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1. The effect of air pollution on COVID‐19 severity in a sample of patients with multiple sclerosis

Author: Bergamaschi, Roberto, Ponzano, Marta, Schiavetti, Irene, Carmisciano, Luca, Cordioli, Cinzia, Filippi, Massimo, Radaelli, Marta, Immovilli, Paolo, Capobianco, Marco, De Rossi, Nicola, Brichetto, Giampaolo, Cocco, Eleonora, Scandellari, Cinzia, Cavalla, Paola, Pesci, Ilaria, Zito, Antonio, Confalonieri, Paolo, Marfia, Girolama Alessandra, Perini, Paola, Inglese, Matilde, Trojano, Maria, Brescia Morra, Vincenzo, Pisoni, Enrico, Tedeschi, Gioacchino, Comi, Giancarlo, Battaglia, Mario Alberto, Patti, Francesco, Salvetti, Marco, Sormani, Maria Pia, Gianmarco Abbadessa, Umberto Aguglia, Lia Allegorico, Rossi Beatrice Maria Allegri, Anastasia Alteno, Maria Pia Amato, Pietro Annovazzi, Carlo Antozzi, Lucia Appendino, Sebastiano Arena, Viola Baione, Roberto Balgera, Valeria Barcella, Damiano Baroncini, Caterina Barrilà, Mario A Battaglia, Alessandra Bellacosa, Gianmarco Bellucci, Roberto Bergamaschi, Valeria Bergamaschi, Daiana Bezzini, Beatrice Biolzi, Alvino Bisecco, Simona Bonavita, Giovanna Borriello, Chiara Bosa, Antonio Bosco, Francesca Bovis, Marco Bozzali, Laura Brambilla, Morra Vincenzo Brescia, Giampaolo Brichetto, Maria Buccafusca, Elisabetta Bucciantini, Sebastiano Bucello, Maria Chiara Buscarinu, Maria Paola Cabboi, Massimiliano Calabrese, Francesca Calabria, Francesca Caleri, Federico Camilli, Luisa Maria Caniatti, Roberto Cantello, Marco Capobianco, Ruggero Capra, Rocco Capuano, Luca Carmisciano, Patrizia Carta, Paola Cavalla, Maria Grazia Celani, Maria Cellerino, Raffaella Cerqua, Clara Chisari, Raffaella Clerici, Marinella Clerico, Eleonora Cocco, Gaia Cola, Giancarlo Comi, Paolo Confalonieri, Antonella Conte, Marta Zaffira Conti, Christian Cordano, Susanna Cordera, Cinzia Cordioli, Francesco Corea, Claudio Correale, Salvatore Cottone, Francesco Crescenzo, Erica Curti, Alessandro d'Ambrosio, Emanuele D'Amico, Maura Chiara Danni, Alessia d'Arma, Vincenzo Dattola, Stefano de Biase, Giovanna De Luca, Stefania Federica De Mercanti, Paolo De Mitri, Nicola De Rossi, Nicola De Stefano, Cava Marco Della, Mario di Napoli, Alessia Di Sapio, Renato Docimo, Anna Dutto, Luana Evangelista, Salvatore Fanara, Diana Ferraro, Maria Teresa Ferrò, Massimo Filippi, Cristina Fioretti, Mario Fratta, Jessica Frau, Marzia Fronza, Roberto Furlan, Alberto Gajofatto, Antonio Gallo, Paolo Gallo, Claudio Gasperini, Anna Ghazaryan, Bruno Giometto, Francesca Gobbin, Flora Govone, Franco Granella, Erica Grange, Maria Grazia Grasso, Angelica Guareschi, Clara Guaschino, Simone Guerrieri, Donata Guidetti, Pietro Iaffaldano, Antonio Ianniello, Luigi Iasevoli, Paolo Immovilli, Daniele Imperiale, Maria Teresa Infante, Matilde Inglese, Rosa Iodice, Aniello Iovino, Giovanna Konrad, Doriana Landi, Roberta Lanzillo, Caterina Lapucci, Luigi Lavorgna, Maria Rita L'Episcopo, Serena Leva, Giuseppe Liberatore, Re Marianna Lo, Marco Longoni, Leonardo Lopiano, Lorena Lorefice, Matteo Lucchini, Giacomo Lus, Davide Maimone, Maria Malentacchi, Giulia Mallucci, Simona Malucchi, Chiara Rosa Mancinelli, Luca Mancinelli, Paolo Manganotti, Giorgia Teresa Maniscalco, Vittorio Mantero, Sabrina Marangoni, Damiano Marastoni, Girolama Alessandra Marfia, Fabiana Marinelli, Alessandro Marti, Boneschi Filippo Martinelli, Zoli Federco Masserano, Francesca Matta, Laura Mendozzi, Giuseppe Meucci, Silvia Miante, Giuseppina Miele, Eva Milano, Massimiliano Mirabella, Rosanna Missione, Marcello Moccia, Lucia Moiola, Sara Montepietra, Margherita MontiBragadin, Federico Montini, Roberta Motta, Raffaele Nardone, Carolina Gabri Nicoletti, Eduardo Nobile-Orazio, Agostino Nozzolillo, Marco Onofrj, Riccardo Orlandi, Anna Palmieri, Damiano Paolicelli, Livia Pasquali, Luisa Pastò, Francesco Patti, Elisabetta Pedrazzoli, Paola Perini, Ilaria Pesci, Maria Petracca, Alfredo Petrone, Carlo Piantadosi, Anna M Pietroboni, Federica Pinardi, Marta Ponzano, Emilio Portaccio, Mattia Pozzato, Carlo Pozzilli, Luca Prosperini, Alessandra Protti, Marta Radaelli, Paolo Ragonese, Sarah Rasia, Sabrina Realmuto, Anna Repice, Eleonora Rigoni, Maria Teresa Rilla, Francesca Rinaldi, Calogero Marcello Romano, Marco Ronzoni, Marco Rovaris, Francesca Ruscica, Loredana Sabattini, Giuseppe Salemi, Marco Salvetti, Lorenzo Saraceno, Alessia Sartori, Arianna Sartori, Elvira Sbragia, Cinzia Scandellari, Giuditta Ilaria Scarano, Valentina Scarano, Irene Schiavetti, Maria Sessa, Caterina Sgarito, Grazia Sibilia, Gabriele Siciliano, Alessio Signori, Elisabetta Signoriello, Leonardo Sinisi, Francesca Sireci, Patrizia Sola, Claudio Solaro, Maria Pia Sormani, Stefano Sotgiu, Maddalena Sparaco, Maria Laura Stromillo, Silvia Strumia, Emanuela Laura Susani, Giulietta Tabiadon, Francesco Teatini, Gioacchino Tedeschi, Valentina Tomassini, Simone Tonietti, Clerici Valentina Torri, Carla Tortorella, Simona Toscano, Rocco Totaro, Maria Trojano, Maria Trotta, Gabriella Turano, Monica Ulivelli, Manzo Valentino, Giovanna Vaula, Domizia Vecchio, Marco Vercellino, Elena Pinuccia Verrengia, Marika Vianello, Eleonora Virgilio, Francesca Vitetta, Stefano Vollaro, Mauro Zaffaroni, Mauro Zampolini, Ignazio Roberto Zarbo, Antonio Zito, Luigi Zuliani, Bergamaschi, R, Ponzano, M, Schiavetti, I, Carmisciano, L, Cordioli, C, Filippi, M, Radaelli, M, Immovilli, P, Capobianco, M, De Rossi, N, Brichetto, G, Cocco, E, Scandellari, C, Cavalla, P, Pesci, I, Zito, A, Confalonieri, P, Marfia, Ga, Perini, P, Inglese, M, Trojano, M, Brescia Morra, V, Pisoni, E, Tedeschi, G, Comi, G, Battaglia, Ma, Patti, F, Salvetti, M, Sormani, Mp, Abbadessa, Gianmarco, Umberto, Aguglia, Lia, Allegorico, Rossi Beatrice Maria Allegri, Anastasia, Alteno, Maria Pia Amato, Pietro, Annovazzi, Carlo, Antozzi, Lucia, Appendino, Sebastiano, Arena, Viola, Baione, Roberto, Balgera, Valeria, Barcella, Damiano, Baroncini, Caterina, Barrilà, Mario, A Battaglia, Alessandra, Bellacosa, Gianmarco, Bellucci, Roberto, Bergamaschi, Valeria, Bergamaschi, Daiana, Bezzini, Beatrice, Biolzi, Bisecco, Alvino, Bonavita, Simona, Giovanna, Borriello, Chiara, Bosa, Bosco, Antonio, Francesca, Bovi, Marco, Bozzali, Laura, Brambilla, Morra Vincenzo Brescia, Giampaolo, Brichetto, Maria, Buccafusca, Elisabetta, Bucciantini, Sebastiano, Bucello, Maria Chiara Buscarinu, Maria Paola Cabboi, Massimiliano, Calabrese, Francesca, Calabria, Francesca, Caleri, Federico, Camilli, Luisa Maria Caniatti, Roberto, Cantello, Marco, Capobianco, Ruggero, Capra, Capuano, Rocco, Luca, Carmisciano, Patrizia, Carta, Paola, Cavalla, Maria Grazia Celani, Maria, Cellerino, Raffaella, Cerqua, Clara, Chisari, Raffaella, Clerici, Marinella, Clerico, Eleonora, Cocco, Gaia, Cola, Giancarlo, Comi, Paolo, Confalonieri, Antonella, Conte, Marta Zaffira Conti, Christian, Cordano, Susanna, Cordera, Cinzia, Cordioli, Corea, Francesco, Claudio, Correale, Salvatore, Cottone, Francesco, Crescenzo, Erica, Curti, Alessandro, D'Ambrosio, Emanuele, D'Amico, Maura Chiara Danni, Alessia, D'Arma, Vincenzo, Dattola, Stefano de Biase, Giovanna De Luca, Stefania Federica De Mercanti, Paolo De Mitri, Nicola De Rossi, Nicola De Stefano, Cava Marco Della, Mario di Napoli, Alessia Di Sapio, Docimo, Renato, Anna, Dutto, Luana, Evangelista, Salvatore, Fanara, Diana, Ferraro, Maria Teresa Ferrò, Massimo, Filippi, Cristina, Fioretti, Fratta, Mario, Jessica, Frau, Marzia, Fronza, Roberto, Furlan, Alberto, Gajofatto, Gallo, Antonio, Paolo, Gallo, Claudio, Gasperini, Anna, Ghazaryan, Bruno, Giometto, Francesca, Gobbin, Flora, Govone, Franco, Granella, Erica, Grange, Maria Grazia Grasso, Angelica, Guareschi, Clara, Guaschino, Simone, Guerrieri, Donata, Guidetti, Pietro, Iaffaldano, Antonio, Ianniello, Luigi, Iasevoli, Paolo, Immovilli, Daniele, Imperiale, Maria Teresa Infante, Matilde, Inglese, Rosa, Iodice, Aniello, Iovino, Giovanna, Konrad, Doriana, Landi, Roberta, Lanzillo, Caterina, Lapucci, Luigi, Lavorgna, Maria Rita L'Episcopo, Serena, Leva, Giuseppe, Liberatore, Re Marianna Lo, Marco, Longoni, Leonardo, Lopiano, Lorena, Lorefice, Matteo, Lucchini, Lus, Giacomo, Davide, Maimone, Maria, Malentacchi, Giulia, Mallucci, Simona, Malucchi, Chiara Rosa Mancinelli, Luca, Mancinelli, Paolo, Manganotti, Giorgia Teresa Maniscalco, Vittorio, Mantero, Sabrina, Marangoni, Damiano, Marastoni, Girolama Alessandra Marfia, Fabiana, Marinelli, Alessandro, Marti, Boneschi Filippo Martinelli, Zoli Federco Masserano, Francesca, Matta, Laura, Mendozzi, Giuseppe, Meucci, Silvia, Miante, Miele, Giuseppina, Eva, Milano, Massimiliano, Mirabella, Missione, Rosanna, Marcello, Moccia, Lucia, Moiola, Sara, Montepietra, Margherita, Montibragadin, Federico, Montini, Roberta, Motta, Raffaele, Nardone, Carolina Gabri Nicoletti, Eduardo, Nobile-Orazio, Agostino, Nozzolillo, Marco, Onofrj, Riccardo, Orlandi, Palmieri, Anna, Damiano, Paolicelli, Livia, Pasquali, Luisa, Pastò, Francesco, Patti, Elisabetta, Pedrazzoli, Paola, Perini, Ilaria, Pesci, Maria, Petracca, Alfredo, Petrone, Carlo, Piantadosi, Anna, M Pietroboni, Federica, Pinardi, Marta, Ponzano, Emilio, Portaccio, Mattia, Pozzato, Carlo, Pozzilli, Luca, Prosperini, Alessandra, Protti, Marta, Radaelli, Paolo, Ragonese, Sarah, Rasia, Sabrina, Realmuto, Anna, Repice, Eleonora, Rigoni, Maria Teresa Rilla, Francesca, Rinaldi, Calogero Marcello Romano, Marco, Ronzoni, Marco, Rovari, Francesca, Ruscica, Loredana, Sabattini, Giuseppe, Salemi, Marco, Salvetti, Lorenzo, Saraceno, Alessia, Sartori, Arianna, Sartori, Elvira, Sbragia, Cinzia, Scandellari, Giuditta Ilaria Scarano, Valentina, Scarano, Irene, Schiavetti, Maria, Sessa, Caterina, Sgarito, Grazia, Sibilia, Gabriele, Siciliano, Alessio, Signori, Signoriello, Elisabetta, Leonardo, Sinisi, Francesca, Sireci, Patrizia, Sola, Claudio, Solaro, Maria Pia Sormani, Stefano, Sotgiu, Sparaco, Maddalena, Maria Laura Stromillo, Silvia, Strumia, Emanuela Laura Susani, Giulietta, Tabiadon, Francesco, Teatini, Tedeschi, Gioacchino, Valentina, Tomassini, Simone, Tonietti, Clerici Valentina Torri, Carla, Tortorella, Simona, Toscano, Rocco, Totaro, Maria, Trojano, Trotta, Maria Consiglia, Gabriella, Turano, Monica, Ulivelli, Manzo, Valentino, Giovanna, Vaula, Domizia, Vecchio, Marco, Vercellino, Elena Pinuccia Verrengia, Marika, Vianello, Eleonora, Virgilio, Francesca, Vitetta, Stefano, Vollaro, Mauro, Zaffaroni, Mauro, Zampolini, Ignazio Roberto Zarbo, Zito, Guido Antonio, Bergamaschi, R., Ponzano, M., Schiavetti, I., Carmisciano, L., Cordioli, C., Filippi, M., Radaelli, M., Immovilli, P., Capobianco, M., De Rossi, N., Brichetto, G., Cocco, E., Scandellari, C., Cavalla, P., Pesci, I., Zito, A., Confalonieri, P., Marfia, G. A., Perini, P., Inglese, M., Trojano, M., Brescia Morra, V., Pisoni, E., Tedeschi, G., Comi, G., Battaglia, M. A., Patti, F., Salvetti, M., Sormani, M. P., Bergamaschi, Roberto, Ponzano, Marta, Schiavetti, Irene, Carmisciano, Luca, Cordioli, Cinzia, Filippi, Massimo, Radaelli, Marta, Immovilli, Paolo, Capobianco, Marco, De Rossi, Nicola, Brichetto, Giampaolo, Cocco, Eleonora, Scandellari, Cinzia, Cavalla, Paola, Pesci, Ilaria, Zito, Antonio, Confalonieri, Paolo, Marfia, Girolama Alessandra, Perini, Paola, Inglese, Matilde, Trojano, Maria, Brescia Morra, Vincenzo, Pisoni, Enrico, Comi, Giancarlo, Battaglia, Mario Alberto, Patti, Francesco, Salvetti, Marco, Sormani, Maria, Pia, Gianmarco, Abbadessa, Alvino, Bisecco, Simona, Bonavita, Antonio, Bosco, Rocco, Capuano, Francesco, Corea, Renato, Docimo, Mario, Fratta, Antonio, Gallo, Iodice, Rosa, Iovino, Aniello, Lanzillo, Roberta, Giacomo, Lu, Giuseppina, Miele, Rosanna, Missione, Moccia, Marcello, Anna, Palmieri, Elisabetta, Signoriello, Maddalena, Sparaco, Gioacchino, Tedeschi, Maria, Trotta, Antonio, Zito, and Luigi, Zuliani
Subjects: air pollution, coronavirus, multiple sclerosis, medicine.medical_specialty, Multivariate analysis, Coronavirus disease 2019 (COVID-19), Clinical Sciences, Air pollution, Sample (statistics), Neurodegenerative, Settore MED/26, medicine.disease_cause, Autoimmune Disease, law.invention, Sustainable Cities and Communities, Clinical Research, law, Humans, Medicine, Climate-Related Exposures and Conditions, Neurology & Neurosurgery, MuSC-19 study group, SARS-CoV-2, business.industry, Multiple sclerosis, Neurosciences, COVID-19, Retrospective cohort study, Original Articles, medicine.disease, Intensive care unit, Particulate Matter, Air Pollution, Multiple Sclerosis, Brain Disorders, coronaviru, Settore MED/26 - NEUROLOGIA, Good Health and Well Being, Neurology, multiple sclerosi, Emergency medicine, Original Article, Neurology (clinical), Ordered logit, business, Human
Abstract: Background and purpose Some studies have shown that air pollution, often assessed by thin particulate matter with diameter below 2.5 µg/m3 (PM2.5), may contribute to severe COVID‐19 courses, as well as play a role in the onset and evolution of multiple sclerosis (MS). However, the impact of air pollution on COVID‐19 has never been explored specifically amongst patients with MS (PwMS). This retrospective observational study aims to explore associations between PM2.5 and COVID‐19 severity amongst PwMS. Methods Data were retrieved from an Italian web‐based platform (MuSC‐19) which includes PwMS with COVID‐19. PM2.5 2016–2018 average concentrations were provided by the Copernicus Atmospheric Monitoring Service. Italian patients inserted in the platform from 15 January 2020 to 9 April 2021 with a COVID‐19 positive test were included. Ordered logistic regression models were used to study associations between PM2.5 and COVID‐19 severity. Results In all, 1087 patients, of whom 13% required hospitalization and 2% were admitted to an intensive care unit or died, were included. Based on the multivariate analysis, higher concentrations of PM2.5 increased the risk of worse COVID‐19 course (odds ratio 1.90; p = 0.009). Conclusions Even if several other factors explain the unfavourable course of COVID‐19 in PwMS, the role of air pollutants must be considered and further investigated., Air pollution, often assessed by particulate matter with diameter below 2.5 µg/m3, may contribute to severe COVID‐19 courses. 1087 patients were included, of whom 13% required hospitalization and 2% were admitted to an intensive care unit or died. Even if several other factors explain the unfavourable course of COVID‐19 in patients with multiple sclerosis, the role of air pollutants must be considered and further investigated.
Published: 2021

2. Interplay Between Cognitive and Bowel/Bladder Function in Multiple Sclerosis

Author: Roberta Lanzillo, Francesco Sacc, Maria Petracca, Vincenzo Brescia Morra, Cinzia Valeria Russo, Barbara Satelliti, Marcello Moccia, Fabrizia Falco, Teresa Costabile, Antonio Carotenuto, Carotenuto, Antonio, Costabile, Teresa, Moccia, Marcello, Falco, Fabrizia, Petracca, Maria, Satelliti, Barbara, Russo, Cinzia Valeria, Saccà, Francesco, Lanzillo, Roberta, and Brescia Morra, Vincenzo
Subjects: medicine.medical_specialty, Physical disability, Bladder, Bowel, Cognition, Disability, Patient reported outcome, Urology, Patient-Reported Outcome, Neurogenic Bowel, Internal medicine, medicine, Clinical Investigation, Cognitive impairment, business.industry, Multiple sclerosis, medicine.disease, Diseases of the genitourinary system. Urology, Neurology, Bladder Disorder, Original Article, Patient-reported outcome, RC870-923, Neurology (clinical), Bladder function, business
Abstract: Purpose: The aim of this study was to evaluate the prevalence of bowel/bladder dysfunction in multiple sclerosis (MS) and its associations with cognitive impairment.Methods: We prospectively enrolled 150 MS patients. Patients were administered the Symbol Digit Modality Test (SDMT), the Neurogenic Bowel Dysfunction Score (NBDS), and the Actionable Bladder Symptom Screening Tool (ABSST). The associations between bowel/bladder dysfunction and cognitive function were assessed through hierarchical regression models using the SDMT and clinicodemographic features as independent variables and NBDS and ABSST scores as dependent variables.Results: The prevalence of bowel/bladder deficits was 44.7%, with 26 patients (17.3%) suffering from bowel deficits and 60 patients (40%) from bladder deficits. The total NBDS and ABSST scores were correlated with the SDMT (β=-0.10, P
Published: 2021

3. Risk of invasive fungal infections among patients treated with disease modifying treatments for multiple sclerosis: a comprehensive review

Author: Antonio Reia, Riccardo Scotto, Emanuela Zappulo, Marcello Moccia, E. Pisano, Antonio Riccardo Buonomo, Ivan Gentile, Giulio Viceconte, V. Brescia Morra, Scotto, R., Reia, A., Buonomo, A. R., Moccia, M., Viceconte, G., Pisano, E., Zappulo, E., Brescia Morra, V., and Gentile, I.
Subjects: Risk, medicine.medical_specialty, Multiple Sclerosis, medicine.drug_class, Opportunistic Infection, Disease, Opportunistic Infections, Monoclonal antibody, Immunosuppressive Agent, Immunologic Factor, Disease modifying treatment, Internal medicine, parasitic diseases, Humans, Immunologic Factors, Medicine, Invasive Fungal Infection, Pharmacology (medical), monoclonal antibodie, business.industry, Multiple sclerosis, General Medicine, medicine.disease, infection, invasive fungal disease, multiple sclerosi, business, Immunosuppressive Agents, Invasive Fungal Infections, Human
Abstract: Introduction: Disease modifying treatments are commonly used in the treatment of multiple sclerosis. As different opportunistic infections have been reported, concerns are also raised regarding the risk of invasive fungal infections. Areas covered: Both clinical trials and observational studies on safety and efficacy of diseases modifying treatment for multiple sclerosis were reviewed and data regarding the occurrence of invasive fungal infections were reported. Papers evaluating the following drugs were reviewed: rituximab, ocrelizumab, alemtuzumab, fingolimod, natalizumab, dimethyl fumarate, interferon, glatiramer acetate, cladribine, teriflunomide. Expert opinion: Overall, the occurrence of invasive fungal infections was low, with most infective events reported among patients treated with monoclonal antibodies and fingolimod. Aspergillosis and cryptococcal meningitidis were the most representative fungal infections. Although not common, these infections may be difficult to diagnose and their fatality rate is often high. For this reason, screening protocols for fungal infections must be implemented in the clinical practice when managing patients with MS.
Published: 2021

4. Persistence, adherence, healthcare resource utilisation and costs for interferon Beta in multiple sclerosis: a population-based study in the Campania region (southern Italy)

Author: Ilaria Loperto, Antonio Carotenuto, Marcello Moccia, Antonio Capacchione, Vincenzo Brescia Morra, Raffaele Palladino, Maria Triassi, Roberta Lanzillo, Moccia, M., Loperto, I., Lanzillo, R., Capacchione, A., Carotenuto, A., Triassi, M., Brescia Morra, V., and Palladino, R.
Subjects: Male, 1110 Nursing, Health administration, Persistence (computer science), 0302 clinical medicine, Pegylated interferon, Health care, 030212 general & internal medicine, PREDICTORS, GLATIRAMER ACETATE, RISK, education.field_of_study, Health Policy, lcsh:Public aspects of medicine, Middle Aged, INSIGHTS, Italy, DISEASE-MODIFYING THERAPIES, Health Policy & Services, Costs and Cost Analysis, Health Resources, Interferon, Female, BURDEN, Life Sciences & Biomedicine, medicine.drug, Research Article, Adult, medicine.medical_specialty, EUROPE, Cost, Population, 1117 Public Health and Health Services, Medication Adherence, Multiple sclerosis, 03 medical and health sciences, Internal medicine, Healthcare resource utilization, medicine, Humans, COHORT, Formulary, Medical prescription, education, Retrospective Studies, Science & Technology, business.industry, lcsh:RA1-1270, Interferon-beta, medicine.disease, EFFICACY, Costs, Health Care Sciences & Services, business, 030217 neurology & neurosurgery, 0807 Library and Information Studies
Abstract: Background To differentiate five formulations of Interferon Beta for the treatment of multiple sclerosis (MS) in clinical practice, by analysing persistence, adherence, healthcare resource utilisation and costs at population level. Methods In this population-based study, we included individuals with MS living in the Campania Region of Italy from 2015 to 2017, on treatment with intramuscular Interferon Beta-1a (Avonex® = 618), subcutaneous pegylated Interferon Beta-1a (Plegridy® = 259), subcutaneous Interferon Beta-1a (Rebif® = 1220), and subcutaneous Interferon Beta-1b (Betaferon® = 348; and Extavia® = 69). We recorded healthcare resource utilisation from administrative databases (hospital discharges, drug prescriptions, MS-related outpatients), and derived costs from the Regional formulary. We classified hospital admissions into MS-related and non-MS-related. Persistence (time to switch to other disease modifying treatments (DMTs)), and adherence (medication possession ratio (MPR) = medication supply obtained/medication supply expected during follow-up period) were calculated. Results Patients treated with Rebif® were younger, when compared with other Interferon Beta formulations (p p p p = 0.03), when compared with Rebif®. The probability of MS-related hospital admissions was 40% higher in Avonex® (p = 0.03), 400% higher in Betaferon® (p p = 0.04), resulting into higher non-DMT-related costs, when compared with Rebif®. Discussion Interferon Beta formulations presented with different prescription patterns, persistence, adherence, healthcare resource utilisation and costs, with Rebif® being used in younger patients and with less MS-related hospital admissions.
Published: 2020

5. Botulinum toxin for the management of spasticity in multiple sclerosis: the Italian botulinum toxin network study

Author: Anna Castagna, Calogera Butera, Ubaldo Del Carro, M. Frontoni, S. Lori, Jessica Frau, Giancarlo Coghe, Francesco Bono, Vincenzo Brescia Morra, Antonio Carotenuto, Marcello Moccia, Pamela Latino, Stefania Lanfranchi, Morena Giovannelli, Marcello Romano, Caterina Nascimbene, Laura Rapisarda, P. Barbero, Loredana Maggi, Elisabetta Groppo, Vitalma Liotti, Roberto Eleopra, Cristina Inglese, Marcello Esposito, Maria Concetta Altavista, Emma Frasson, Maria Buccafusca, Salvatore Lo Fermo, Martina Petracca, Moccia, Marcello, Frau, Jessica, Carotenuto, Antonio, Butera, Calogera, Coghe, Giancarlo, Barbero, Pierangelo, Frontoni, Marco, Groppo, Elisabetta, Giovannelli, Morena, Del Carro, Ubaldo, Inglese, Cristina, Frasson, Emma, Castagna, Anna, Buccafusca, Maria, Latino, Pamela, Nascimbene, Caterina, Romano, Marcello, Liotti, Vitalma, Lanfranchi, Stefania, Rapisarda, Laura, Lori, Silvia, Esposito, Marcello, Maggi, Loredana, Petracca, Martina, Lo Fermo, Salvatore, Altavista, Maria Concetta, Bono, Francesco, Eleopra, Roberto, and Brescia Morra, Vincenzo
Subjects: Adult, medicine.medical_specialty, Multiple Sclerosis, Botulinum, Modified Ashworth scale, Hypophonia, Dermatology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Activities of Daily Living, Humans, Medicine, Multiple sclerosi, Symptomatic treatment, 030212 general & internal medicine, Spasticity, Botulinum Toxins, Type A, Multiple sclerosis, Adverse effect, Expanded Disability Status Scale, business.industry, General Medicine, Middle Aged, Botulinum toxin, Clinical trial, Psychiatry and Mental health, Cross-Sectional Studies, Treatment Outcome, Italy, Neuromuscular Agents, Muscle Spasticity, Concomitant, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Botulinum toxin (BT) is an effective and safe treatment for spasticity, with limited evidence in multiple sclerosis (MS). We aim to describe the use of BT for the management of MS spasticity in the clinical practice, its combination with other anti-spastic treatments in MS and possible MS clinical correlates. This is a multicentre cross-sectional observational study including 386 MS patients, receiving BT for spasticity in 19 Italian centres (age 53.6 ± 10.9 years; female 228 (59.1%); disease duration 18.7 ± 9.2 years; baseline Expanded Disability Status Scale (EDSS) 6.5 (2.0–9.0)). BT was used for improving mobility (n = 170), functioning in activities of daily living (n = 56), pain (n = 56), posturing-hygiene (n = 63) and daily assistance (n = 41). BT formulations were AbobotulinumtoxinA (n = 138), OnabotulinumtoxinA (n = 133) and IncobotulinumtoxinA (n = 115). After conversion to unified dose units, higher BT dose was associated with higher EDSS (Coeff = 0.591; p
Published: 2020

6. Changes in lymphocytes, neutrophils and immunoglobulins in year-1 cladribine treatment in multiple sclerosis

Author: Bianca Covelli, Antonio Luca Spiezia, Vincenza Cerbone, Marcello Moccia, Antonio Carotenuto, Federica Novarella, Nicola Capasso, Roberta Lanzillo, Vincenzo Brescia Morra, Giulia Scalia, Maria Petracca, Eduardo Alberto Molinari, Spiezia, Antonio Luca, Cerbone, Vincenza, Molinari, Eduardo Alberto, Capasso, Nicola, Lanzillo, Roberta, Carotenuto, Antonio, Petracca, Maria, Novarella, Federica, Covelli, Bianca, Scalia, Giulia, Brescia Morra, Vincenzo, and Moccia, Marcello
Subjects: Multiple Sclerosis, Neutrophils, Immunoglobulins, medicine, Immunoglobulin, Humans, Multiple sclerosi, Lymphocytes, Cladribine, biology, business.industry, Multiple sclerosis, Neutrophil, General Medicine, medicine.disease, Neurology, Immunology, biology.protein, Lymphocyte, Neurology (clinical), Antibody, business, medicine.drug, Human
Published: 2022

7. B Cells in the CNS at Postmortem Are Associated With Worse Outcome and Cell Types in Multiple Sclerosis

Author: Steven Harry Pieter van de Pavert, Claudia Angela Michela Gandini Wheeler-Kingshott, Lukas Haider, Marcello Moccia, Frederik Barkhof, Amy Patel, Arman Eshaghi, Vincenzo Brescia Morra, Olga Ciccarelli, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neuroinfection & -inflammation, Moccia, Marcello, Haider, Luka, Eshaghi, Arman, van de Pavert, Steven Harry Pieter, Brescia Morra, Vincenzo, Patel, Amy, Wheeler-Kingshott, Claudia Angela Michela, Barkhof, Frederik, and Ciccarelli, Olga
Subjects: Male, Pathology, medicine.medical_specialty, Neurofilament, Article, medicine, Cytotoxic T cell, Humans, Optic neuritis, Aged, B-Lymphocytes, Glial fibrillary acidic protein, biology, CD68, business.industry, Multiple sclerosis, Middle Aged, Multiple Sclerosis, Chronic Progressive, medicine.disease, Neurology, biology.protein, Female, Neurology (clinical), Autopsy, business, Glymphatic System, Immunostaining, CD8
Abstract: Background and ObjectivesTo define the clinical and pathologic correlations of compartmentalized perivascular B cells in postmortem progressive multiple sclerosis (MS) brains.MethodsBrain slices were acquired from 11 people with secondary progressive (SP) MS, 5 people with primary progressive (PP) MS, and 4 controls. Brain slices were immunostained for B lymphocytes (CD20), T lymphocytes (CD3), cytotoxic T lymphocytes (CD8), neuronal neurofilaments (NF200), myelin (SMI94), macrophages/microglia (CD68 and IBA1), astrocytes (glial fibrillary acidic protein [GFAP]), and mitochondria (voltage-dependent anion channel and cytochrome c oxidase subunit 4). Differences in CD20 immunostaining intensity between disease groups and associations between CD20 immunostaining intensity and both clinical variables and other immunostaining intensities were explored with linear mixed regression models and Cox regression models, as appropriate.ResultsCD20 immunostaining intensity was higher in PPMS (Coeff = 0.410; 95% confidence interval [CI] = 0.046, 0.774; p = 0.027) and SPMS (Coeff = 0.302; 95% CI = 0.020, 0.585; p = 0.036) compared with controls. CD20 immunostaining intensity was higher in cerebellar, spinal cord, and pyramidal onset (Coeff = 0.274; 95% CI = 0.039, 0.510; p = 0.022) compared with optic neuritis and sensory onset. Higher CD20 immunostaining intensity was associated with younger age at onset (hazard ratio [HR] = 1.033; 95% CI = 1.013, 1.053; p = 0.001), SP conversion (HR = 1.056; 95% CI = 1.022, 1.091; p = 0.001), wheelchair dependence (HR = 1.472; 95% CI = 1.108, 1.954; p = 0.008), and death (HR = 1.684; 95% CI = 1.238, 2.291; p = 0.001). Higher immunostaining intensity for CD20 was associated with higher immunostaining intensity for CD3 (Coeff = 0.114; 95% CI = 0.005, 0.224; p = 0.040), CD8 (Coeff = 0.275; 95% CI = 0.200, 0.350; p < 0.001), CD68 (Coeff = 0.084; 95% CI = 0.023, 0.144; p = 0.006), GFAP (Coeff = 0.002; 95% CI = 0.001, 0.004; p = 0.030), and damaged mitochondria (Coeff = 3.902; 95% CI = 0.891, 6.914; p = 0.011).DiscussionPerivascular B cells were associated with worse clinical outcomes and CNS-compartmentalized inflammation. Our findings further support the concept of targeting compartmentalized B-cell inflammation in progressive MS.
Published: 2022

8. ProspeCtive study to evaluate efficacy, safety and tOlerability of dietary supplemeNT of Curcumin (BCM95) in subjects with Active relapsing MultIple Sclerosis treated with subcutaNeous Interferon beta 1a 44 mcg TIW (CONTAIN): A randomized, controlled trial

Author: G. Vacca, Barbara Satelliti, Maria Petracca, Roberta Lanzillo, Francesco Assogna, Gianluigi D'Ambrosio, Antonio Capacchione, Monica Ragucci, Mario Quarantelli, Marcello Moccia, Antonio Carotenuto, Vincenzo Brescia Morra, Petracca, M., Quarantelli, M., Moccia, M., Vacca, G., Satelliti, B., D'Ambrosio, G., Carotenuto, A., Ragucci, M., Assogna, F., Capacchione, A., Lanzillo, R., and Morra, V. B.
Subjects: medicine.medical_specialty, Curcumin, Multiple Sclerosis, Combination therapy, Placebo, Gastroenterology, law.invention, Interferon β-1a, Multiple Sclerosis, Relapsing-Remitting, Randomized controlled trial, Adjuvants, Immunologic, law, Recurrence, Internal medicine, medicine, Clinical endpoint, Humans, Multiple sclerosi, Prospective Studies, Neurodegeneration, Prospective cohort study, Inflammation, business.industry, Multiple sclerosis, Interferon beta-1a, General Medicine, medicine.disease, Magnetic Resonance Imaging, Treatment Outcome, Neurology, Tolerability, Dietary Supplements, Neurology (clinical), business, medicine.drug
Abstract: Background multiple sclerosis (MS) is a complex disease sustained by several pathogenic mechanisms. As such, combination therapy strategies, targeting a range of disease mechanisms, might represent the ideal therapeutic approach. Here we investigated the efficacy of curcumin, a naturally occurring poly-phenolic phytochemical with potent anti-inflammatory and antioxidant properties, in subjects under treatment with IFN β-1a, to test the effects of this combination therapy on clinical and MRI parameters of inflammation and neurodegeneration in relapsing MS (RMS). Methods eighty active RMS were prospectively enrolled, randomized (1:1) to either the IFN-curcumin or the IFN-placebo group and followed up longitudinally with clinical and MRI assessments for 24 months. Primary endpoint was the efficacy of curcumin versus placebo as add-on therapy on new/enlarging T2 lesions in RMS subjects under treatment with subcutaneous IFN β-1a 44 mcg TIW. Efficacy on clinical parameters (relapses and disability progression), other MRI parameters of inflammation (T1 Gd-enhancing lesions, combined unique active-CUA lesions) and neurodegeneration (T1-hypointense lesions, grey matter loss and white matter microstructural damage) as well as safety and tolerability of curcumin were explored as secondary endpoints. Results ten subjects dropped out from the study by month 12 (6 in the IFN-curcumin group and 4 in the IFN-placebo group), and 27 by month 24 (11 in the IFN-curcumin group and 16 in the IFN-placebo group). Although no between-group difference was present in terms of proportion of subjects free from new/enlarging T2 lesions, a lower proportion of patients with CUA lesions was noted at month 12 in the IFN-curcumin group in comparison with the IFN-placebo group (7.5% vs 17.5%, χ² test p= 0.0167). This result was not confirmed at month 24. The statistical analysis failed to reveal any difference between the two treatment groups – IFN-curcumin and IFN-placebo – in terms of relapses, disability progression, other MRI metrics of inflammation and MRI changes suggestive of ongoing neurodegeneration. No difference in the rate and nature of adverse events was observed between the two treatment groups. Conclusion Although the study drop-out rate was too high to allow definite conclusions, our findings suggest that curcumin might add to IFN β-1a efficacy on radiological signs of inflammation in MS, while it did not seem to exert any neuroprotective effect as assessed by clinical and MRI parameters. (NCT01514370)
Published: 2021

9. Update on infective complications in patients treated with alemtuzumab for multiple sclerosis: review and meta-analysis of real-world and randomized studies

Author: Antonio Carotenuto, Cinzia Valeria Russo, Emanuela Zappulo, Marcello Moccia, Giulio Viceconte, Antonio Riccardo Buonomo, Alberto Enrico Maraolo, Ivan Gentile, Buonomo, A. R., Viceconte, G., Zappulo, E., Maraolo, A. E., Russo, C. V., Carotenuto, A., Moccia, M., and Gentile, I.
Subjects: medicine.medical_specialty, Multiple Sclerosis, Immunologic Factors, opportunistic infection, Opportunistic Infections, Severity of Illness Index, law.invention, Immunologic Factor, Randomized controlled trial, law, Internal medicine, Severity of illness, medicine, Prevalence, Humans, Pharmacology (medical), In patient, monoclonal antibodie, Alemtuzumab, Randomized Controlled Trials as Topic, business.industry, Multiple sclerosis, General Medicine, medicine.disease, multiple sclerosi, Meta-analysis, business, Human, medicine.drug
Abstract: Objective: We aimed to systematically assess the pooled prevalence of infective complications in randomized controlled trials (RCTs) and real-world studies (RWSs) investigating alemtuzumab treatment in multiple sclerosis (MS), also looking at selected infections and their severity. Methods: We included in the analysis RCTs and RWSs investigating the use of alemtuzumab in MS in which infective complications were reported, as well as case reports of rare infections. We conducted a meta-analysis of proportions and a random effect model meta-regression to investigate heterogeneity. Results: The pooled prevalence of infective complications in alemtuzumab treated MS patients is 24%. The most common reported infections are respiratory tract infections (47%) and the most part of the infections are mild-to-moderate (85%). Severe infections account for 6% of the total estimate. We found first-time-reported cases of invasive aspergillosis, hepatitis E virus infection, EBV hepatitis, and cerebral toxoplasmosis. The prevalence of infections is higher in studies conducted before 2009, and in studies with higher proportion of male participants. Conclusions: Clinicians should be aware that the prevalence of serious infections during alemtuzumab can be higher than expected from RCTs. Peculiar opportunistic infections should be considered when evaluating a patient treated with alemtuzumab who develops signs of infection.
Published: 2021

10. A Retrospective Exploratory Analysis on Cardiovascular Risk and Cognitive Dysfunction in Multiple Sclerosis

Author: Teresa Costabile, Vincenzo Brescia Morra, Fabrizia Falco, Marcello Moccia, Antonio Reia, Matteo Conenna, Roberta Lanzillo, Giuseppe Servillo, Martina Petruzzo, Maria Petracca, Antonio Carotenuto, Reia, A., Petruzzo, M., Falco, F., Costabile, T., Conenna, M., Carotenuto, A., Petracca, M., Servillo, G., Lanzillo, R., Brescia Morra, V., and Moccia, M.
Subjects: medicine.medical_specialty, Population, Neurosciences. Biological psychiatry. Neuropsychiatry, 030204 cardiovascular system & hematology, Verbal learning, multiple sclerosis, Article, cognitive, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Multiple sclerosi, Cognitive decline, education, education.field_of_study, Framingham Risk Score, California Verbal Learning Test, business.industry, General Neuroscience, cardiovascular, Neuropsychology, Retrospective cohort study, Cognition, Cardiovascular, Cognitive, Multiple sclerosis, verbal learning, business, 030217 neurology & neurosurgery, RC321-571
Abstract: Background. Cardiovascular comorbidities have been associated with cognitive decline in the general population. Objectives. To evaluate the associations between cardiovascular risk and neuropsychological performances in MS. Methods. This is a retrospective study, including 69 MS patients. For all patients, we calculated the Framingham risk score, which provides the 10-year probability of developing macrovascular disease, using age, sex, diabetes, smoking, systolic blood pressure, and cholesterol levels as input variables. Cognitive function was examined with the Brief International Cognitive Assessment for MS (BICAMS), including the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-II (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R). Results. Each point increase of the Framingham risk score corresponded to 0.21 lower CVLT-II score. Looking at Framingham risk score components, male sex and higher total cholesterol levels corresponded to lower CVLT scores (Coeff = −8.54, 95%CI = −15.51, −1.57, and Coeff = −0.11, 95%CI = −0.20, −0.02, respectively). No associations were found between cardiovascular risk and SDMT or BVMT-R. Conclusions. In our exploratory analyses, cardiovascular risk was associated with verbal learning dysfunction in MS. Lifestyle and pharmacological interventions on cardiovascular risk factors should be considered carefully in the management of MS, given the possible effects on cognitive function.
Published: 2021

11. Neuroimaging Correlates of Cognitive Dysfunction in Adults with Multiple Sclerosis

Author: Maria Petracca, Sirio Cocozza, Vincenzo Brescia Morra, Giuseppe Pontillo, Arturo Brunetti, Marcello Moccia, Antonio Carotenuto, Roberta Lanzillo, Petracca, M., Pontillo, G., Moccia, M., Carotenuto, A., Cocozza, S., Lanzillo, R., Brunetti, A., and Brescia Morra, V.
Subjects: positron emission tomography, Review, multiple sclerosis, 030218 nuclear medicine & medical imaging, lcsh:RC321-571, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Neuroimaging, cognitive dysfunction, medicine, magnetic resonance imaging, Multiple sclerosi, Cognitive decline, Cognitive impairment, sodium, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, neuroimaging, medicine.diagnostic_test, business.industry, General Neuroscience, Multiple sclerosis, food and beverages, Magnetic resonance imaging, Cognition, medicine.disease, Cognitive dysfunction, Positron emission tomography, Sodium, business, Neuroscience, 030217 neurology & neurosurgery
Abstract: Cognitive impairment is a frequent and meaningful symptom in multiple sclerosis (MS), caused by the accrual of brain structural damage only partially counteracted by effective functional reorganization. As both these aspects can be successfully investigated through the application of advanced neuroimaging, here, we offer an up-to-date overview of the latest findings on structural, functional and metabolic correlates of cognitive impairment in adults with MS, focusing on the mechanisms sustaining damage accrual and on the identification of useful imaging markers of cognitive decline.
Published: 2021

12. Disability assessment using Google Maps

Author: Francesca Trojsi, Domenico Ippolito, Paolo Ragonese, Sabrina Esposito, Giacomo Lus, Giovanna Borriello, Gioacchino Tedeschi, Maddalena Sparaco, Gianmarco Abbadessa, Luigi Lavorgna, Francesco Brigo, Elisabetta Signoriello, Marinella Clerico, Pietro Iaffaldano, Roberta Lanzillo, Simona Bonavita, Raffaele Palladino, Rosa Gemma Viterbo, Simone Cepparulo, Marcello Moccia, Maria Troiano, Lavorgna, L., Iaffaldano, P., Abbadessa, G., Lanzillo, R., Esposito, S., Ippolito, D., Sparaco, M., Cepparulo, S., Lus, G., Viterbo, R., Clerico, M., Trojsi, F., Raganose, P., Borriello, G., Signoriello, E., Palladino, R., Moccia, M., Brigo, F., Troiano, M., Tedeschi, G., Bonavita, S., Lavorgna L., Iaffaldano P., Abbadessa G., Lanzillo R., Esposito S., Ippolito D., Sparaco M., Cepparulo S., Lus G., Viterbo R., Clerico M., Trojsi F., Ragonese P., Borriello G., Signoriello E., Palladino R., Moccia M., Brigo F., Troiano M., Tedeschi G., and Bonavita S.
Subjects: medicine.medical_specialty, Neurology, Multiple Sclerosis, Concordance, Ambulatory disorders, Dermatology, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Internal medicine, medicine, Google Maps, Humans, 030212 general & internal medicine, Depression (differential diagnoses), Ambulatory disorder, Fatigue, Neuroradiology, Expanded Disability Status Scale, business.industry, General Medicine, Odds ratio, Confidence interval, Search Engine, Psychiatry and Mental health, Cross-Sectional Studies, Ambulatory, e-Health, Original Article, Neurology (clinical), business, Digital health, 030217 neurology & neurosurgery
Abstract: Objectives To evaluate the concordance between Google Maps® application (GM®) and clinical practice measurements of ambulatory function (e.g., Ambulation Score (AS) and respective Expanded Disability Status Scale (EDSS)) in people with multiple sclerosis (pwMS). Materials and methods This is a cross-sectional multicenter study. AS and EDSS were calculated using GM® and routine clinical methods; the correspondence between the two methods was assessed. A multinomial logistic model is investigated which demographic (age, sex) and clinical features (e.g., disease subtype, fatigue, depression) might have influenced discrepancies between the two methods. Results Two hundred forty-three pwMS were included; discrepancies in AS and in EDDS assessments between GM® and routine clinical methods were found in 81/243 (33.3%) and 74/243 (30.4%) pwMS, respectively. Progressive phenotype (odds ratio [OR] = 2.8; 95% confidence interval [CI] 1.1–7.11, p = 0.03), worse fatigue (OR = 1.03; 95% CI 1.01–1.06, p = 0.01), and more severe depression (OR = 1.1; 95% CI 1.04–1.17, p = 0.002) were associated with discrepancies between GM® and routine clinical scoring. Conclusion GM® could easily be used in a real-life clinical setting to calculate the AS and the related EDSS scores. GM® should be considered for validation in further clinical studies. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05389-7.
Published: 2021

13. Monocular Diplopia in Idiopathic Intracranial Hypertension: A Case Report and Literature Review

Author: Mattia Sansone, Gianluigi R Palmieri, Marcello Moccia, Roberto De Simone, Palmieri, Gianluigi R, Sansone, Mattia, De Simone, Roberto, and Moccia, Marcello
Subjects: monocular diplopia, medicine.medical_specialty, Neurology, endocrine system diseases, genetic structures, media_common.quotation_subject, 03 medical and health sciences, 0302 clinical medicine, Ophthalmology, Internal Medicine, Medicine, Contrast (vision), diplopia, Strabismus, Monocular Diplopia, media_common, Diplopia, Monocular, business.industry, Oculomotor nerve, eye diseases, Idiopathic intracranial hypertension, Binocular Diplopia, papilloedema, 030221 ophthalmology & optometry, sense organs, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Background Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e., oculomotor nerve palsies, ocular myopathies, neuromuscular junction disorders) and ophthalmic disorders (i.e., decompensation of a pre-existing strabismus). In contrast, monocular diplopia is generally explained by intraocular pathology (i.e., refractive errors, ocular media abnormalities, dry eyes), causing the image of a single object to fall, at the same time, on the fovea and on the extra-foveal retina of the same eye. Methods We report the case of a 22-year-old woman presenting with acute-onset monocular diplopia. Results The diagnosis of idiopathic intracranial hypertension (IIH) was based on the presence of papilloedema and elevated cerebrospinal fluid (CSF) pressure. Monocular diplopia resolved after CSF subtraction. Conclusions We describe a case of monocular diplopia as a presenting symptom of IIH, and discuss diagnostic issues of this possibly underestimated symptom in neurology clinical practice. Careful ophthalmic and neuro-ophthalmic examination can identify clinical features of diplopia, and drive diagnosis and treatment. Learning points Monocular diplopia is mostly an ophthalmological condition but can occur in a number of neurological diseases.Idiopathic intracranial hypertension can present with monocular diplopia.Differential diagnoses of diplopia in neurology and ophthalmology settings need to account for headache disorders.
Published: 2021

14. Defining the course of tumefactive multiple sclerosis: A large retrospective multicentre study

Author: Lorenzo Gaetani, Doriana Landi, Diana Ferraro, Paolo Ragonese, Alberto Gajofatto, Caterina Di Carmine, Paola Cavalla, Maria Pia Amato, Eleonora Cocco, Roberta Lanzillo, Alessia Manni, Roberta Fantozzi, Claudio Gasperini, D. Farina, Giuseppe Fenu, Sara Zagaglia, Raffaella Cerqua, Claudio Solaro, Antonio Gallo, Carolina Gabri Nicoletti, Pietro Iaffaldano, Federica Pinardi, Valentina Torri Clerici, Isabella Righini, Fabio Buttari, Damiano Paolicelli, Pietro Annovazzi, Carla Tortorella, Rocco Totaro, Giovanna De Luca, Chiara De Fino, Valentina Tomassini, Luca Prosperini, Marcello Moccia, Viviana Nociti, Maria Chiara Buscarinu, Maria Di Gregorio, Massimiliano Di Filippo, Di Gregorio M., Torri Clerici V.L.A., Fenu G., Gaetani L., Gallo A., Cavalla P., Ragonese P., Annovazzi P., Gajofatto A., Prosperini L., Landi D., Nicoletti C.G., Di Carmine C., Totaro R., Nociti V., De Fino C., Ferraro D., Tomassini V., Tortorella C., Righini I., Amato M.P., Manni A., Paolicelli D., Iaffaldano P., Lanzillo R., Moccia M., Buttari F., Fantozzi R., Cerqua R., Zagaglia S., Farina D., De Luca G., Buscarinu M.C., Pinardi F., Cocco E., Gasperini C., Solaro C.M., Di Filippo M., Di Gregorio, M., Torri Clerici, V. L. A., Fenu, G., Gaetani, L., Gallo, A., Cavalla, P., Ragonese, P., Annovazzi, P., Gajofatto, A., Prosperini, L., Landi, D., Nicoletti, C. G., Di Carmine, C., Totaro, R., Nociti, V., De Fino, C., Ferraro, D., Tomassini, V., Tortorella, C., Righini, I., Amato, M. P., Manni, A., Paolicelli, D., Iaffaldano, P., Lanzillo, R., Moccia, M., Buttari, F., Fantozzi, R., Cerqua, R., Zagaglia, S., Farina, D., De Luca, G., Buscarinu, M. C., Pinardi, F., Cocco, E., Gasperini, C., Solaro, C. M., and Di Filippo, M.
Subjects: Male, tumefactive demyelinating lesions (TDLs), 0302 clinical medicine, Retrospective Studie, Interquartile range, differential diagnosis, 030212 general & internal medicine, Prospective Studies, Young adult, Prospective cohort study, Child, treatment, Tumefactive multiple sclerosi, Tumefactive demyelinating lesions, Demyelinating Disease, Middle Aged, Magnetic Resonance Imaging, Differential diagnosis, Multiple sclerosis, Tumefactive demyelinating lesions, Tumefactive multiple sclerosis, Neurology, Multiple sclerosis, Tumefactive multiple sclerosis, Female, Human, Adult, medicine.medical_specialty, Multiple Sclerosis, Adolescent, differential diagnosi, Settore MED/26, 03 medical and health sciences, Young Adult, Oligoclonal Band, Internal medicine, medicine, Humans, Multiple sclerosi, Tumefactive multiple sclerosis (TuMS), Aged, Retrospective Studies, Tumefactive demyelinating lesion, Expanded Disability Status Scale, business.industry, Oligoclonal Bands, Retrospective cohort study, Odds ratio, medicine.disease, Confidence interval, Prospective Studie, Demyelinating Diseases, prognosis, Neurology (clinical), business, 030217 neurology & neurosurgery
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: 29.5years, 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 2.3years (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&nbsp
Published: 2021

15. Editorial: Digital Technology in Neurology: From Clinical Assessment to Neurorehabilitation

Author: Francesco Brigo, Sabina Brennan, Marcello Moccia, Simona Bonavita, Moccia, M., Brigo, F., Brennan, S., and Bonavita, S.
Subjects: medicine.medical_specialty, neurorehabilitation, Neurology, business.industry, Multiple sclerosis, neurology, medicine.disease, multiple sclerosis, stroke, lcsh:RC346-429, Physical medicine and rehabilitation, multiple sclerosi, Medicine, Neurology (clinical), digital technology, business, Stroke, Neurorehabilitation, lcsh:Neurology. Diseases of the nervous system
Published: 2021

16. SARS-CoV-2 serology after COVID-19 in multiple sclerosis: An international cohort study

Author: Maria Pia Sormani, Irene Schiavetti, Doriana Landi, Luca Carmisciano, Nicola De Rossi, Cinzia Cordioli, Lucia Moiola, Marta Radaelli, Paolo Immovilli, Marco Capobianco, Vincenzo Brescia Morra, Maria Trojano, Gioacchino Tedeschi, Giancarlo Comi, Mario Alberto Battaglia, Francesco Patti, Yara Dadalti Fragoso, Sedat Sen, Aksel Siva, Roberto Furlan, Marco Salvetti, Gianmarco Abbadessa, Umberto Aguglia, Lia Allegorico, Rossi Beatrice Maria Allegri, Maria Pia Amato, Pietro Annovazzi, Carlo Antozzi, Lucia Appendino, Sebastiano Arena, Viola Baione, Roberto Balgera, Valeria Barcella, Damiano Baroncini, Caterina Barrilà, Mario A. Battaglia, Alessandra Bellacosa, Gianmarco Bellucci, Roberto Bergamaschi, Valeria Bergamaschi, Daiana Bezzini, Beatrice Biolzi, Alvino Bisecco, Simona Bonavita, Giovanna Borriello, Chiara Bosa, Antonio Bosco, Francesca Bovis, Marco Bozzali, Laura Brambilla, Morra Vincenzo Brescia, Giampaolo Brichetto, Maria Buccafusca, Elisabetta Bucciantini, Sebastiano Bucello, Maria Chiara Buscarinu, Maria Paola Cabboi, Massimiliano Calabrese, Francesca Calabria, Francesca Caleri, Federico Camilli, Luisa Maria Caniatti, Roberto Cantello, Ruggero Capra, Rocco Capuano, Patrizia Carta, Paola Cavalla, Maria Grazia Celani, Maria Cellerino, Raffaella Cerqua, Clara Chisari, Raffaella Clerici, Marinella Clerico, Eleonora Cocco, Gaia Cola, Paolo Confalonieri, Antonella Conte, Marta Zaffira Conti, Christian Cordano, Susanna Cordera, Francesco Corea, Claudio Correale, Salvatore Cottone, Francesco Crescenzo, Erica Curti, Alessandro d’Ambrosio, Emanuele D’Amico, Maura Chiara Danni, Alessia d’Arma, Vincenzo Dattola, Stefano de Biase, Giovanna De Luca, Stefania Federica De Mercanti, Paolo De Mitri, Nicola De Stefano, Marco Della Cava, Mario di Napoli, Alessia Di Sapio, Renato Docimo, Anna Dutto, Luana Evangelista, Salvatore Fanara, Diana Ferraro, Maria Teresa Ferrò, Massimo Filippi, Cristina Fioretti, Mario Fratta, Jessica Frau, Marzia Fronza, Alberto Gajofatto, Antonio Gallo, Paolo Gallo, Claudio Gasperini, Anna Ghazaryan, Bruno Giometto, Francesca Gobbin, Flora Govone, Franco Granella, Erica Grange, Maria Grazia Grasso, Angelica Guareschi, Clara Guaschino, Simone Guerrieri, Donata Guidetti, Pietro Iaffaldano, Antonio Ianniello, Luigi Iasevoli, Daniele Imperiale, Maria Teresa Infante, Matilde Inglese, Rosa Iodice, Aniello Iovino, Giovanna Konrad, Roberta Lanzillo, Caterina Lapucci, Luigi Lavorgna, Rita L’Episcopo Maria, Serena Leva, Giuseppe Liberatore, Marianna Lo Re, Marco Longoni, Leonardo Lopiano, Lorena Lorefice, Matteo Lucchini, Giacomo Lus, Davide Maimone, Maria Malentacchi, Giulia Mallucci, Simona Malucchi, Chiara Rosa Mancinelli, Luca Mancinelli, Paolo Manganotti, Teresa Giorgia Maniscalco, Vittorio Mantero, Sabrina Marangoni, Damiano Marastoni, Alessandra Girolama Marfia, Fabiana Marinelli, Alessandro Marti, Filippo Martinelli Boneschi, Federco Masserano Zoli, Francesca Matta, Laura Mendozzi, Giuseppe Meucci, Silvia Miante, Giuseppina Miele, Eva Milano, Massimiliano Mirabella, Rosanna Missione, Marcello Moccia, Sara Montepietra, Margherita Monti Bragadin, Federico Montini, Roberta Motta, Raffaele Nardone, Carolina Gabri Nicoletti, Eduardo Nobile-Orazio, Agostino Nozzolillo, Marco Onofrj, Riccardo Orlandi, Anna Palmieri, Damiano Paolicelli, Livia Pasquali, Luisa Pastò, Elisabetta Pedrazzoli, Paola Perini, Ilaria Pesci, Maria Petracca, Alfredo Petrone, Carlo Piantadosi, Anna M. Pietroboni, Federica Pinardi, Marta Ponzano, Emilio Portaccio, Mattia Pozzato, Carlo Pozzilli, Luca Prosperini, Alessandra Protti, Paolo Ragonese, Sarah Rasia, Sabrina Realmuto, Anna Repice, Eleonora Rigoni, Maria Teresa Rilla, Francesca Rinaldi, Calogero Marcello Romano, Marco Ronzoni, Marco Rovaris, Francesca Ruscica, Loredana Sabattini, Giuseppe Salemi, Lorenzo Saraceno, Alessia Sartori, Arianna Sartori, Elvira Sbragia, Cinzia Scandellari, Ilaria Scarano Giuditta, Valentina Scarano, Valentina Schillaci, Maria Sessa, Caterina Sgarito, Grazia Sibilia, Gabriele Siciliano, Alessio Signori, Elisabetta Signoriello, Leonardo Sinisi, Francesca Sireci, Patrizia Sola, Claudio Solaro, Stefano Sotgiu, Maddalena Sparaco, Maria Laura Stromillo, Silvia Strumia, Laura Emanuela Susani, Giulietta Tabiadon, Francesco Teatini, Valentina Tomassini, Simone Tonietti, Clerici Valentina Torri, Carla Tortorella, Simona Toscano, Rocco Totaro, Maria Trotta, Gabriella Turano, Monica Ulivelli, Manzo Valentino, Giovanna Vaula, Domizia Vecchio, Marco Vercellino, Elena Pinuccia Verrengia, Marika Vianello, Eleonora Virgilio, Francesca Vitetta, Stefano Vollaro, Mauro Zaffaroni, Mauro Zampolini, Ignazio Roberto Zarbo, Antonio Zito, Luigi Zuliani, Sormani, M. P., Schiavetti, I., Landi, D., Carmisciano, L., De Rossi, N., Cordioli, C., Moiola, L., Radaelli, M., Immovilli, P., Capobianco, M., Brescia Morra, V., Trojano, M., Tedeschi, G., Comi, G., Battaglia, M. A., Patti, F., Fragoso, Y. D., Sen, S., Siva, A., Furlan, R., Salvetti, M., Bisecco, Alvino, Pia Sormani, Maria, Schiavetti, Irene, Landi, Doriana, Carmisciano, Luca, De Rossi, Nicola, Cordioli, Cinzia, Moiola, Lucia, Radaelli, Marta, Immovilli, Paolo, Capobianco, Marco, Brescia Morra, Vincenzo, Trojano, Maria, Tedeschi, Gioacchino, Comi, Giancarlo, Alberto Battaglia, Mario, Patti, Francesco, Dadalti Fragoso, Yara, Sen, Sedat, Siva, Aksel, Furlan, Roberto, Salvetti, Marco, Study Group Gianmarco Abbadessa, MuSC-19, Aguglia, Umberto, Allegorico, Lia, Beatrice Maria Allegri, Rossi, Pia Amato, Maria, Annovazzi, Pietro, Antozzi, Carlo, Appendino, Lucia, Arena, Sebastiano, Baione, Viola, Balgera, Roberto, Barcella, Valeria, Baroncini, Damiano, Barrilà, Caterina, A Battaglia, Mario, Bellacosa, Alessandra, Bellucci, Gianmarco, Bergamaschi, Roberto, Bergamaschi, Valeria, Bezzini, Daiana, Biolzi, Beatrice, Bonavita, Simona, Borriello, Giovanna, Bosa, Chiara, Bosco, Antonio, Bovis, Francesca, Bozzali, Marco, Brambilla, Laura, Vincenzo Brescia, Morra, Brichetto, Giampaolo, Buccafusca, Maria, Bucciantini, Elisabetta, Bucello, Sebastiano, Chiara Buscarinu, Maria, Paola Cabboi, Maria, Calabrese, Massimiliano, Calabria, Francesca, Caleri, Francesca, Camilli, Federico, Maria Caniatti, Luisa, Cantello, Roberto, Capra, Ruggero, Capuano, Rocco, Carta, Patrizia, Cavalla, Paola, Grazia Celani, Maria, Cellerino, Maria, Cerqua, Raffaella, Chisari, Clara, Clerici, Raffaella, Clerico, Marinella, Cocco, Eleonora, Cola, Gaia, Confalonieri, Paolo, Conte, Antonella, Zaffira Conti, Marta, Cordano, Christian, Cordera, Susanna, Corea, Francesco, Correale, Claudio, Cottone, Salvatore, Crescenzo, Francesco, Curti, Erica, D'Ambrosio, Alessandro, D'Amico, Emanuele, Chiara Danni, Maura, D'Arma, Alessia, Dattola, Vincenzo, de Biase, Stefano, De Luca, Giovanna, Federica De Mercanti, Stefania, De Mitri, Paolo, De Stefano, Nicola, Della Cava, Marco, di Napoli, Mario, Di Sapio, Alessia, Docimo, Renato, Dutto, Anna, Evangelista, Luana, Fanara, Salvatore, Ferraro, Diana, Teresa Ferrò, Maria, Filippi, Massimo, Fioretti, Cristina, Fratta, Mario, Frau, Jessica, Fronza, Marzia, Gajofatto, Alberto, Gallo, Antonio, Gallo, Paolo, Gasperini, Claudio, Ghazaryan, Anna, Giometto, Bruno, Gobbin, Francesca, Govone, Flora, Granella, Franco, Grange, Erica, Grazia Grasso, Maria, Guareschi, Angelica, Guaschino, Clara, Guerrieri, Simone, Guidetti, Donata, Iaffaldano, Pietro, Ianniello, Antonio, Iasevoli, Luigi, Imperiale, Daniele, Teresa Infante, Maria, Inglese, Matilde, Iodice, Rosa, Iovino, Aniello, Konrad, Giovanna, Lanzillo, Roberta, Lapucci, Caterina, Lavorgna, Luigi, L'Episcopo Maria, Rita, Leva, Serena, Liberatore, Giuseppe, Lo Re, Marianna, Longoni, Marco, Lopiano, Leonardo, Lorefice, Lorena, Lucchini, Matteo, Lus, Giacomo, Maimone, Davide, Malentacchi, Maria, Mallucci, Giulia, Malucchi, Simona, Rosa Mancinelli, Chiara, Mancinelli, Luca, Manganotti, Paolo, Giorgia Maniscalco, Teresa, Mantero, Vittorio, Marangoni, Sabrina, Marastoni, Damiano, Girolama Marfia, Alessandra, Marinelli, Fabiana, Marti, Alessandro, Martinelli Boneschi, Filippo, Masserano Zoli, Federco, Matta, Francesca, Mendozzi, Laura, Meucci, Giuseppe, Miante, Silvia, Miele, Giuseppina, Milano, Eva, Mirabella, Massimiliano, Missione, Rosanna, Moccia, Marcello, Montepietra, Sara, Monti Bragadin, Margherita, Montini, Federico, Motta, Roberta, Nardone, Raffaele, Gabri Nicoletti, Carolina, Nobile-Orazio, Eduardo, Nozzolillo, Agostino, Onofrj, Marco, Orlandi, Riccardo, Palmieri, Anna, Paolicelli, Damiano, Pasquali, Livia, Pastò, Luisa, Pedrazzoli, Elisabetta, Perini, Paola, Pesci, Ilaria, Petracca, Maria, Petrone, Alfredo, Piantadosi, Carlo, M Pietroboni, Anna, Pinardi, Federica, Ponzano, Marta, Portaccio, Emilio, Pozzato, Mattia, Pozzilli, Carlo, Prosperini, Luca, Protti, Alessandra, Ragonese, Paolo, Rasia, Sarah, Realmuto, Sabrina, Repice, Anna, Rigoni, Eleonora, Teresa Rilla, Maria, Rinaldi, Francesca, Marcello Romano, Calogero, Ronzoni, Marco, Rovaris, Marco, Ruscica, Francesca, Sabattini, Loredana, Salemi, Giuseppe, Saraceno, Lorenzo, Sartori, Alessia, Sartori, Arianna, Sbragia, Elvira, Scandellari, Cinzia, Scarano Giuditta, Ilaria, Scarano, Valentina, Schillaci, Valentina, Sessa, Maria, Sgarito, Caterina, Sibilia, Grazia, Siciliano, Gabriele, Signori, Alessio, Signoriello, Elisabetta, Sinisi, Leonardo, Sireci, Francesca, Sola, Patrizia, Solaro, Claudio, Sotgiu, Stefano, Sparaco, Maddalena, Laura Stromillo, Maria, Strumia, Silvia, Emanuela Susani, Laura, Tabiadon, Giulietta, Teatini, Francesco, Tomassini, Valentina, Tonietti, Simone, Valentina Torri, Clerici, Tortorella, Carla, Toscano, Simona, Totaro, Rocco, Trotta, Maria, Turano, Gabriella, Ulivelli, Monica, Valentino, Manzo, Vaula, Giovanna, Vecchio, Domizia, Vercellino, Marco, Pinuccia Verrengia, Elena, Vianello, Marika, Virgilio, Eleonora, Vitetta, Francesca, Vollaro, Stefano, Zaffaroni, Mauro, Zampolini, Mauro, Roberto Zarbo, Ignazio, Zito, Antonio, Zuliani, Luigi, Abbadessa, Gianmarco, Trotta, Maria Consiglia, and Zito, Guido Antonio
Subjects: 0301 basic medicine, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), immunosuppressive therapie, coronavirus, Settore MED/26, medicine.disease_cause, Antibodies, Viral, immunosuppressive therapies, Antibodies, Serology, Cohort Studies, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Seroepidemiologic Studies, Pandemic, Medicine, Humans, Multiple sclerosi, Viral, Coronavirus, business.industry, immunomodulatory therapie, immunomodulatory therapies, COVID-19, medicine.disease, Virology, coronaviru, Settore MED/26 - NEUROLOGIA, Sars-COV-2, 030104 developmental biology, Neurology, Neurology (clinical), business, SARS-CoV-2, Multiple Sclerosis, 030217 neurology & neurosurgery, Cohort study
Abstract: Background: The MuSC-19 project is an Italian cohort study open to international partners that collects data on multiple sclerosis (MS) patients with COVID-19. During the second wave of the pandemic, serological tests became routinely available. Objective: To evaluate the seroprevalence of anti-SARS-CoV-2 antibodies according to the use of disease-modifying therapy (DMT) in a subset of patients included in the MuSC-19 data set who had undergone a serological test. Methods: We evaluated the association between positive serological test results and time elapsed since infection onset, age, sex, Expanded Disability Status Scale score, comorbidities and DMT exposure using a multivariable logistic model. Results: Data were collected from 423 patients (345 from Italy, 61 from Turkey and 17 from Brazil) with a serological test performed during follow-up. Overall, 325 out of 423 tested patients (76.8%) had a positive serological test. At multivariate analysis, therapy with anti-CD20 was significantly associated with a reduced probability of developing antibodies after COVID-19 (odds ratio (OR) = 0.20, p = 0.002). Conclusion: Patients with MS maintain the capacity to develop humoral immune response against SARS-COV-2, although to a lesser extent when treated with anti-CD20 drugs. Overall, our results are reassuring with respect to the possibility to achieve sufficient immunization with vaccination.
Published: 2021

17. Teleconsultation will replace most face-to-face interactions in the multiple sclerosis clinic – No

Author: Marcello Moccia and Moccia, M.
Subjects: 2019-20 coronavirus outbreak, Remote Consultation, Telemedicine, Multiple sclerosis clinic, Multiple Sclerosis, Coronavirus disease 2019 (COVID-19), business.industry, Multiple sclerosis, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.disease, Ambulatory Care Facilities, Ambulatory Care Facilitie, Face-to-face, Neurology, Multiple Sclerosi, medicine, Humans, Neurology (clinical), Medical emergency, business, Human
Published: 2021

18. COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Author: Maria Pia Sormani, Irene Schiavetti, Luca Carmisciano, Cinzia Cordioli, Massimo Filippi, Marta Radaelli, Paolo Immovilli, Marco Capobianco, Nicola De Rossi, Giampaolo Brichetto, Eleonora Cocco, Cinzia Scandellari, Paola Cavalla, Ilaria Pesci, Antonio Zito, Paolo Confalonieri, Girolama Alessandra Marfia, Paola Perini, Matilde Inglese, Maria Trojano, Vincenzo Brescia Morra, Gioacchino Tedeschi, Giancarlo Comi, Mario Alberto Battaglia, Francesco Patti, Marco Salvetti, Gianmarco Abbadessa, Umberto Aguglia, Lia Allegorico, Beatrice Maria Allegri Rossi, Maria Pia Amato, Pietro Annovazzi, Carlo Antozzi, Lucia Appendino, Sebastiano Arena, Viola Baione, Roberto Balgera, Valeria Barcella, Damiano Baroncini, Caterina Barrilà, Alessandra Bellacosa, Gianmarco Bellucci, Roberto Bergamaschi, Valeria Bergamaschi, Daiana Bezzini, Beatrice Biolzi, Alvino Bisecco, Simona Bonavita, Giovanna Borriello, Chiara Bosa, Antonio Bosco, Francesca Bovis, Marco Bozzali, Laura Brambilla, Maria Buccafusca, Elisabetta Bucciantini, Sebastiano Bucello, Maria Chiara Buscarinu, Maria Paola Cabboi, Massimiliano Calabrese, Francesca Calabria, Francesca Caleri, Federico Camilli, Luisa Maria Caniatti, Roberto Cantello, Ruggero Capra, Rocco Capuano, Patrizia Carta, Maria Grazia Celani, Maria Cellerino, Raffaella Cerqua, Clara Chisari, Raffaella Clerici, Marinella Clerico, Gaia Cola, Antonella Conte, Marta Zaffira Conti, Christian Cordano, Susanna Cordera, Francesco Corea, Claudio Correale, Salvatore Cottone, Francesco Crescenzo, Erica Curti, Alessandro d'Ambrosio, Emanuele D'Amico, Maura Chiara Danni, Alessia d'Arma, Vincenzo Dattola, Stefano de Biase, Giovanna De Luca, Stefania Federica De Mercanti, Paolo De Mitri, Nicola De Stefano, Marco Della Cava, Mario di Napoli, Alessia Di Sapio, Renato Docimo, Anna Dutto, Luana Evangelista, Salvatore Fanara, Ferraro Diana, Maria Teresa Ferrò, Cristina Fioretti, Mario Fratta, Jessica Frau, Marzia Fronza, Roberto Furlan, Alberto Gajofatto, Antonio Gallo, Paolo Gallo, Claudio Gasperini, Anna Ghazaryan, Bruno Giometto, Francesca Gobbin, Flora Govone, Franco Granella, Erica Grange, Maria Grazia Grasso, Angelica Guareschi, Clara Guaschino, Simone Guerrieri, Donata Guidetti, Pietro Iaffaldano, Antonio Ianniello, Luigi Iasevoli, Daniele Imperiale, Maria Teresa Infante, Rosa Iodice, Aniello Iovino, Giovanna Konrad, Doriana Landi, Roberta Lanzillo, Caterina Lapucci, Luigi Lavorgna, Maria Rita L'Episcopo, Serena Leva, Giuseppe Liberatore, Marianna Lo Re, Marco Longoni, Leonardo Lopiano, Lorena Lorefice, Matteo Lucchini, Giacomo Lus, Davide Maimone, Maria Malentacchi, Giulia Mallucci, Simona Malucchi, Chiara Rosa Mancinelli, Luca Mancinelli, Paolo Manganotti, Giorgia Teresa Maniscalco, Vittorio Mantero, Sabrina Marangoni, Damiano Marastoni, Fabiana Marinelli, Alessandro Marti, Filippo Martinelli Boneschi, Federco Masserano Zoli, Francesca Matta, Laura Mendozzi, Giuseppe Meucci, Silvia Miante, Giuseppina Miele, Eva Milano, Massimiliano Mirabella, Rosanna Missione, Marcello Moccia, Lucia Moiola, Sara Montepietra, Margherita MontiBragadin, Federico Montini, Roberta Motta, Raffaele Nardone, Carolina Gabri Nicoletti, Eduardo Nobile-Orazio, Agostino Nozzolillo, Marco Onofrj, Riccardo Orlandi, Anna Palmieri, Damiano Paolicelli, Livia Pasquali, Luisa Pastò, Elisabetta Pedrazzoli, Maria Petracca, Alfredo Petrone, Carlo Piantadosi, Anna M Pietroboni, Federica Pinardi, Marta Ponzano, Emilio Portaccio, Mattia Pozzato, Carlo Pozzilli, Luca Prosperini, Alessandra Protti, Paolo Ragonese, Sarah Rasia, Sabrina Realmuto, Anna Repice, Eleonora Rigoni, Maria Teresa Rilla, Francesca Rinaldi, Calogero Marcello Romano, Marco Ronzoni, Marco Rovaris, Francesca Ruscica, Loredana Sabattini, Giuseppe Salemi, Lorenzo Saraceno, Alessia Sartori, Arianna Sartori, Elvira Sbragia, Giuditta Ilaria Scarano, Valentina Scarano, Valentina Schillaci, Maria Sessa, Caterina Sgarito, Grazia Sibilia, Gabriele Siciliano, Alessio Signori, Elisabetta Signoriello, Leonardo Sinisi, Francesca Sireci, Patrizia Sola, Claudio Solaro, Stefano Sotgiu, Maddalena Sparaco, Maria Laura Stromillo, Silvia Strumia, Emanuela Laura Susani, Giulietta Tabiadon, Francesco Teatini, Valentina Tomassini, Simone Tonietti, Clerici Valentina Torri, Carla Tortorella, Simona Toscano, Rocco Totaro, Maria Trotta, Gabriella Turano, Monica Ulivelli, Manzo Valentino, Giovanna Vaula, Domizia Vecchio, Marco Vercellino, Elena Pinuccia Verrengia, Marika Vianello, Eleonora Virgilio, Francesca Vitetta, Stefano Vollaro, Mauro Zaffaroni, Mauro Zampolini, Ignazio Roberto Zarbo, Luigi Zuliani, Pia Sormani, Maria, Schiavetti, Irene, Carmisciano, Luca, Cordioli, Cinzia, Filippi, Massimo, Radaelli, Marta, Immovilli, Paolo, Capobianco, Marco, De Rossi, Nicola, Brichetto, Giampaolo, Cocco, Eleonora, Scandellari, Cinzia, Cavalla, Paola, Pesci, Ilaria, Zito, Guido Antonio, Confalonieri, Paolo, Alessandra Marfia, Girolama, Perini, Paola, Inglese, Matilde, Trojano, Maria, Brescia Morra, Vincenzo, Tedeschi, Gioacchino, Comi, Giancarlo, Alberto Battaglia, Mario, Patti, Francesco, Salvetti, Marco, Abbadessa, Gianmarco, Aguglia, Umberto, Allegorico, Lia, Maria Allegri Rossi, Beatrice, Pia Amato, Maria, Annovazzi, Pietro, Antozzi, Carlo, Appendino, Lucia, Arena, Sebastiano, Baione, Viola, Balgera, Roberto, Barcella, Valeria, Baroncini, Damiano, Barrilà, Caterina, Bellacosa, Alessandra, Bellucci, Gianmarco, Bergamaschi, Roberto, Bergamaschi, Valeria, Bezzini, Daiana, Biolzi, Beatrice, Bisecco, Alvino, Bonavita, Simona, Borriello, Giovanna, Bosa, Chiara, Bosco, Antonio, Bovis, Francesca, Bozzali, Marco, Brambilla, Laura, Buccafusca, Maria, Bucciantini, Elisabetta, Bucello, Sebastiano, Chiara Buscarinu, Maria, Paola Cabboi, Maria, Calabrese, Massimiliano, Calabria, Francesca, Caleri, Francesca, Camilli, Federico, Maria Caniatti, Luisa, Cantello, Roberto, Capra, Ruggero, Capuano, Rocco, Carta, Patrizia, Grazia Celani, Maria, Cellerino, Maria, Cerqua, Raffaella, Chisari, Clara, Clerici, Raffaella, Clerico, Marinella, Cola, Gaia, Conte, Antonella, Zaffira Conti, Marta, Cordano, Christian, Cordera, Susanna, Corea, Francesco, Correale, Claudio, Cottone, Salvatore, Crescenzo, Francesco, Curti, Erica, D'Ambrosio, Alessandro, D'Amico, Emanuele, Chiara Danni, Maura, D'Arma, Alessia, Dattola, Vincenzo, de Biase, Stefano, De Luca, Giovanna, Federica De Mercanti, Stefania, De Mitri, Paolo, De Stefano, Nicola, Della Cava, Marco, di Napoli, Mario, Di Sapio, Alessia, Docimo, Renato, Dutto, Anna, Evangelista, Luana, Fanara, Salvatore, Diana, Ferraro, Teresa Ferrò, Maria, Fioretti, Cristina, Fratta, Mario, Frau, Jessica, Fronza, Marzia, Furlan, Roberto, Gajofatto, Alberto, Gallo, Antonio, Gallo, Paolo, Gasperini, Claudio, Ghazaryan, Anna, Giometto, Bruno, Gobbin, Francesca, Govone, Flora, Granella, Franco, Grange, Erica, Grazia Grasso, Maria, Guareschi, Angelica, Guaschino, Clara, Guerrieri, Simone, Guidetti, Donata, Iaffaldano, Pietro, Ianniello, Antonio, Iasevoli, Luigi, Imperiale, Daniele, Teresa Infante, Maria, Iodice, Rosa, Iovino, Aniello, Konrad, Giovanna, Landi, Doriana, Lanzillo, Roberta, Lapucci, Caterina, Lavorgna, Luigi, Rita L'Episcopo, Maria, Leva, Serena, Liberatore, Giuseppe, Lo Re, Marianna, Longoni, Marco, Lopiano, Leonardo, Lorefice, Lorena, Lucchini, Matteo, Lus, Giacomo, Maimone, Davide, Malentacchi, Maria, Mallucci, Giulia, Malucchi, Simona, Rosa Mancinelli, Chiara, Mancinelli, Luca, Manganotti, Paolo, Teresa Maniscalco, Giorgia, Mantero, Vittorio, Marangoni, Sabrina, Marastoni, Damiano, Marinelli, Fabiana, Marti, Alessandro, Martinelli Boneschi, Filippo, Masserano Zoli, Federco, Matta, Francesca, Mendozzi, Laura, Meucci, Giuseppe, Miante, Silvia, Miele, Giuseppina, Milano, Eva, Mirabella, Massimiliano, Missione, Rosanna, Moccia, Marcello, Moiola, Lucia, Montepietra, Sara, Montibragadin, Margherita, Montini, Federico, Motta, Roberta, Nardone, Raffaele, Gabri Nicoletti, Carolina, Nobile-Orazio, Eduardo, Nozzolillo, Agostino, Onofrj, Marco, Orlandi, Riccardo, Palmieri, Anna, Paolicelli, Damiano, Pasquali, Livia, Pastò, Luisa, Pedrazzoli, Elisabetta, Petracca, Maria, Petrone, Alfredo, Piantadosi, Carlo, M Pietroboni, Anna, Pinardi, Federica, Ponzano, Marta, Portaccio, Emilio, Pozzato, Mattia, Pozzilli, Carlo, Prosperini, Luca, Protti, Alessandra, Ragonese, Paolo, Rasia, Sarah, Realmuto, Sabrina, Repice, Anna, Rigoni, Eleonora, Teresa Rilla, Maria, Rinaldi, Francesca, Marcello Romano, Calogero, Ronzoni, Marco, Rovaris, Marco, Ruscica, Francesca, Sabattini, Loredana, Salemi, Giuseppe, Saraceno, Lorenzo, Sartori, Alessia, Sartori, Arianna, Sbragia, Elvira, Ilaria Scarano, Giuditta, Scarano, Valentina, Schillaci, Valentina, Sessa, Maria, Sgarito, Caterina, Sibilia, Grazia, Siciliano, Gabriele, Signori, Alessio, Signoriello, Elisabetta, Sinisi, Leonardo, Sireci, Francesca, Sola, Patrizia, Solaro, Claudio, Sotgiu, Stefano, Sparaco, Maddalena, Laura Stromillo, Maria, Strumia, Silvia, Laura Susani, Emanuela, Tabiadon, Giulietta, Teatini, Francesco, Tomassini, Valentina, Tonietti, Simone, Valentina Torri, Clerici, Tortorella, Carla, Toscano, Simona, Totaro, Rocco, Trotta, Maria Consiglia, Turano, Gabriella, Ulivelli, Monica, Valentino, Manzo, Vaula, Giovanna, Vecchio, Domizia, Vercellino, Marco, Pinuccia Verrengia, Elena, Vianello, Marika, Virgilio, Eleonora, Vitetta, Francesca, Vollaro, Stefano, Zaffaroni, Mauro, Zampolini, Mauro, Roberto Zarbo, Ignazio, Zuliani, Luigi, Sormani, M. P., Schiavetti, I., Carmisciano, L., Cordioli, C., Filippi, M., Radaelli, M., Immovilli, P., Capobianco, M., De Rossi, N., Brichetto, G., Cocco, E., Scandellari, C., Cavalla, P., Pesci, I., Zito, A., Confalonieri, P., Marfia, G. A., Perini, P., Inglese, M., Trojano, M., Brescia Morra, V., Tedeschi, G., Comi, G., Battaglia, M. A., Patti, F., Salvetti, M., Zito, Antonio, BRESCIA MORRA, Vincenzo, Trotta, Maria, Sormani, Maria Pia, Marfia, Girolama Alessandra, and Battaglia, Mario Alberto
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Coronavirus disease 2019 (COVID-19), Population, Intensive Care Unit, COVID-19, Cohort Studies, Comorbidity, Female, Hospitalization, Humans, Intensive Care Units, Italy, Middle Aged, Retrospective Studies, Risk Factors, Severity of Illness Index, Context (language use), Settore MED/26, Lower risk, Retrospective Studie, Internal medicine, Multiple Sclerosi, Medicine, In patient, National level, education, education.field_of_study, Expanded Disability Status Scale, business.industry, Risk Factor, Ethics committee, medicine.disease, Icu admission, Settore MED/26 - NEUROLOGIA, Neurology, Relative risk, Family medicine, Cohort, Honorarium, Observational study, Neurology (clinical), Cohort Studie, business, Human
Abstract: Background: It is unclear how multiple sclerosis (MS) affects the severity of Covid-19. Methods: Hospitalization, Intensive Care Unit (ICU) admission and death after Covid-19 diagnosis of 1362 MS patients were compared to the age and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher-risk: EDSS>3 or at least one comorbidity, lower-risk: EDSS
Published: 2021

19. Demyelinating disorders following COVID-19 vaccination

Author: Marcello Moccia and Moccia, M.
Subjects: 2019-20 coronavirus outbreak, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, business.industry, Multiple sclerosis, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Vaccination, MEDLINE, COVID-19, medicine.disease, Neurology, Immunology, medicine, Humans, Neurology (clinical), business, Demyelinating Disorder, Demyelinating Diseases
Published: 2021

20. Physical Exercise Moderates the Effects of Disability on Depression in People with Multiple Sclerosis during the COVID-19 Outbreak

Author: Francesca Trojsi, Giuseppe Servillo, Simona Bonavita, Laura Rosa, Matilde Inglese, Maria Cellerino, Massimo Filippi, Teresa Costabile, Giovanna Borriello, Roberta Lanzillo, Giacomo Boffa, Maria Petracca, Agostino Nozzolillo, Cristiano Scandurra, Martina Petruzzo, Marcello Moccia, Alessandro Chiodi, Antonio Ianniello, Lucia Moiola, Antonio Carotenuto, Luigi Lavorgna, Vincenzo Brescia Morra, Carotenuto, Antonio, Scandurra, Cristiano, Costabile, Teresa, Lavorgna, Luigi, Borriello, Giovanna, Moiola, Lucia, Inglese, Matilde, Trojsi, Francesca, Petruzzo, Martina, Ianniello, Antonio, Nozzolillo, Agostino, Cellerino, Maria, Boffa, Giacomo, Rosa, Laura, Chiodi, Alessandro, Servillo, Giuseppe, Moccia, Marcello, Bonavita, Simona, Filippi, Massimo, Petracca, Maria, Brescia Morra, Vincenzo, and Lanzillo, Roberta
Subjects: Physical disability, lcsh:Medicine, Context (language use), Physical exercise, multiple sclerosis, Article, 03 medical and health sciences, 0302 clinical medicine, physical exercise, COVID-19, anxiety, depression, Medicine, 030212 general & internal medicine, Depression (differential diagnoses), business.industry, Multiple sclerosis, Anxiety, Depression, lcsh:R, General Medicine, medicine.disease, Mental health, multiple sclerosi, medicine.symptom, business, Psychosocial, 030217 neurology & neurosurgery, Clinical psychology
Abstract: Physical disability impacts psychosocial wellbeing in people with multiple sclerosis. However, the role of physical activity in this context is still debated. By taking advantage of a previous survey, conducted online from 22 April to 7 May 2020, we performed a post-hoc analysis with the aim to assess the associations between disability, physical exercise, and mental health in multiple sclerosis. We retrieved the following data: (i) sociodemographic information, (ii) changes in lifestyle (including exercise), (iii) physical disability, as measured with the Patient-Determined Disease Steps scale, and (iv) anxiety feelings and depressive symptoms assessed via the items included in the Quality of Life in Neurological Disorders measurement system. Examination of the interaction plot showed that the effect of disability on depression, but not on anxious symptoms, was significant for all levels of physical exercise (low: b = 1.22, 95% C.I. 0.85, 1.58, p &lt, 0.001, moderate: b = 0.95, 95% C.I. 0.66, 1.24, p &lt, and high: b = 0.68, 95% C.I. 0.24, 1.13, p = 0.003). Based on these data, we can conclude that disability significantly impacted depression during the COVID-19 pandemic, with physical activity playing a moderating role. Our results suggest that favoring exercise in multiple sclerosis (MS) would ameliorate psychological wellbeing regardless of the level of physical disability.
Published: 2021

21. The Framingham cardiovascular risk score and 5-year progression of multiple sclerosis

Author: Fabrizio Luiso, Antonio Reia, Antonio Carotenuto, Vincenzo Brescia Morra, Lia Allegorico, Martina Petruzzo, Roberta Lanzillo, Giorgia Teresa Maniscalco, Marcello Moccia, Cinzia Valeria Russo, Raffaele Palladino, Petruzzo, Martina, Reia, Antonio, Maniscalco, Giorgia Teresa, Luiso, Fabrizio, Lanzillo, Roberta, Russo, Cinzia Valeria, Carotenuto, Antonio, Allegorico, Lia, Palladino, Raffaele, Brescia Morra, Vincenzo, and Moccia, Marcello
Subjects: medicine.medical_specialty, Clinical Neurology, multiple sclerosis, PROFILE, DISABILITY PROGRESSION, DISEASE, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Humans, Multiple sclerosi, 030212 general & internal medicine, BRAIN ATROPHY, Retrospective Studies, Macrovascular disease, relapse, Framingham Risk Score, Science & Technology, Neurology & Neurosurgery, business.industry, cardiovascular, Hazard ratio, Neurosciences, Retrospective cohort study, 1103 Clinical Sciences, MS, medicine.disease, Confidence interval, COMORBIDITIES, LIFE, Blood pressure, Neurology, disability, Cardiovascular Diseases, Heart Disease Risk Factors, Disease Progression, Neurology (clinical), Neurosciences & Neurology, CIGARETTE-SMOKING, business, FOLLOW-UP, 1109 Neurosciences, Body mass index, Life Sciences & Biomedicine, 030217 neurology & neurosurgery
Abstract: Background and purpose Cardiovascular risk factors and comorbidities can affect the prognosis of multiple sclerosis (MS). The Framingham risk score is an algorithm that can estimate the 10-year risk of developing macrovascular disease. Our objectives were to evaluate the possible association between the Framingham risk score at baseline and MS relapses, disability, and disease-modifying therapy (DMT) choices over a 5-year follow-up. Methods This is a retrospective cohort study including 251 MS subjects. At baseline, we calculated the Framingham risk score considering the following variables: age, sex, diabetes, smoking, systolic blood pressure, and body mass index. MS outcomes including relapses, disability, and treatments were collected over 5 years. Cox proportional regression models were employed to estimate hazard ratios (HRs). Results A one-point increase in the Framingham risk score was associated with 31% higher risk of relapse (HR = 1.31; 95% confidence interval [CI] = 1.03, 1.68), 19% higher risk of reaching of EDSS 6.0 (HR = 1.19; 95% CI = 1.05, 3.01), and 62% higher risk of DMT escalation (HR = 1.62; 95% CI = 1.22, 3.01). Conclusions Higher cardiovascular risk was associated with higher risk of relapses, disability, and DMT escalation in MS. Early identification, correction, and treatment of cardiovascular comorbidities should be carefully considered within MS management.
Published: 2021

22. Ocrelizumab depletes T-lymphocytes more than rituximab in multiple sclerosis

Author: Antonio Carotenuto, Roberta Lanzillo, Marcello Moccia, Cinzia Valeria Russo, Agostino Nozzolillo, Francesco Saccà, Nicola Capasso, Giulia Scalia, Marcello De Angelis, Martina Petruzzo, Vincenzo Brescia Morra, Capasso, N., Nozzolillo, A., Scalia, G., Lanzillo, R., Carotenuto, A., De Angelis, M., Petruzzo, M., Saccà, Francesco, Russo, C. V., Brescia Morra, V., and Moccia, M.
Subjects: Multiple Sclerosis, Lymphocyte, Antibodies, Monoclonal, Humanized, CD19, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Retrospective Studie, hemic and lymphatic diseases, medicine, Humans, Multiple sclerosi, 030212 general & internal medicine, Ocrelizumab, Lymphocyte Count, Retrospective Studies, CD20, biology, business.industry, Multiple sclerosis, General Medicine, medicine.disease, medicine.anatomical_structure, Neurology, Immunology, biology.protein, Rituximab, Neurology (clinical), Antibody, business, 030217 neurology & neurosurgery, CD8, medicine.drug, Human
Abstract: Background: We aim to directly compare changes in lymphocyte subpopulations between chimeric (rituximab) and humanised (ocrelizumab) anti-CD20 antibodies in multiple sclerosis (MS). Methods: In this retrospective analysis of prospectively collected data, we included 88 patients with MS, treated with rituximab (n=50) or ocrelizumab (n=38). We used flow cytometry in the peripheral blood to count total lymphocytes and lymphocytes expressing different phenotypic markers (CD4, CD8, CD19, CD20, CD4/CD8 ratio), before treatment and after 1, 3 and 6 months. Results: On linear mixed effect regression models, after 1, 3 and 6 months, patients treated with rituximab and with ocrelizumab were similar in total lymphocyte count, CD19 lymphocytes, CD20 lymphocytes and CD4/CD8 ratio. However, patients treated with ocrelizumab presented with lower CD4 T lymphocytes and CD8 T lymphocytes after 1, 3 and 6 months (all p
Published: 2021

23. Interferon beta for the treatment of multiple sclerosis in the Campania Region of Italy: Merging the real-life to routinely collected healthcare data

Author: Antonio Capacchione, Raffaele Palladino, Roberta Lanzillo, Maria Triassi, Vincenzo Brescia Morra, Emma Montella, Marcello Moccia, Antonio Carotenuto, Giuseppina Affinito, Moccia, M., Affinito, G., Capacchione, A., Lanzillo, R., Carotenuto, A., Montella, E., Triassi, M., Morra, V. B., and Palladino, R.
Subjects: Male, Registrie, Epidemiology, Biochemistry, Geographical locations, Persistence (computer science), Medical Conditions, Mathematical and Statistical Techniques, Immunologic Factor, Retrospective Studie, Outpatients, Multiple Sclerosi, Medicine and Health Sciences, Registries, Healthcare data, education.field_of_study, Multidisciplinary, Statistics, Neurodegenerative Diseases, Middle Aged, Hospitals, Multidisciplinary Sciences, Europe, Treatment Outcome, Neurology, Italy, Physical Sciences, symbols, Science & Technology - Other Topics, Regression Analysis, Medicine, Female, Research Article, Human, Adult, medicine.medical_specialty, Multiple Sclerosis, Patients, General Science & Technology, Science, Population, Immunology, MEDLINE, Linear Regression Analysis, Research and Analysis Methods, Autoimmune Diseases, symbols.namesake, Internal medicine, Linear regression, medicine, Humans, Immunologic Factors, Poisson regression, European Union, Statistical Methods, education, Retrospective Studies, Hospitalizations, Science & Technology, business.industry, Multiple sclerosis, Biology and Life Sciences, Proteins, Interferon-beta, medicine.disease, Demyelinating Disorders, Discontinuation, Health Care, Health Care Facilities, Medical Risk Factors, Clinical Immunology, Interferons, Clinical Medicine, People and places, business, Mathematics
Abstract: Background We aim to overcome limitations of previous clinical and population-based studies by merging a clinical registry to routinely-collected healthcare data, and to specifically describe differences in clinical outcomes, healthcare resource utilization and costs between interferon beta formulations for multiple sclerosis (MS). Methods We included 850 patients with MS treated with interferon beta formulations, from 2015 to 2019, seen at the MS Clinical Care and Research Centre (Federico II University of Naples, Italy) and with linkage to routinely-collected healthcare data (prescription data, hospital admissions, outpatient services). We extracted and computed clinical outcomes (relapses, 6-month EDSS progression using a roving EDSS as reference), persistence (time spent on a specific interferon beta formulation), adherence (medication possession ratio (MPR)), healthcare resource utilization and costs (annualized hospitalization rate (AHR), costs for hospital admissions and DMTs). To evaluate differences between interferon beta formulations, we used linear regression (adherence), Poisson regression (AHR), mixed-effect regression (costs), and Cox-regression models (time varying variables); covariates were age, sex, treatment duration, baseline EDSS and adherence. Results Looking at clinical outcomes, rates of relapses and EDSS progression were lower than studies run on previous cohorts; there was no differences in relapse risk between interferon beta formulations. Risk of discontinuation was higher for Betaferon®/Extavia® (HR = 3.28; 95%CI = 2.11, 5.12; p Conclusions We have showed the feasibility of merging routinely-collected healthcare data to a clinical registry for future MS research, and have confirmed interferon beta formulations play an important role in the management of MS, with positive clinical outcomes. Differences between interferon beta formulations are mostly driven by adherence and healthcare resource utilization.
Published: 2021

24. Digital Technology in Clinical Trials for Multiple Sclerosis: Systematic Review

Author: Luigi Lavorgna, Vincenzo Brescia Morra, Marcello Moccia, Martina Petruzzo, Marcello De Angelis, Roberta Lanzillo, Antonio Carotenuto, De Angelis, Marcello, Lavorgna, Luigi, Carotenuto, Antonio, Petruzzo, Martina, Lanzillo, Roberta, Brescia Morra, Vincenzo, and Moccia, Marcello
Subjects: medicine.medical_specialty, 020205 medical informatics, Treatment adherence, Psychological intervention, 02 engineering and technology, Review, multiple sclerosis, 03 medical and health sciences, outcome measures, 0302 clinical medicine, Physical medicine and rehabilitation, 0202 electrical engineering, electronic engineering, information engineering, Medicine, Cognitive rehabilitation therapy, business.industry, Multiple sclerosis, Outcome measures, clinical trial, General Medicine, Disease monitoring, medicine.disease, Clinical trial, multiple sclerosi, The Internet, digital technology, business, 030217 neurology & neurosurgery
Abstract: Clinical trials in multiple sclerosis (MS) have been including digital technology tools to overcome limitations in treatment delivery and disease monitoring. In March 2020, we conducted a systematic search on pubmed.gov and clinicaltrials.gov databases (with no restrictions) to identify all relevant published and unpublished clinical trials, in English language, including MS patients, in which digital technology was applied. We used “multiple sclerosis” and “clinical trial” as the main search words, and “app”, “digital”, “electronic”, “internet” and “mobile” as additional search words, separately. Digital technology is part of clinical trial interventions to deliver psychotherapy and motor rehabilitation, with exergames, e-training, and robot-assisted exercises. Digital technology has been used to standardise previously existing outcome measures, with automatic acquisitions, reduced inconsistencies, and improved detection of symptoms (e.g., electronic recording of motor performance). Other clinical trials have been using digital technology for monitoring symptoms that would be otherwise difficult to detect (e.g., fatigue, balance), for measuring treatment adherence and side effects, and for self-assessment purposes. Collection of outcome measures is progressively shifting from paper-based on site, to internet-based on site, and, in the future, to internet-based at home, with the detection of clinical and treatment features that would have remained otherwise invisible. Similarly, remote interventions provide new possibilities of motor and cognitive rehabilitation.
Published: 2021

25. Review for 'A case report of late‐onset atypical Hemolytic Uremic Syndrome during interferon beta in multiple sclerosis: Open issues in literature review'

Author: Marcello Moccia
Subjects: Interferon beta, business.industry, Multiple sclerosis, Immunology, Atypical hemolytic uremic syndrome, Medicine, Late onset, business, medicine.disease
Published: 2020

26. Telemedicine for management of patients with amyotrophic lateral sclerosis through COVID-19 tail

Author: Bombaci, Alessandro, Abbadessa, Gianmarco, Trojsi, Francesca, Leocani, Letizia, Bonavita, Simona, Lavorgna, Luigi, Gioacchino Tedeschi, Giovanni Mancardi, Alessandro Padovani, Marinella Clerico, Francesco Brigo, Roberta Lanzillo, Antonio Russo, Bruno Giometto, Giulia Straccia, Rosa Iodice, Sebastiano Bucello, Pietro Annovazzi, Marcello Moccia, Luca Prosperini, Maria Laura Stromillo, Anna Maria Repice, Giuseppina Miele, Alberto Lerario, Antonio De Martino, Francesco Iodice, Francesco Di Lorenzo, Luca Cuffaro, Michele Romoli, Marcello Silvestro, Carlo Alberto Artusi, Bombaci, Alessandro, Abbadessa, Gianmarco, Trojsi, Francesca, Leocani, Letizia, Bonavita, Simona, Lavorgna, Luigi, Bombaci, A., Abbadessa, G., Trojsi, F., Leocani, L., Bonavita, S., Lavorgna, L., Tedeschi, G., Mancardi, G., Padovani, A., Clerico, M., Brigo, F., Lanzillo, R., Russo, A., Giometto, B., Straccia, G., Iodice, R., Bucello, S., Annovazzi, P., Moccia, M., Prosperini, L., Stromillo, M. L., Repice, A. M., Miele, G., Lerario, A., De Martino, A., Iodice, F., Di Lorenzo, F., Cuffaro, L., Romoli, M., Silvestro, M., Artusi, C. A., Bombaci, A, Abbadessa, G, Trojsi, F, Leocani, L, Bonavita, S, Lavorgna, L, Tedeschi, G, Mancardi, G, Padovani, A, Clerico, M, Brigo, F, Lanzillo, R, Russo, A, Giometto, B, Straccia, G, Iodice, R, Bucello, S, Annovazzi, P, Moccia, M, Prosperini, L, Stromillo, M, Repice, A, Miele, G, Lerario, A, De Martino, A, Iodice, F, Di Lorenzo, F, Cuffaro, L, Romoli, M, Silvestro, M, Artusi, C, Alessandro, Bombaci, Gianmarco, Abbadessa, Francesca, Trojsi, Letizia, Leocani, Simona, Bonavita, Luigi, Lavorgna, Tedeschi, Gioacchino, Mancardi, Giovanni, Padovani, Alessandro, Clerico, Marinella, Brigo, Francesco, Lanzillo, Roberta, Russo, Antonio, Giometto, Bruno, Straccia, Giulia, Iodice, Rosa, Bucello, Sebastiano, Annovazzi, Pietro, Moccia, Marcello, Prosperini, Luca, Laura Stromillo, Maria, Maria Repice, Anna, Miele, Giuseppina, Lerario, Alberto, De Martino, Antonio, Iodice, Francesco, Di Lorenzo, Francesco, Cuffaro, Luca, Romoli, Michele, Silvestro, Marcello, and Alberto Artusi, Carlo
Subjects: medicine.medical_specialty, Telemedicine, Neurology, Coronavirus disease 2019 (COVID-19), Clinical Neurology, Monitoring, Ambulatory, Context (language use), Disease, Review Article, Dermatology, Tele-health, Teleneurology, ALS patients, COVID-19, Remote monitoring, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, Humans, 030212 general & internal medicine, Amyotrophic lateral sclerosis, Intensive care medicine, business.industry, Amyotrophic Lateral Sclerosis, General Medicine, medicine.disease, Psychiatry and Mental health, ALS patient, Neurology (clinical), Neurosurgery, business, 030217 neurology & neurosurgery
Abstract: Over the last months, due to coronavirus disease (COVID-19) pandemic, containment measures have led to important social restriction. Healthcare systems have faced a complete rearrangement of resources and spaces, with the creation of wards devoted to COVID-19 patients. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. Telemedicine may allow meet the needs of these patients. In this commentary, we briefly discuss the digital tools to remotely monitor and manage ALS patients. Focusing on detecting disease progression and preventing life-threatening conditions, we propose a toolset able to improve ALS management during this unprecedented situation.
Published: 2020
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27. Mild or no COVID-19 symptoms in cladribine-treated multiple sclerosis: Two cases and implications for clinical practice

Author: Maria Petracca, Marcello Moccia, Roberta Lanzillo, Marcello De Angelis, Vincenzo Brescia Morra, De Angelis, Marcello, Petracca, Maria, Lanzillo, Roberta, Brescia Morra, Vincenzo, and Moccia, Marcello
Subjects: lymphocytes, Coronavirus disease 2019 (COVID-19), Lymphocyte, Clinical Neurology, COVID-19, cladribine, multiple sclerosis, Article, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Immune system, medicine, 030212 general & internal medicine, Cladribine, biology, business.industry, General Medicine, medicine.disease, Vaccination, medicine.anatomical_structure, Viral replication, Neurology, Immunology, biology.protein, Neurology (clinical), Antibody, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Background The use of disease-modifying therapies (DMTs) in multiple sclerosis (MS) could affect COVID-19 outcomes by modulating the immune response, which, in turn, might favor viral replication and/or confer protection from COVID-19 induced inflammatory response Case report We report on two MS patients treated with cladribine, with heterogeneous demographics and clinical features, who developed mild or no symptoms from COVID-19 and produced anti-SARS-CoV-2 antibodies, notwithstanding low lymphocyte levels. Implications Benign COVID-19 clinical course and anti-SARS-CoV-2 antibody production can occur in MS patients with lymphopenia, suggesting the possibility to respond to COVID-19 vaccination, once available, in this vulnerable population.
Published: 2020
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28. Disability through COVID‐19 pandemic: neurorehabilitation cannot wait

Author: Karin Diserens, Carlo Caltagirone, Letizia Leocani, Marcello Moccia, Leocani, L., Diserens, K., Moccia, M., Caltagirone, C., and Neurorehabilitation Scientific Panel of the European Academy of Neurology-EAN
Subjects: robotic, Telemedicine, Movement disorders, medicine.medical_treatment, Clinical Neurology, 03 medical and health sciences, 0302 clinical medicine, Telerehabilitation, Intensive care, Pandemic, Medicine, Dementia, 030212 general & internal medicine, Neurorehabilitation, neurorehabilitation, Rehabilitation, business.industry, COVID-19, medicine.disease, Neurology, telemedicine, telerehabilitation, Neurology (clinical), Medical emergency, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Coronavirus disease 2019 (CoViD-19) pandemic is strongly impacting all domains of our healthcare systems, including rehabilitation. In Italy, the first hit European country, medical activities were postponed to allow shifting of staff and facilities to intensive care, with neurorehabilitation limited to time-dependent diseases, 1 including CoViD-19 complications. 2,3 Hospital access to people with chronic neurodegenerative conditions such as multiple sclerosis, movement disorders or dementia, more at risks of serious consequences from the infection, 4 has been postponed. Patients also seek less for hospital care, with over 50% reduced stroke admissions as from an Italian survey, 5 possibly in fear of being infected or denied to see their families after being hospitalized. This situation can be bearable only for a short time, as any initial freezing reaction to a danger.
Published: 2020

29. The Use of Social Media and Digital Devices Among Italian Neurologists

Author: Luigi Lavorgna, Francesco Brigo, Gianmarco Abbadessa, Sebastiano Bucello, Marinella Clerico, Eleonora Cocco, Rosa Iodice, Roberta Lanzillo, Letizia Leocani, Alberto Lerario, Marcello Moccia, Alessandro Padovani, Luca Prosperini, Anna Repice, Maria Stromillo, Francesca Trojsi, Gianluigi Mancardi, Gioacchino Tedeschi, Simona Bonavita, Lavorgna, L., Brigo, F., Abbadessa, G., Bucello, S., Clerico, M., Cocco, E., Iodice, R., Lanzillo, R., Leocani, L., Lerario, A., Moccia, M., Padovani, A., Prosperini, L., Repice, A., Stromillo, M., Trojsi, F., Mancardi, G., Tedeschi, G., Bonavita, S., Lavorgna, Luigi, Brigo, Francesco, Abbadessa, Gianmarco, Bucello, Sebastiano, Clerico, Marinella, Cocco, Eleonora, Iodice, Rosa, Lanzillo, Roberta, Leocani, Letizia, Lerario, Alberto, Moccia, Marcello, Padovani, Alessandro, Prosperini, Luca, Repice, Anna, Stromillo, Maria, Trojsi, Francesca, Mancardi, Gianluigi, Tedeschi, Gioacchino, and Bonavita, Simona
Subjects: 020205 medical informatics, media_common.quotation_subject, social media, digital device, digital health, Face (sociological concept), 02 engineering and technology, lcsh:RC346-429, digital devices, 03 medical and health sciences, 0302 clinical medicine, wearable devices, Health care, 0202 electrical engineering, electronic engineering, information engineering, Social media, Everyday life, app, Wearable technology, lcsh:Neurology. Diseases of the nervous system, media_common, Original Research, Medical education, business.industry, Digital health, Friendship, Neurology, Personal computer, Neurology (clinical), Psychology, business, 030217 neurology & neurosurgery
Abstract: Background: Digital devices and online social networks are changing clinical practice. In this study, we explored attitudes, awareness, opinions, and experiences of neurologists toward social media and digital devices. Methods: Each member of the Italian Society of Neurology (SIN) participated in an online survey (January to May 2018) to collect information on their attitude toward digital health. Results: Four hundred and five neurologists participated in the study. At work, 95% of responders use the personal computer, 87% the smartphone, and 43.5% the tablet. These devices are used to obtain health information (91%), maintain contact with colleagues (71%), provide clinical information (59%), and receive updates (67%). Most participants (56%) use social media to communicate with patients, although 65% are against a friendship with them on social media. Most participants interact with patients on social media outside working hours (65.2%) and think that social media have improved (38.0%) or greatly improved (25.4%) the relationship with patients. Most responders (66.7%) have no wearable devices available in clinical practice. Conclusion: Italian neurologists have different practices and views regarding the doctor-patient relationship in social media. The availability of digital devices in daily practice is limited. The use of social networks and digital devices will increasingly permeate into everyday life, bringing a new dimension to health care. The danger is that advancement will not go hand in hand with a legal and cultural adaptation, thus creating ambiguity and risks for clinicians and patients. Neurologists will need to be able to face the opportunities and challenges of this new scenario.
Published: 2020

30. Multiple Sclerosis in the Campania Region (South Italy): Algorithm Validation and 2015–2017 Prevalence

Author: Maria Pia Sormani, Nicola Capasso, Vincenzo Brescia Morra, Martina Petruzzo, Marcello Moccia, Raffaele Palladino, Roberta Lanzillo, Ilaria Loperto, Maria Grazia Fumo, Maria Triassi, Roberta Giordana, Moccia, Marcello, Brescia Morra, Vincenzo, Lanzillo, Roberta, Loperto, Ilaria, Giordana, Roberta, Fumo, Maria Grazia, Petruzzo, Martina, Capasso, Nicola, Triassi, Maria, Sormani, Maria Pia, and Palladino, Raffaele
Subjects: Male, Multiple Sclerosis, Health, Toxicology and Mutagenesis, prevalence, Prevalence, lcsh:Medicine, Environmental Sciences & Ecology, Toxicology, Article, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Clinical registry, 030212 general & internal medicine, Medical prescription, Healthcare data, Public, Environmental & Occupational Health, Retrospective Studies, OUTCOMES, Science & Technology, business.industry, Multiple sclerosis, lcsh:R, Public Health, Environmental and Occupational Health, medicine.disease, INSIGHTS, SIZE, Italy, multiple sclerosi, routinely collected healthcare data, Cohort, Female, Routinely collected healthcare data, business, Algorithm, Life Sciences & Biomedicine, 030217 neurology & neurosurgery, Environmental Sciences, Algorithms
Abstract: We aim to validate a case-finding algorithm to detect individuals with multiple sclerosis (MS) using routinely collected healthcare data, and to assess the prevalence of MS in the Campania Region (South Italy). To identify individuals with MS living in the Campania Region, we employed an algorithm using different routinely collected healthcare administrative databases (hospital discharges, drug prescriptions, outpatient consultations with payment exemptions), from 1 January 2015 to 31 December 2017. The algorithm was validated towards the clinical registry from the largest regional MS centre (n = 1460). We used the direct method to standardise the prevalence rate and the capture-recapture method to estimate the proportion of undetected cases. The case-finding algorithm including individuals with at least one MS record during the study period captured 5362 MS patients (females = 64.4%, age = 44.6 &plusmn, 12.9 years), with 99.0% sensitivity (95% CI = 98.3%, 99.4%). Standardised prevalence rate per 100,000 people was 89.8 (95% CI = 87.4, 92.2) (111.8 for females [95% CI = 108.1, 115.6] and 66.2 for males [95% CI = 63.2, 69.2]). The number of expected MS cases was 2.7% higher than cases we detected. We developed a case-finding algorithm for MS using routinely collected healthcare data from the Campania Region, which was validated towards a clinical dataset, with high sensitivity and low proportion of undetected cases. Our prevalence estimates are in line with those reported by international studies conducted using similar methods. In the future, this cohort could be used for studies with high granularity of clinical, environmental, healthcare resource utilisation, and pharmacoeconomic variables.
Published: 2020

31. Unraveling diagnostic uncertainty in transition phase from relapsing-remitting to secondary progressive multiple sclerosis

Author: Giacomo Lus, Ylenia Vaia, Antonio Carotenuto, Elisabetta Signoriello, Marcello Moccia, Simona Bonavita, Roberta Lanzillo, Vincenzo Brescia Morra, Carotenuto, Antonio, Signoriello, Elisabetta, Lanzillo, Roberta, Vaia, Ylenia, Moccia, Marcello, Bonavita, Simona, Lus, Giacomo, Brescia Morra, Vincenzo, and BRESCIA MORRA, Vincenzo
Subjects: medicine.medical_specialty, Multiple Sclerosis, predictor, Logistic regression, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, Recurrence, Internal medicine, medicine, Humans, In patient, Disabled Persons, 030212 general & internal medicine, First episode, business.industry, Proportional hazards model, Multiple sclerosis, Uncertainty, General Medicine, Multiple Sclerosis, Chronic Progressive, medicine.disease, Neurology, Relapsing remitting, disability, multiple sclerosi, Disease Progression, Secondary progressive multiple sclerosis, Biomarker (medicine), biomarker, Neurology (clinical), Progressive multiple sclerosis, business, 030217 neurology & neurosurgery
Abstract: Background: Clinicians struggle to timely diagnose secondary-progressive multiple sclerosis (SP-MS), with a ‘transition phase’ period of diagnostic uncertainty. We aimed at defining clinical markers predicting evolution to SP-MS. Methods:: We reviewed 210 newly diagnosed MS patients experiencing at least one confirmed disability worsening (CDW). CDWs were classified as disability worsening either due to incomplete recovery following relapse (r-CDW), or independent of relapse activity (nr-CDW). Logistic regression and Cox regression models were used to evaluate variables at CDW associated with SP-MS diagnosis. Results: On CDW, higher EDSS (OR: 2.73, p=0.002) and nr-CDW (OR: 2.63, p=0.03) were associated with conversion to SP-MS over the follow-up. In addition, the risk of SP-MS was higher in patients with EDSS>3.0 at CDW (HR: 2.26, p
Published: 2020

32. Generalised boundary shift integral for longitudinal assessment of spinal cord atrophy

Author: Manuel Jorge Cardoso, Olga Ciccarelli, Aubrey Johnson, Claudia A. M. Wheeler-Kingshott, Marcello Moccia, Francesco Grussu, Frederik Barkhof, Marios C. Yiannakas, Ferran Prados, Sebastien Ourselin, Radiology and nuclear medicine, Amsterdam Neuroscience - Neurodegeneration, University College London, Università degli Studi di Pavia, King's College London, Universitat Oberta de Catalunya (UOC), Prados, F., Moccia, M., Johnson, A., Yiannakas, M., Grussu, F., Cardoso, M. J., Ciccarelli, O., Ourselin, S., Barkhof, F., and Wheeler-Kingshott, C.
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Cognitive Neuroscience, Neuroimaging, Volume change, GBSI Method, 050105 experimental psychology, lcsh:RC321-571, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Double-Blind Method, Surface fitting, Image Interpretation, Computer-Assisted, medicine, Humans, 0501 psychology and cognitive sciences, Segmentation, Longitudinal Studies, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Spinal cord atrophy, business.industry, Multiple sclerosis, 05 social sciences, Boundary Shift Integral, medicine.disease, Spinal cord, Magnetic Resonance Imaging, medicine.anatomical_structure, Spinal Cord, Neurology, Disease Progression, Female, Radiology, business, 030217 neurology & neurosurgery
Abstract: Spinal cord atrophy measurements obtained from structural magnetic resonance imaging (MRI) are associated with disability in many neurological diseases and serve as in vivo biomarkers of neurodegeneration. Longitudinal spinal cord atrophy rate is commonly determined from the numerical difference between two volumes (based on 3D surface fitting) or two cross-sectional areas (CSA, based on 2D edge detection) obtained at different time-points. Being an indirect measure, atrophy rates are susceptible to variable segmentation errors at the edge of the spinal cord. To overcome those limitations, we developed a new registration-based pipeline that measures atrophy rates directly. We based our approach on the generalised boundary shift integral (GBSI) method, which registers 2 scans and uses a probabilistic XOR mask over the edge of the spinal cord, thereby measuring atrophy more accurately than segmentation-based techniques. Using a large cohort of longitudinal spinal cord images (610 subjects with multiple sclerosis from a multi-centre trial and 52 healthy controls), we demonstrated that GBSI is a sensitive, quantitative and objective measure of longitudinal spinal cord volume change. The GBSI pipeline is repeatable, reproducible, and provides more precise measurements of longitudinal spinal cord atrophy than segmentation-based methods in longitudinal spinal cord atrophy studies.
Published: 2020

33. Editorial: Pathophysiologic Insights From Biomarker Studies in Neurological Disorders

Author: Tobias Warnecke, Stefan Bittner, Tobias Ruck, Marcello Moccia, Bittner, S., Moccia, M., Warnecke, T., and Ruck, T.
Subjects: business.industry, neurodegeneration, neuroimmunology, Bioinformatics, lcsh:RC346-429, Pathophysiology, Editorial, Neuroimmunology, Neurology, biomarker, Biomarker (medicine), Medicine, Neurology (clinical), pathomechanism, business, lcsh:Neurology. Diseases of the nervous system, pathophysiology
Published: 2020

34. Single-Center 8-Years Clinical Follow-Up of Cladribine-Treated Patients From Phase 2 and 3 Trials

Author: Marcello Moccia, Roberta Lanzillo, Martina Petruzzo, Agostino Nozzolillo, Marcello De Angelis, Antonio Carotenuto, Raffaele Palladino, Vincenzo Brescia Morra, Moccia, M., Lanzillo, R., Petruzzo, M., Nozzolillo, A., De Angelis, M., Carotenuto, A., Palladino, R., and Brescia Morra, V.
Subjects: Reduced risk, medicine.medical_specialty, real-world, cladribine, Placebo, Single Center, multiple sclerosis, lcsh:RC346-429, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Disability progression, 030212 general & internal medicine, Cladribine, lcsh:Neurology. Diseases of the nervous system, relapse, treatment, business.industry, Multiple sclerosis, Disease progression, 1103 Clinical Sciences, Brief Research Report, medicine.disease, Clinical trial, Neurology, disability, 1701 Psychology, multiple sclerosi, Neurology (clinical), 1109 Neurosciences, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Background: Cladribine is approved for the treatment of highly-active relapsing multiple sclerosis (MS), where it is also effective on disability progression. In the present single-center study, we aim to report on the 8-years clinical follow-up of 27 patients included in phase 2 and 3 clinical trials for cladribine. Methods: We included patients exposed to cladribine (n = 13) or placebo (n = 14) in ONWARD, CLARITY, and ORACLE-MS trials, and followed-up at the same center after trial termination. Outcomes of long-term disease progression were recorded. Results: During 8-year follow-up, patients treated with cladribine presented with reduced risk of EDSS progression (HR = 0.148; 95%CI = 0.031, 0.709; p = 0.017), of reaching EDSS 6.0 (HR = 0.115; 95%CI = 0.015, 0.872; p = 0.036), and of SP conversion (HR = 0.010; 95%CI = 0.001, 0.329; p = 0.010), when compared with placebo. Conclusions: Our exploratory study provides additional evidence that cladribine may be useful to prevent or, at least, mitigate the risk of disability progression after 8 years.
Published: 2020

35. Fatigue in multiple sclerosis: The role of thalamus

Author: Marcello Moccia, Sara Collorone, Fioravante Capone, Vincenzo Di Lazzaro, Rosa Cortese, Capone, F., Collorone, S., Cortese, R., Di Lazzaro, V., and Moccia, M.
Subjects: Multiple Sclerosis, neuroimaging, business.industry, Multiple sclerosis, Thalamus, Neurophysiology, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neurology, Neuroimaging, multiple sclerosi, thalamus, Fatigue, MRI, multiple sclerosis, Humans, Nerve Net, Medicine, Neurology (clinical), business, Neuroscience, 030217 neurology & neurosurgery
Abstract: Fatigue is very common in multiple sclerosis (MS) and is often considered as its most disabling symptom. Over the last 20 years, an increasing number of studies have evaluated the pathogenetic bases of MS-related fatigue. Converging evidence from neurophysiology and neuroimaging research suggests that a dysfunction in a cortico-subcortical pathway, centered on thalamus, is involved in the pathogenesis of fatigue. However, type and significance of such dysfunction remain unknown, and some studies reported an increase in the activity and connectivity within the thalamic network, whereas others suggested its reduction. Hereby, we review the results of neuroimaging studies supporting the different hypotheses about the role of thalamic network in the pathophysiology of MS-related fatigue and discuss limitations and shortcomings of available data, highlighting the key challenges in the field and the directions for future research.
Published: 2020

36. 2D linear measures of ventricular enlargement may be relevant markers of brain atrophy and long-term disability progression in multiple sclerosis

Author: Sirio Cocozza, Chiara Paolella, Elena Augusta Vola, Teresa Perillo, Roberta Lanzillo, Maria Brunella Cipullo, Antonio Carotenuto, Giuseppe Pontillo, Arturo Brunetti, Mario Quarantelli, Marcello Moccia, Enrico Tedeschi, Marco Masullo, Camilla Russo, Andrea Elefante, Maria Petracca, Martina Di Stasi, Vincenzo Brescia Morra, Pontillo, Giuseppe, Cocozza, Sirio, Di Stasi, Martina, Carotenuto, Antonio, Paolella, Chiara, Cipullo, Maria Brunella, Perillo, Teresa, Vola, Elena Augusta, Russo, Camilla, Masullo, Marco, Moccia, Marcello, Lanzillo, Roberta, Tedeschi, Enrico, Elefante, Andrea, Brescia Morra, Vincenzo, Brunetti, Arturo, Quarantelli, Mario, and Petracca, Maria
Subjects: Adult, Male, medicine.medical_specialty, Atrophy, Brain, Magnetic resonance imaging, Multiple sclerosis, Logistic regression, 030218 nuclear medicine & medical imaging, Cerebral Ventricles, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Recurrence, Internal medicine, medicine, Cutoff, Humans, Radiology, Nuclear Medicine and imaging, Retrospective Studies, Brain Diseases, Receiver operating characteristic, Surrogate endpoint, business.industry, Reproducibility of Results, General Medicine, medicine.disease, medicine.anatomical_structure, ROC Curve, Ventricle, 030220 oncology & carcinogenesis, Brain size, Cardiology, Disease Progression, Female, Radiology, business
Abstract: Aim of this study was to investigate the reliability and validity of 2D linear measures of ventricular enlargement as indirect markers of brain atrophy and possible predictors of clinical disability. In this retrospective longitudinal analysis of relapsing-remitting MS patients, brain volumes were computed at baseline and after 2 years. Frontal horn width (FHW), intercaudate distance (ICD), third ventricle width (TVW), and 4th ventricle width were obtained. Two-dimensional measures associated with brain volume at correlation analyses were entered in linear and logistic regression models testing the relationship with baseline clinical disability and 10-year confirmed disability progression (CDP), respectively. Possible cutoff values for clinically relevant atrophy were estimated via receiver operating characteristic (ROC) analyses and probed as 10-year CDP predictors using hierarchical logistic regression. Eighty-seven patients were available (61/26 = F/M; 34.1 ± 8.5 years). Moderate negative correlations emerged between ICD and TVW and normalized brain volume (NBV; p
Published: 2020

37. Peripapillary Vessel Density as Early Biomarker in Multiple Sclerosis

Author: Gilda Cennamo, Roberta Lanzillo, Antonietta Melenzane, Giuseppe Servillo, Marcello Moccia, Antonio Luca Spiezia, Daniela Montorio, Chiara Criscuolo, Fausto Tranfa, Anna Lamberti, Vincenzo Brescia Morra, Martina Petruzzo, Marcello De Angelis, Maria Petracca, Antonio Carotenuto, Cennamo, Gilda, Carotenuto, Antonio, Montorio, Daniela, Petracca, Maria, Moccia, Marcello, Melenzane, Antonietta, Tranfa, Fausto, Lamberti, Anna, Spiezia, Antonio L., Servillo, Giuseppe, De Angelis, Marcello, Petruzzo, Martina, Criscuolo, Chiara, Lanzillo, Roberta, and Brescia Morra, Vincenzo
Subjects: medicine.medical_specialty, vascular pathology, lcsh:RC346-429, 03 medical and health sciences, 0302 clinical medicine, Vessel density, Clinical history, Ophthalmology, biomarker, angio-optical coherence tomograph, clinically isolated syndrome, vessel density (VD), medicine, In patient, Optic neuritis, lcsh:Neurology. Diseases of the nervous system, Original Research, Expanded Disability Status Scale, Clinically isolated syndrome, business.industry, angio-optical coherence tomography, Multiple sclerosis, medicine.disease, Neurology, 030221 ophthalmology & optometry, Biomarker (medicine), Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Background: To evaluate retinal vessel density (VD) in macular and in peripapillary regions in patients with recent onset of multiple sclerosis, at initial demyelinating event (IDE) and in matched relapsing-remitting multiple sclerosis (RRMS) patients. Methods: We evaluated VD in superficial capillary plexus, deep capillary plexus, choriocapillaris and radial peripapillary capillary plexus in IDE, RRMS patients and in matched healthy controls (HCs) through Optical Coherence Tomography Angiography (OCT-A). Clinical history, including history of optic neuritis, Expanded Disability Status scale and disease duration of patients were collected. Results: Thirty patients (20 with IDE and 10 with RRMS) and 15 HCs were enrolled. IDE patients showed a lower VD in radial peripapillary capillary plexus compared with controls (coeff. β = −3.578; p = 0.002). RRMS patients displayed a lower VD in both superficial capillary plexus and radial peripapillary capillary plexus compared with HCs (coeff. β = −4.955; p = 0.002, and coeff. β = −7.446; p < 0.001, respectively). Furthermore, RRMS patients showed a decreased VD in radial peripapillary capillary plexus compared with IDE patients (coeff. β = −3.868; p = 0.003). Conclusions: Peripapillary region vessel density reduction, revealed through OCT-A, might be considered as an early event in MS, and might be relevant as a biomarker of disease pathology.
Published: 2020

38. Characteristics and treatment of Multiple Sclerosis-related trigeminal neuralgia: An Italian multi-centre study

Author: Giorgia Teresa Maniscalco, Cinzia Cordioli, Maria Chiara Buscarinu, Diana Ferraro, Massimiliano Calabrese, Claudio Gasperini, Marcello Moccia, Alberto Gajofatto, Antonio Gallo, Eleonora Cocco, Valentina Camera, Pietro Annovazzi, Roberta Fantozzi, Marta Radaelli, Giovanna De Luca, Valentina Tomassini, Roberta Lanzillo, Claudio Solaro, Lorena Lorefice, Carla Tortorella, Federica Pinardi, Fabio Buttari, Paolo Ragonese, Paola Cavalla, Viviana Nociti, Salvatore Lo Fermo, Laura Boffa, Rirems, Damiano Paolicelli, Massimiliano Di Filippo, Ferraro, D., Annovazzi, P., Moccia, M., Lanzillo, R., De Luca, G., Nociti, V., Fantozzi, R., Paolicelli, D., Ragonese, P., Gajofatto, A., Boffa, L., Cavalla, P., Lo Fermo, S., Buscarinu, M. C., Lorefice, L., Cordioli, C., Calabrese, M., Gallo, A., Pinardi, F., Tortorella, C., Di Filippo, M., Camera, V., Maniscalco, G. T., Radaelli, M., Buttari, F., Tomassini, V., Cocco, E., Gasperini, C., Solaro, C., Ferraro D., Annovazzi P., Moccia M., Lanzillo R., De Luca G., Nociti V., Fantozzi R., Paolicelli D., Ragonese P., Gajofatto A., Boffa L., Cavalla P., Lo Fermo S., Buscarinu M.C., Lorefice L., Cordioli C., Calabrese M., Gallo A., Pinardi F., Tortorella C., Di Filippo M., Camera V., Maniscalco G.T., Radaelli M., Buttari F., Tomassini V., Cocco E., Gasperini C., and Solaro C.
Subjects: Pediatrics, medicine.medical_treatment, multiple sclerosis, microvascular decompression surgery, time factors, 0302 clinical medicine, Radiofrequency thermocoagulation, Trigeminal neuralgia, Multiple Sclerosi, Outcome Assessment, Health Care, italy, middle aged, pain, 030212 general & internal medicine, Oxcarbazepine, humans, education.field_of_study, trigeminal neuralgia, adult, Disability, Multiple Sclerosis, Pain, radiosurgery, General Medicine, Analgesics, Non-Narcotic, health care, follow-up studies, Settore MED/26 - NEUROLOGIA, aged, retrospective studies, female, Neurology, disability, analgesics, non-narcotic, male, severity of illness index, sex factors, neurosurgical procedures, outcome assessment, health care, analgesics, medicine.drug, medicine.medical_specialty, Population, Microvascular decompression, 03 medical and health sciences, medicine, education, outcome assessment, business.industry, Multiple sclerosis, Carbamazepine, medicine.disease, Discontinuation, non-narcotic, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Background The prevalence of trigeminal neuralgia (TN) in Multiple Sclerosis (MS) patients is higher than in the general population and its management can be particularly challenging. Our aim is to describe the characteristics, treatment and prognostic factors of MS-related TN in a retrospective multicentre study. Methods Neurologists members of the RIREMS group (Rising Researchers in MS) enrolled MS patients with a TN diagnosis and filled out a spreadsheet comprising their clinical data. Results Population consisted of 298 patients. First-choice preventive treatments were carbamazepine and oxcarbazepine. A surgical procedure was performed in 81 (30%) patients, most commonly gamma knife stereotactic radiosurgery (37%), followed by microvascular decompression (22%) and radiofrequency thermocoagulation (21%); one third of patients underwent at least two procedures. Surgery was associated with higher disability, male sex and longer interval between MS and TN onset. Patients (77%) who stayed on at least one preventive medication at most recent follow-up, after a mean period of 8 years, had a higher disability compared to the untreated group. Furthermore, patients with higher disability at TN onset were less likely to discontinue their first preventive medication due to pain remission, had bilateral TN more frequently and underwent surgical interventions earlier. Conclusion MS patients with a higher disability at TN onset and with a longer interval between MS and TN onset had differing clinical features and outcomes: pain was more frequently bilateral, surgery was more frequent and anticipated, and preventive medication discontinuation due to pain remission was less common.
Published: 2020

39. Prevalence of SARS-CoV-2 Antibodies in Multiple Sclerosis: The Hidden Part of the Iceberg

Author: Raffaele Palladino, Nicola Capasso, Maria Triassi, Viviana Pastore, Francesco Aruta, Maria Petracca, Emanuela Zappulo, Antonio Carotenuto, Rosa Iodice, Vincenzo Brescia Morra, Antonio Riccardo Buonomo, Aniello Iovino, Ivan Gentile, Marcello Moccia, Emma Montella, Roberta Lanzillo, Francesca Pennino, Capasso, Nicola, Palladino, Raffaele, Montella, Emma, Pennino, Francesca, Lanzillo, Roberta, Carotenuto, Antonio, Petracca, Maria, Iodice, Rosa, Iovino, Aniello, Aruta, Francesco, Pastore, Viviana, Buonomo, Antonio Riccardo, Zappulo, Emanuela, Gentile, Ivan, Triassi, Maria, Brescia Morra, Vincenzo, and Moccia, Marcello
Subjects: medicine.medical_specialty, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Population, lcsh:Medicine, COVID-19, antibody, infection, multiple sclerosis, seroprevalence, Asymptomatic, Article, 03 medical and health sciences, 0302 clinical medicine, McNemar's test, Internal medicine, Chi-square test, Seroprevalence, Medicine, 030212 general & internal medicine, education, education.field_of_study, biology, business.industry, Multiple sclerosis, lcsh:R, General Medicine, medicine.disease, Exact test, Neurology, multiple sclerosi, biology.protein, Neurology (clinical), medicine.symptom, Antibody, business, 030217 neurology & neurosurgery
Abstract: Background. We compared the prevalence of SARS-CoV-2 IgG/IgM in multiple sclerosis (MS), low-risk, and high-risk populations and explored possible clinical correlates. Methods. In this cross-sectional study, we recruited MS patients, low-risk (university staff from non-clinical departments), and high-risk individuals (healthcare staff from COVID-19 wards) from 11 May to 15 June 2020. We used lateral flow immunoassay to detect SARS-CoV-2 IgG and IgM. We used t-test, Fisher&rsquo, s exact test, chi square test, or McNemar&rsquo, s test, as appropriate, to evaluate between-group differences. Results. We recruited 310 MS patients (42.3 &plusmn, 12.4 years, females 67.1%), 862 low-risk individuals (42.9 &plusmn, 13.3 years, females 47.8%), and 235 high-risk individuals (39.4 &plusmn, 10.9 years, females 54.5%). The prevalence of SARS-CoV-2 IgG/IgM in MS patients (n = 9, 2.9%) was significantly lower than in the high-risk population (n = 25, 10.6%) (p &lt, 0.001), and similar to the low-risk population (n = 11, 1.3%) (p = 0.057), these results were also confirmed after random matching by age and sex (1:1:1). No significant differences were found in demographic, clinical, treatment, and laboratory features. Among MS patients positive to SARS-CoV-2 IgG/IgM (n = 9), only two patients retrospectively reported mild and short-lasting COVID-19 symptoms. Conclusions. MS patients have similar risk of SARS-CoV-2 infection to the general population, and can be asymptomatic from COVID-19, also if using treatments with systemic immunosuppression.
Published: 2020

40. Assessing disability and relapses in multiple sclerosis on tele-neurology

Author: Letizia Leocani, Gioacchino Tedeschi, Simona Bonavita, Luigi Lavorgna, Roberta Lanzillo, Marcello Moccia, Vincenzo Brescia Morra, Moccia, Marcello, Lanzillo, Roberta, Brescia Morra, Vincenzo, Bonavita, Simona, Tedeschi, Gioacchino, Leocani, Letizia, Lavorgna, Luigi, Moccia, M., Lanzillo, R., Brescia Morra, V., Bonavita, S., Tedeschi, G., Leocani, L., and Lavorgna, L.
Subjects: medicine.medical_specialty, Multiple Sclerosis, Neurology, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Clinical Neurology, Neurological examination, Dermatology, Brief Communication, Betacoronavirus, Disability Evaluation, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, 0302 clinical medicine, medicine, Humans, Multiple sclerosi, 030212 general & internal medicine, Pandemics, Neuroradiology, COVID, medicine.diagnostic_test, SARS-CoV-2, business.industry, Multiple sclerosis, COVID-19, General Medicine, Tele-medicine, medicine.disease, Telemedicine, Cognitive test, Psychiatry and Mental health, Physical therapy, Chronic disability, Neurology (clinical), Neurosurgery, Tele-neurology, Coronavirus Infections, business, 030217 neurology & neurosurgery
Abstract: Background: As a consequence of the coronavirus disease 2019 (COVID-19) pandemic, a large amount of consultations will be delivered through tele-medicine, especially for diseases causing chronic disability and requiring immunomodulatory treatments, such as multiple sclerosis (MS). Methods: We have hereby reviewed available tools for tele-neurology examination in MS, including components of neurological examination that can be assessed through video, patient-reported outcome measures (PROMs), and digital technology. Results: Overall, we have suggested a battery for assessing MS disability and relapses on tele-medicine, which brings together conventional examination, PROMs (e.g., Patient Determined Disease Steps, MS Impact Scale), and cognitive tests (Symbol Digit Modalities Test) that can be delivered remotely and in multiple languages. Discussion: The use of common tools for neurological examination could improve tele-neurology practice for both general neurologists and MS specialists, and quality of care for people with MS.
Published: 2020

41. Validation of the Italian version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19

Author: Roberta Lanzillo, Francesca Di Lauro, Laura De Giglio, Alessandro Chiodi, L. Rosa, Antonio Carotenuto, Ilaria Ferrante, Carlo Pozzilli, Maurizio Bianchi, Maria Petracca, Antonio Ianniello, Marcello Moccia, Vincenzo Brescia Morra, Carotenuto, A., De Giglio, L., Chiodi, A., Petracca, M., Rosa, L., Bianchi, M., Ferrante, I., Lauro, F., Moccia, M., Ianniello, A., Pozzilli, C., Brescia Morra, V., and Lanzillo, R.
Subjects: Male, Psychometrics, Italian, Reproducibility of Result, Human sexuality, Dermatology, Disability, MSISQ-19, Multiple sclerosis, Sexuality, Validation, External validity, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Cronbach's alpha, Surveys and Questionnaires, medicine, Surveys and Questionnaire, Humans, Multiple sclerosi, 030212 general & internal medicine, business.industry, Construct validity, Reproducibility of Results, General Medicine, medicine.disease, Exploratory factor analysis, Psychiatry and Mental health, Sexual dysfunction, Italy, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Psychometric, Clinical psychology, Human
Abstract: Background: People with multiple sclerosis (MS) may experience sexual dysfunction throughout the disease course. Validated scales to assess sexual dysfunction in MS for Italian patients are lacking. Hence, we aimed at validating Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19) for Italian MS patients. Methods: We included both male and female MS patients. Each patient completed the Italian translation of the MSISQ-19. Construct validity was explored by the exploratory factor analysis and the Cronbach’s alpha coefficient. Test-retest stability and concurrent internal and external validity were examined by Pearson’ correlation coefficients. Results: We enrolled 369 MS patients (323 female and 46 male). Italian MSISQ-19 showed a Cronbach’s alpha of 0.92. MSISQ-19 test and retest total scores correlated between each other (r = 0.48, p = 0.01). MSISQ-19 total score also correlated with primary, secondary and tertiary subscales (p < 0.001). Conclusion: The Italian Version of the MSISQ-19 showed satisfactory internal consistency and reliability with moderately adequate test-retest reproducibility, suggesting that it may be used as a valuable measure of sexual dysfunction in the Italian population.
Published: 2020

42. Spinal cord atrophy in a primary progressive multiple sclerosis trial: Improved sample size using GBSI

Author: Ronald A. van Schijndel, Olga Ciccarelli, Nicola Valsecchi, Ferran Prados, Frederik Barkhof, Marcello Moccia, Moccia, M., Valsecchi, N., Ciccarelli, O., Van Schijndel, R., Barkhof, F., Prados, F., Radiology and nuclear medicine, and Amsterdam Neuroscience - Neuroinfection & -inflammation
Subjects: medicine.medical_specialty, Cognitive Neuroscience, Primary Progressive Multiple Sclerosis, GBSI, lcsh:Computer applications to medicine. Medical informatics, 050105 experimental psychology, lcsh:RC346-429, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Cerebrospinal fluid, Atrophy, Spinal cord segment, medicine, Humans, 0501 psychology and cognitive sciences, Radiology, Nuclear Medicine and imaging, Multiple sclerosi, lcsh:Neurology. Diseases of the nervous system, Spinal cord, Spinal cord atrophy, business.industry, 05 social sciences, Brain, Reproducibility of Results, Regular Article, Multiple Sclerosis, Chronic Progressive, medicine.disease, Magnetic Resonance Imaging, Clinical trial, medicine.anatomical_structure, Cross-Sectional Studies, Neurology, Sample size determination, Sample Size, lcsh:R858-859.7, Neurology (clinical), Radiology, business, 030217 neurology & neurosurgery
Abstract: Highlights • The GBSI provided clinically meaningful measurements of spinal cord atrophy, with low sample size. • Deriving spinal cord atrophy from brain MRI using the GBSI is easier than spinal cord MRI. • Spinal cord atrophy on GBSI could be used as a secondary outcome measure., Background We aimed to evaluate the implications for clinical trial design of the generalised boundary-shift integral (GBSI) for spinal cord atrophy measurement. Methods We included 220 primary-progressive multiple sclerosis patients from a phase 2 clinical trial, with baseline and week-48 3DT1-weighted MRI of the brain and spinal cord (1 × 1 × 1 mm3), acquired separately. We obtained segmentation-based cross-sectional spinal cord area (CSA) at C1-2 (from both brain and spinal cord MRI) and C2-5 levels (from spinal cord MRI) using DeepSeg, and, then, we computed corresponding GBSI. Results Depending on the spinal cord segment, we included 67.4–98.1% patients for CSA measurements, and 66.9–84.2% for GBSI. Spinal cord atrophy measurements obtained with GBSI had lower measurement variability, than corresponding CSA. Looking at the image noise floor, the lowest median standard deviation of the MRI signal within the cerebrospinal fluid surrounding the spinal cord was found on brain MRI at the C1-2 level. Spinal cord atrophy derived from brain MRI was related to the corresponding measures from dedicated spinal cord MRI, more strongly for GBSI than CSA. Spinal cord atrophy measurements using GBSI, but not CSA, were associated with upper and lower limb motor progression. Discussion Notwithstanding the reduced measurement variability, the clinical correlates, and the possibility of using brain acquisitions, spinal cord atrophy using GBSI should remain a secondary outcome measure in MS studies, until further advancements increase the quality of acquisition and reliability of processing.
Published: 2020

43. Telemedicine and the challenge of epilepsy management at the time of COVID-19 pandemic

Author: Francesco, Brigo, Bonavita, S., Leocani, L., Gioacchino, Tedeschi, Lavorgna, L., Giovanni, Mancardi, Alessandro, Padovani, Clerico, Marinella, Roberta, Lanzillo, Antonio, Russo, Bruno, Giometto, Giulia, Straccia, Rosa, Iodice, Sebastiano, Bucello, Pietro, Annovazzi, Marcello, Moccia, Luca, Prosperini, Maria Laura Stromillo, Anna Maria Repice, Giuseppina, Miele, Alberto, Lerario, Antonio De Martino, Francesco, Iodice, Francesco Di Lorenzo, Luca, Cuffaro, Michele, Romoli, Marcello Silvestro, Artusi, Carlo Alberto, Brigo, F., Bonavita, S., Leocani, L., Tedeschi, G., Lavorgna, L., Brigo, Francesco, Bonavita, Simona, Leocani, Letizia, Tedeschi, Gioacchino, and Lavorgna, Luigi
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Telemedicine, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Clinical Neurology, COVID-19 pandemic, Mobile device, Article, Social media, Behavioral Neuroscience, Epilepsy, Betacoronavirus, Seizures, Pandemic, Medicine, Humans, Viral, Intensive care medicine, Mobile devices, Coronavirus Infections, Pandemics, biology, SARS-CoV-2, business.industry, COVID-19, Pneumonia, medicine.disease, biology.organism_classification, Seizure, Neurology, Neurology (clinical), business
Published: 2020

44. Pathophysiologic Insights from Biomarker Studies in Neurological Disorders

Author: Tobias Warnecke, Tobias Ruck, Marcello Moccia, and Stefan Bittner
Subjects: Neuroimmunology, business.industry, Biomarker (medicine), Medicine, business, Bioinformatics, Pathophysiology
Published: 2020

45. Harmonization of real-world studies in multiple sclerosis: Retrospective analysis from the rirems group

Author: Federica Pinardi, Simona Mallucchi, Paolo Ragonese, Eleonora Cocco, Valentina Tomassini, Alice Laroni, Lorena Lorefice, Claudio Solaro, Alberto Gajofatto, Cinzia Cordioli, Viviana Nociti, Maria Chiara Buscarinu, Claudio Gasperini, Marta Radaelli, Antonio Gallo, Luca Prosperini, Massimiliano Di Filippo, Massimiliano Calabrese, Damiano Paolicelli, Paola Cavalla, Diana Ferraro, Pietro Annovazzi, Roberta Lanzillo, Marcello Moccia, Carla Tortorella, Moccia, M., Annovazzi, P., Buscarinu, M. C., Calabrese, M., Cavalla, P., Cordioli, C., Di Filippo, M., Ferraro, D., Gajofatto, A., Gallo, A., Lanzillo, R., Laroni, A., Lorefice, L., Mallucchi, S., Nociti, V., Paolicelli, D., Pinardi, F., Prosperini, L., Radaelli, M., Ragonese, P., Tomassini, V., Tortorella, C., Cocco, E., Gasperini, C., Solaro, C., Moccia M., Annovazzi P., Buscarinu M.C., Calabrese M., Cavalla P., Cordioli C., Di Filippo M., Ferraro D., Gajofatto A., Gallo A., Lanzillo R., Laroni A., Lorefice L., Mallucchi S., Nociti V., Paolicelli D., Pinardi F., Prosperini L., Radaelli M., Ragonese P., Tomassini V., Tortorella C., Cocco E., Gasperini C., and Solaro C.
Subjects: Adult, Longitudinal study, medicine.medical_specialty, Harmonization, Outcome measures, Multiple sclerosis, Outcome measure, 03 medical and health sciences, 0302 clinical medicine, Real world, medicine, Humans, Multiple sclerosi, 030212 general & internal medicine, Age of Onset, Aged, Retrospective Studies, Expanded Disability Status Scale, business.industry, Retrospective cohort study, General Medicine, Variance (accounting), medicine.disease, Neurology, Italy, Family medicine, Observational study, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Multiple Sclerosis
Abstract: Background: Worldwide multiple sclerosis (MS) centers have coordinated their efforts to use data acquired in clinical practice for real-world observational studies. In this retrospective study, we aim to harmonize outcome measures, and to evaluate their heterogeneity within the Rising Italian Researchers in MS (RIReMS) study group. Methods: RIReMS members filled in a structured questionnaire evaluating the use of different outcome measures in clinical practice. Thereafter, thirty-four already-published papers from RIReMS centers were used for heterogeneity analyses, using the DerSimonian and Laird random-effects method to compute the between-study variance (τ2). Results: Based on questionnaire results, we defined basic modules for diagnosis and follow-up, consisting of outcome measures recorded by all participating centers at the time of diagnosis, and, then, at least annually; we also defined more detailed/optional modules, with outcome measures recorded less frequently and/or in the presence of specific clinical indications. Looking at heterogeneity, we found 5-year variance in age at onset (ES=27.34; 95%CI=26.18, 28.49; p41.4 years (ES=4.37; 95%CI=3.40, 5.35; p2 years (ES=5.41; 95%CI=3.22, 7.60; p = 0.02; τ2=1.00). Discussion: We suggest common sets of biomarkers to be acquired in clinical practice, that can be used for research purposes. Also, we provide researchers with specific indications for improving inclusion criteria and data analysis, ultimately allowing data harmonization and high-quality collaborative studies.
Published: 2020

46. Brain tissue volumes and relaxation rates in multiple sclerosis: implications for cognitive impairment

Author: Anna Prinster, Teresa Costabile, Bruno Alfano, Vincenzo Brescia Morra, Rosario Megna, Mario Quarantelli, Antonio Carotenuto, Roberta Lanzillo, Giuseppe Servillo, G. Vacca, Marcello Moccia, Marco Comerci, Megna, Rosario, Alfano, Bruno, Lanzillo, Roberta, Costabile, Teresa, Comerci, Marco, Vacca, Giovanni, Carotenuto, Antonio, Moccia, Marcello, Servillo, Giuseppe, Prinster, Anna, Brescia Morra, Vincenzo, and Quarantelli, Mario
Subjects: Adult, Male, medicine.medical_specialty, Neurology, Adolescent, Severity of Illness Index, Relapsing/remitting, White matter, Young Adult, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, 0302 clinical medicine, Atrophy, Internal medicine, Humans, Medicine, Cognitive Dysfunction, Multiple sclerosi, 030212 general & internal medicine, Gray Matter, Expanded Disability Status Scale, business.industry, Multiple sclerosis, Quantitative MRI, Middle Aged, medicine.disease, Magnetic Resonance Imaging, White Matter, Hyperintensity, Cognitive test, Cognitive impairment, medicine.anatomical_structure, Cardiology, Female, Neurology (clinical), business, Relaxation rates, 030217 neurology & neurosurgery, Stroop effect
Abstract: Both normal gray matter atrophy and brain tissue relaxation rates, in addition to total lesion volume, have shown significant correlations with cognitive test scores in multiple sclerosis (MS). Aim of the study was to assess the relative contributions of macro- and microstructural changes of both normal and abnormal brain tissues, probed, respectively, by their volumes and relaxation rates, to the cognitive status and physical disability of MS patients. MRI studies from 241 patients with relapsing–remitting MS were retrospectively analyzed by fully automated multiparametric relaxometric segmentation. Ordinal backward regression analysis was applied to the resulting volumes and relaxation rates of both normal (gray matter, normal-appearing white matter and CSF) and abnormal (T2-weighted lesions) brain tissues, controlling for age, sex and disease duration, to identify the main independent contributors to the cognitive status, as measured by the percentage of failed tests at a cognitive test battery (Rao’s Brief Repeatable Battery and Stroop test, available in 186 patients), and to the physical disability, as assessed by the Expanded Disability Status Scale (EDSS). The R1 relaxation rate (a putative marker of tissue disruption) of the MS lesions appeared the single most significant contributor to cognitive impairment (p
Published: 2018

47. Cardiovascular profile improvement during Natalizumab treatment

Author: Vincenzo Brescia Morra, Raffaele Palladino, Roberta Lanzillo, Roberto Albero, Marcello Moccia, Cinzia Valeria Russo, Antonio Carotenuto, Francesco Saccà, Anna De Rosa, Moccia, Marcello, Albero, Roberto, Lanzillo, Roberta, SaccÃ&nbsp, Francesco, de Rosa, Anna, Russo, Cinzia Valeria, Carotenuto, Antonio, Palladino, Raffaele, and Brescia Morra, Vincenzo
Subjects: Adult, Male, Risk, 0301 basic medicine, medicine.medical_specialty, Neurology, Cardiovascular Abnormalities, Population, Blood lipids, Cardiovascular, Biochemistry, Gastroenterology, Multiple sclerosis, Disability Evaluation, 03 medical and health sciences, Cellular and Molecular Neuroscience, chemistry.chemical_compound, 0302 clinical medicine, Natalizumab, Recurrence, Internal medicine, medicine, Humans, Multiple sclerosi, Uric, education, education.field_of_study, Neurology & Neurosurgery, business.industry, Cholesterol, 1103 Clinical Sciences, Middle Aged, medicine.disease, Treatment Outcome, 030104 developmental biology, Blood pressure, chemistry, Disease Progression, Uric acid, Female, Neurology (clinical), 1109 Neurosciences, business, Biomarkers, 030217 neurology & neurosurgery, medicine.drug
Abstract: Cardiovascular comorbidities are associated with the risk of MS progression. Thus, we aim to measure variations of cardiovascular risk factors during Natalizumab treatment and their possible clinical associations. Seventy-one relapsing-remitting MS patients treated with Natalizumab were followed-up during a 12.9 ± 6.2 months. Cardiovascular risk factors were recorded on first and last study visits: systolic blood pressure, uric acid, total cholesterol, LDL, HDL, and triglycerides. EDSS progression and relapse occurrence were recorded. At multilevel mixed-effects linear regression models, the population presented with a significant reduction of total cholesterol (Coeff = -7.340; 95%CI = -13.152--1.527; p = 0.013), and of HDL cholesterol (Coeff = -3.473; 95%CI = -6.333--0.613; p = 0.017), and a non-significant reduction of LDL cholesterol (Coeff = -1.872; 95%CI = -8.481-0.736; p = 0.053), and of triglycerides (Coeff = -8.815; 95%CI = -34.011-5.380; p = 0.094). Uric acid levels increased during the study period (Coeff = 0.159; 95%CI = 0.212-0.340; p = 0.038). No significant associations were found with clinical outcomes. Serum lipids decreased and anti-oxidant uric acid increased during Natalizumab treatment. These biomarkers need to be further explored in relation to clinical outcomes on larger cohorts with longer follow-ups.
Published: 2017

48. Correction to: Disability assessment using Google Maps

Author: Francesca Trojsi, Marcello Moccia, Rosa Gemma Viterbo, Simona Bonavita, Pietro Iaffaldano, Simone Cepparulo, Raffaele Palladino, Domenico Ippolito, Paolo Ragonese, Francesco Brigo, Sabrina Esposito, Roberta Lanzillo, Giacomo Lus, Gianmarco Abbadessa, Maria Troiano, Maddalena Sparaco, Marinella Clerico, Giovanna Borriello, Elisabetta Signoriello, Gioacchino Tedeschi, and Luigi Lavorgna
Subjects: Psychiatry and Mental health, Information retrieval, Text mining, business.industry, Neurology (clinical), Dermatology, General Medicine, Psychology, business, Disability assessment
Published: 2021

49. Retinal and choriocapillary vascular changes in early stages of multiple sclerosis: A prospective study

Author: Antonio Luca Spiezia, Roberta Lanzillo, Maria Petracca, Gilda Cennamo, Anna Lamberti, Daniela Montorio, Antonio Carotenuto, Marcello Moccia, Vincenzo Brescia Morra, and Chiara Criscuolo
Subjects: medicine.medical_specialty, chemistry.chemical_compound, Neurology, chemistry, business.industry, Ophthalmology, Multiple sclerosis, Medicine, Retinal, Neurology (clinical), business, medicine.disease, Prospective cohort study
Published: 2021

50. Ocrelizumab treatment in multiple sclerosis: Prospective real world observational multi-center study in Campania, Italy

Author: Vincenzo Brescia Morra, Leonardo Sinisi, Marcello Moccia, Rosa Iodice, Roberta Lanzillo, Gioacchino Tedeschi, Giacomo Lus, Simona Bonavita, Giuseppina Miele, Fratta Mario, Alvino Bisecco, Giorgia Teresa Maniscalco, Maria Petracca, Romano Felice, Raffaele Dubbioso, Maria Di Gregorio, Antonio Luca Spiezia, Nicola Capasso, Elisabetta Signoriello, and Antonio Carotenuto
Subjects: medicine.medical_specialty, Neurology, business.industry, Multiple sclerosis, Multi center study, Medicine, Observational study, Ocrelizumab, Medical physics, Neurology (clinical), business, medicine.disease, medicine.drug
Published: 2021

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