubkov, A., Schwartz, I., Schwartz, D., Abboud, M., Rubinek, T., Yossepowitch, O., Weinstein, T. Tags: All Immunology, Autoimmune diseases, All Clinical Neurology, All Epilepsy/Seizures Research Article Source Type: research

Visual System Involvement in Glial Fibrillary Acidic Protein Astrocytopathy: Two Case Reports and a Systematic Literature Review
We describe 2 cases of GFAP astrocytopathy with predominant visual symptoms and present a systematic review of the literature. Methods We describe 2 patients with GFAP astrocytopathy from our neurology department. We performed a systematic review of the literature according to PRISMA guidelines, including all patients with this disease and available clinical data, focusing on visual involvement. Results Patient 1 presented with bilateral optic disc edema and severe sudden bilateral loss of vision poorly responsive to therapy. Patient 2 showed bilateral optic disc edema, headache, and mild visual loss with complete recove...
Source: Neurology Neuroimmunology and Neuroinflammation - August 15, 2023 Category: Neurology Authors: Greco, G., Masciocchi, S., Diamanti, L., Bini, P., Vegezzi, E., Marchioni, E., Colombo, E., Rigoni, E., Businaro, P., Ferraro, O. E., Bianchi Marzoli, S., Bergamaschi, R., Franciotta, D., Gastaldi, M. Tags: All Neuro-ophthalmology, Optic nerve, Visual loss, All Demyelinating disease (CNS), Optic neuritis; see Neuro-ophthalmology/Optic Nerve Research Article Source Type: research