MS Briefs

Key clinical point: A pro-inflammatory diet characterized by higher dietary inflammatory index (DII) and energy-adjusted DII (E-DII) during adolescence is a significant risk factor for the onset of multiple sclerosis (MS).

Major finding: The risks for MS increased significantly when E-DII was used as a continuous variable (adjusted odds ratio [aOR], 1.53; P = .001) and categorical variable (fourth vs. first quartile: aOR, 7.01; P less than .001). A similar pattern was seen for DII as both continuous and categorical variables.

Study details: This large population-based incident case-control study conducted in Iran included 547 patients with incident MS and 1057 individuals from the general population.

Disclosures: Dr Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the DII from the University of South Carolina to develop computer and mobile applications. Dr Shivappa is an employee of CHI.

Citation: Abdollahpour I et al. Clin Nutr. 2020 Mar 6. doi: 10.1016/j.clnu.2020.02.033.

Key clinical point: A pro-inflammatory diet characterized by higher dietary inflammatory index (DII) and energy-adjusted DII (E-DII) during adolescence is a significant risk factor for the onset of multiple sclerosis (MS).

Major finding: The risks for MS increased significantly when E-DII was used as a continuous variable (adjusted odds ratio [aOR], 1.53; P = .001) and categorical variable (fourth vs. first quartile: aOR, 7.01; P less than .001). A similar pattern was seen for DII as both continuous and categorical variables.

Study details: This large population-based incident case-control study conducted in Iran included 547 patients with incident MS and 1057 individuals from the general population.

Disclosures: Dr Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the DII from the University of South Carolina to develop computer and mobile applications. Dr Shivappa is an employee of CHI.

Citation: Abdollahpour I et al. Clin Nutr. 2020 Mar 6. doi: 10.1016/j.clnu.2020.02.033.

Key clinical point: A pro-inflammatory diet characterized by higher dietary inflammatory index (DII) and energy-adjusted DII (E-DII) during adolescence is a significant risk factor for the onset of multiple sclerosis (MS).

Major finding: The risks for MS increased significantly when E-DII was used as a continuous variable (adjusted odds ratio [aOR], 1.53; P = .001) and categorical variable (fourth vs. first quartile: aOR, 7.01; P less than .001). A similar pattern was seen for DII as both continuous and categorical variables.

Study details: This large population-based incident case-control study conducted in Iran included 547 patients with incident MS and 1057 individuals from the general population.

Disclosures: Dr Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the DII from the University of South Carolina to develop computer and mobile applications. Dr Shivappa is an employee of CHI.

Citation: Abdollahpour I et al. Clin Nutr. 2020 Mar 6. doi: 10.1016/j.clnu.2020.02.033.

Key clinical point: In patients with multiple sclerosis (MS), protein concentrations of inflammatory cytokines, interleukin (IL)-27, transforming growth factor beta-1 (TGF-β1), and IL-10 are upregulated after 8 weeks of vitamin D₃ supplementation.

Major finding: In patients with MS, 8 weeks of vitamin D₃ administration upregulated the levels of IL-27 (P = .001), TGF-β1 (P less than .001), and IL-10 (P less than .001), whereas levels of IL-17A (P = .024) and IL-6 (P less than .001) were downregulated.

Study details: The study assessed venous blood samples drawn from individuals with MS (n=25) and control participants including first-degree relative (n=25) and healthy participants (n=25) before and after vitamin D₃ supplementation of 50,000 IU.

Disclosures: Dr SR Arefhosseini received financial support from Nutrition Research Center and Tabriz University of Medical Sciences, Tabriz, Iran.

Citation: Hashemi R et al. PLoS One. 2020 Apr 6. doi: 10.1371/journal.pone.0231145.

Key clinical point: In patients with multiple sclerosis (MS), protein concentrations of inflammatory cytokines, interleukin (IL)-27, transforming growth factor beta-1 (TGF-β1), and IL-10 are upregulated after 8 weeks of vitamin D₃ supplementation.

Major finding: In patients with MS, 8 weeks of vitamin D₃ administration upregulated the levels of IL-27 (P = .001), TGF-β1 (P less than .001), and IL-10 (P less than .001), whereas levels of IL-17A (P = .024) and IL-6 (P less than .001) were downregulated.

Study details: The study assessed venous blood samples drawn from individuals with MS (n=25) and control participants including first-degree relative (n=25) and healthy participants (n=25) before and after vitamin D₃ supplementation of 50,000 IU.

Disclosures: Dr SR Arefhosseini received financial support from Nutrition Research Center and Tabriz University of Medical Sciences, Tabriz, Iran.

Citation: Hashemi R et al. PLoS One. 2020 Apr 6. doi: 10.1371/journal.pone.0231145.

Key clinical point: In patients with multiple sclerosis (MS), protein concentrations of inflammatory cytokines, interleukin (IL)-27, transforming growth factor beta-1 (TGF-β1), and IL-10 are upregulated after 8 weeks of vitamin D₃ supplementation.

Major finding: In patients with MS, 8 weeks of vitamin D₃ administration upregulated the levels of IL-27 (P = .001), TGF-β1 (P less than .001), and IL-10 (P less than .001), whereas levels of IL-17A (P = .024) and IL-6 (P less than .001) were downregulated.

Study details: The study assessed venous blood samples drawn from individuals with MS (n=25) and control participants including first-degree relative (n=25) and healthy participants (n=25) before and after vitamin D₃ supplementation of 50,000 IU.

Disclosures: Dr SR Arefhosseini received financial support from Nutrition Research Center and Tabriz University of Medical Sciences, Tabriz, Iran.

Citation: Hashemi R et al. PLoS One. 2020 Apr 6. doi: 10.1371/journal.pone.0231145.

Key clinical point: Study finds direct evidence of transient neurotoxicity immediately after immunoablative autologous hematopoietic stem cell transplantation (IAHSCT) for aggressive multiple sclerosis (MS).

Major finding: Three months post-IAHSCT, levels of serum markers of both neuroaxonal and glial cell injury (serum Neurofilament Light Chain [sNfL] and serum Glial Fibrillary Acidic Protein [sGFAP]) increased from baseline by 32.1% (P = .029) and 74.8% (P = .0004), respectively. sNfL increases correlated with the dose of busulfan administered during transplant conditioning (P = .034), Expanded Disability Status Scale score (P = .041), as well as brain volume loss (P = .044), attributed to gray matter loss (P = .0023).

Study details: sNfL and sGFAP levels were evaluated pre- and post-IAHSCT at 3, 6, 9, and 12 months in 22 patients with MS and 28 noninflammatory control participants.

Disclosures: The study was funded by the MS Society of Canada. The authors declared no conflict of interest.

Citation: Thebault S et al. Ann Clin Transl Neurol. 2020 Apr 18. doi: 10.1002/acn3.51045.

Key clinical point: Study finds direct evidence of transient neurotoxicity immediately after immunoablative autologous hematopoietic stem cell transplantation (IAHSCT) for aggressive multiple sclerosis (MS).

Major finding: Three months post-IAHSCT, levels of serum markers of both neuroaxonal and glial cell injury (serum Neurofilament Light Chain [sNfL] and serum Glial Fibrillary Acidic Protein [sGFAP]) increased from baseline by 32.1% (P = .029) and 74.8% (P = .0004), respectively. sNfL increases correlated with the dose of busulfan administered during transplant conditioning (P = .034), Expanded Disability Status Scale score (P = .041), as well as brain volume loss (P = .044), attributed to gray matter loss (P = .0023).

Study details: sNfL and sGFAP levels were evaluated pre- and post-IAHSCT at 3, 6, 9, and 12 months in 22 patients with MS and 28 noninflammatory control participants.

Disclosures: The study was funded by the MS Society of Canada. The authors declared no conflict of interest.

Citation: Thebault S et al. Ann Clin Transl Neurol. 2020 Apr 18. doi: 10.1002/acn3.51045.

Key clinical point: Study finds direct evidence of transient neurotoxicity immediately after immunoablative autologous hematopoietic stem cell transplantation (IAHSCT) for aggressive multiple sclerosis (MS).

Major finding: Three months post-IAHSCT, levels of serum markers of both neuroaxonal and glial cell injury (serum Neurofilament Light Chain [sNfL] and serum Glial Fibrillary Acidic Protein [sGFAP]) increased from baseline by 32.1% (P = .029) and 74.8% (P = .0004), respectively. sNfL increases correlated with the dose of busulfan administered during transplant conditioning (P = .034), Expanded Disability Status Scale score (P = .041), as well as brain volume loss (P = .044), attributed to gray matter loss (P = .0023).

Study details: sNfL and sGFAP levels were evaluated pre- and post-IAHSCT at 3, 6, 9, and 12 months in 22 patients with MS and 28 noninflammatory control participants.

Disclosures: The study was funded by the MS Society of Canada. The authors declared no conflict of interest.

Citation: Thebault S et al. Ann Clin Transl Neurol. 2020 Apr 18. doi: 10.1002/acn3.51045.

Key clinical point: Inner nuclear layer (INL) and outer nuclear layer (ONL) measures may be novel biomarkers of neurodegeneration in patients with progressive multiple sclerosis (PMS).

Major finding: Independent of age, PMS vs. relapsing-remitting MS (RRMS) was associated with a faster thinning of peri-papillary retinal nerve fiber layer (β = −0.34%/year; P less than .001), ganglion cell+inner plexiform layer (β = −0.27%/year; P less than .001), INL (β = −0.10%/year; P = .01), and ONL (β = −0.13%/year; P = .01).

Study details: In all, 178 RRMS, 186 PMS, and 66 control participants were followed for a median of 3.7 years; retinal imaging was performed with spectral-domain optical coherence tomography.

Disclosures: This study was funded by the NIH/NINDS, National MS Society, Race to Erase MS, Walters Foundation, and ACTRIMS. The authors declared no conflict of interest.

Citation: Sotirchos ES et al. Ann Neurol. 2020 Apr 13. doi: 10.1002/ana.25738.

Key clinical point: Inner nuclear layer (INL) and outer nuclear layer (ONL) measures may be novel biomarkers of neurodegeneration in patients with progressive multiple sclerosis (PMS).

Major finding: Independent of age, PMS vs. relapsing-remitting MS (RRMS) was associated with a faster thinning of peri-papillary retinal nerve fiber layer (β = −0.34%/year; P less than .001), ganglion cell+inner plexiform layer (β = −0.27%/year; P less than .001), INL (β = −0.10%/year; P = .01), and ONL (β = −0.13%/year; P = .01).

Study details: In all, 178 RRMS, 186 PMS, and 66 control participants were followed for a median of 3.7 years; retinal imaging was performed with spectral-domain optical coherence tomography.

Disclosures: This study was funded by the NIH/NINDS, National MS Society, Race to Erase MS, Walters Foundation, and ACTRIMS. The authors declared no conflict of interest.

Citation: Sotirchos ES et al. Ann Neurol. 2020 Apr 13. doi: 10.1002/ana.25738.

Key clinical point: Inner nuclear layer (INL) and outer nuclear layer (ONL) measures may be novel biomarkers of neurodegeneration in patients with progressive multiple sclerosis (PMS).

Major finding: Independent of age, PMS vs. relapsing-remitting MS (RRMS) was associated with a faster thinning of peri-papillary retinal nerve fiber layer (β = −0.34%/year; P less than .001), ganglion cell+inner plexiform layer (β = −0.27%/year; P less than .001), INL (β = −0.10%/year; P = .01), and ONL (β = −0.13%/year; P = .01).

Study details: In all, 178 RRMS, 186 PMS, and 66 control participants were followed for a median of 3.7 years; retinal imaging was performed with spectral-domain optical coherence tomography.

Disclosures: This study was funded by the NIH/NINDS, National MS Society, Race to Erase MS, Walters Foundation, and ACTRIMS. The authors declared no conflict of interest.

Citation: Sotirchos ES et al. Ann Neurol. 2020 Apr 13. doi: 10.1002/ana.25738.

Key clinical point: Patients with newly diagnosed multiple sclerosis (MS) or clinically isolated syndrome (CIS) are more likely to have subtly impaired cognitive function irrespective of race/ethnicity.

Major finding: Mean oral Symbol Digit Modalities Test (SDMT) scores were lower in patients with MS/CIS vs. control participants (52.2 vs. 58.3; P less than .0001). Independent predictors of lower oral SDMT scores included being black (β = −5.97) or Hispanic (β = −3.06), having MS (β = −6.04), lower educational attainment (β = −5.02), and having a household income ≤$65,000 (β = −2.28). No significant interaction was found between race/ethnicity and having MS on SDMT scores (P = .41).

Study details: 1,174 adult patients (mean age, 40.7 years) from the MS Sunshine Study were included in this analysis (MS/CIS cases, n = 554; matched control participants, n = 620).

 Disclosures: This study was supported in part by the National Institute of Neurologic Disorders and Stroke. The presenting author received personal compensation or funding from Genzyme, Biogen, Serrono, MedDay, and Novartis, and grant support from the NIH, the National MS Society, California Community Foundation, and the Charitable Guthy-Jackson Foundation.

Citation: Amezcua L et al. Neurology. 2020 Mar 9. doi: 10.1212/WNL.0000000000009210.

Key clinical point: Patients with newly diagnosed multiple sclerosis (MS) or clinically isolated syndrome (CIS) are more likely to have subtly impaired cognitive function irrespective of race/ethnicity.

Major finding: Mean oral Symbol Digit Modalities Test (SDMT) scores were lower in patients with MS/CIS vs. control participants (52.2 vs. 58.3; P less than .0001). Independent predictors of lower oral SDMT scores included being black (β = −5.97) or Hispanic (β = −3.06), having MS (β = −6.04), lower educational attainment (β = −5.02), and having a household income ≤$65,000 (β = −2.28). No significant interaction was found between race/ethnicity and having MS on SDMT scores (P = .41).

Study details: 1,174 adult patients (mean age, 40.7 years) from the MS Sunshine Study were included in this analysis (MS/CIS cases, n = 554; matched control participants, n = 620).

 Disclosures: This study was supported in part by the National Institute of Neurologic Disorders and Stroke. The presenting author received personal compensation or funding from Genzyme, Biogen, Serrono, MedDay, and Novartis, and grant support from the NIH, the National MS Society, California Community Foundation, and the Charitable Guthy-Jackson Foundation.

Citation: Amezcua L et al. Neurology. 2020 Mar 9. doi: 10.1212/WNL.0000000000009210.

Key clinical point: Patients with newly diagnosed multiple sclerosis (MS) or clinically isolated syndrome (CIS) are more likely to have subtly impaired cognitive function irrespective of race/ethnicity.

Major finding: Mean oral Symbol Digit Modalities Test (SDMT) scores were lower in patients with MS/CIS vs. control participants (52.2 vs. 58.3; P less than .0001). Independent predictors of lower oral SDMT scores included being black (β = −5.97) or Hispanic (β = −3.06), having MS (β = −6.04), lower educational attainment (β = −5.02), and having a household income ≤$65,000 (β = −2.28). No significant interaction was found between race/ethnicity and having MS on SDMT scores (P = .41).

Study details: 1,174 adult patients (mean age, 40.7 years) from the MS Sunshine Study were included in this analysis (MS/CIS cases, n = 554; matched control participants, n = 620).

 Disclosures: This study was supported in part by the National Institute of Neurologic Disorders and Stroke. The presenting author received personal compensation or funding from Genzyme, Biogen, Serrono, MedDay, and Novartis, and grant support from the NIH, the National MS Society, California Community Foundation, and the Charitable Guthy-Jackson Foundation.

Citation: Amezcua L et al. Neurology. 2020 Mar 9. doi: 10.1212/WNL.0000000000009210.

Key clinical point: The number of T1-hypointense areas (T1-count), corrected for T2-fluid-attenuated inversion recovery (FLAIR)-hyperintense lesion volume, reflects the disease severity and activity in patients with multiple sclerosis (MS).

Major finding: T1-count (Spearman’s correlation coefficient [rho] = 0.51, P less than .001), gray-matter atrophy (rho = 0.40; P less than .01), and white-matter atrophy (rho = 0.49; P less than .001) significantly correlated with the expanded disability status scale. T1-count divided by FLAIR lesion volume correlated with the MS severity score (rho = 0.60; P less than .001).

Study details: This study included 42 patients with MS who were treated in a single university hospital in Japan; each patient underwent brain volumetry and was followed-up for more than 3 years until 2017.

Disclosures: Ichiro Nakashima was funded by JSPS KAKENHI. The authors declared no conflict of interest.

Citation: Akaishi T et al. PLoS One. 2020 Apr 3. doi: 10.1371/journal.pone.0231225.

Key clinical point: The number of T1-hypointense areas (T1-count), corrected for T2-fluid-attenuated inversion recovery (FLAIR)-hyperintense lesion volume, reflects the disease severity and activity in patients with multiple sclerosis (MS).

Major finding: T1-count (Spearman’s correlation coefficient [rho] = 0.51, P less than .001), gray-matter atrophy (rho = 0.40; P less than .01), and white-matter atrophy (rho = 0.49; P less than .001) significantly correlated with the expanded disability status scale. T1-count divided by FLAIR lesion volume correlated with the MS severity score (rho = 0.60; P less than .001).

Study details: This study included 42 patients with MS who were treated in a single university hospital in Japan; each patient underwent brain volumetry and was followed-up for more than 3 years until 2017.

Disclosures: Ichiro Nakashima was funded by JSPS KAKENHI. The authors declared no conflict of interest.

Citation: Akaishi T et al. PLoS One. 2020 Apr 3. doi: 10.1371/journal.pone.0231225.

Key clinical point: The number of T1-hypointense areas (T1-count), corrected for T2-fluid-attenuated inversion recovery (FLAIR)-hyperintense lesion volume, reflects the disease severity and activity in patients with multiple sclerosis (MS).

Major finding: T1-count (Spearman’s correlation coefficient [rho] = 0.51, P less than .001), gray-matter atrophy (rho = 0.40; P less than .01), and white-matter atrophy (rho = 0.49; P less than .001) significantly correlated with the expanded disability status scale. T1-count divided by FLAIR lesion volume correlated with the MS severity score (rho = 0.60; P less than .001).

Study details: This study included 42 patients with MS who were treated in a single university hospital in Japan; each patient underwent brain volumetry and was followed-up for more than 3 years until 2017.

Disclosures: Ichiro Nakashima was funded by JSPS KAKENHI. The authors declared no conflict of interest.

Citation: Akaishi T et al. PLoS One. 2020 Apr 3. doi: 10.1371/journal.pone.0231225.

Key clinical point: Most women diagnosed with multiple sclerosis (MS) can have children without incurring an increased risk of relapses and should be encouraged to breastfeed exclusively as this lowers the risk of postpartum relapses.

Major finding: The annualized relapse rates (ARRs) declined from 0.37 before pregnancy to 0.14 during pregnancy (P less than .0001), with no rebound disease activity in the postpartum period. ARR was found to be 0.27 at 3 months postpartum and 0.37 at 4-6 months, matching prepregnancy rates. Exclusive breastfeeding for at least 2 months after delivery reduced the risk of relapse in the first 6 months postpartum (adjusted hazard ratio, 0.37; P = .0093).

Study details: This study evaluated the electronic health records of 466 pregnancies among 375 women with MS and their infants at the Kaiser Permanente Southern and Northern California between 2008 and 2016.

Disclosures: This study was supported by the National Multiple Sclerosis Society. Annette Langer-Gould has received grant support and awards from the NIH, the Patient-Centered Outcomes Research Institute, and the National MS Society; and currently serves as a voting member on the California Technology Assessment Forum, a core program of the Institute for Clinical and Economic Review (ICER). She has received sponsored and reimbursed travel from the ICER. The remaining authors declared no conflict of interest.

Citation: Langer-Gould A et al. Neurology. 2020 Apr 13. doi: 10.1212/WNL.0000000000009374.

Key clinical point: Most women diagnosed with multiple sclerosis (MS) can have children without incurring an increased risk of relapses and should be encouraged to breastfeed exclusively as this lowers the risk of postpartum relapses.

Major finding: The annualized relapse rates (ARRs) declined from 0.37 before pregnancy to 0.14 during pregnancy (P less than .0001), with no rebound disease activity in the postpartum period. ARR was found to be 0.27 at 3 months postpartum and 0.37 at 4-6 months, matching prepregnancy rates. Exclusive breastfeeding for at least 2 months after delivery reduced the risk of relapse in the first 6 months postpartum (adjusted hazard ratio, 0.37; P = .0093).

Study details: This study evaluated the electronic health records of 466 pregnancies among 375 women with MS and their infants at the Kaiser Permanente Southern and Northern California between 2008 and 2016.

Disclosures: This study was supported by the National Multiple Sclerosis Society. Annette Langer-Gould has received grant support and awards from the NIH, the Patient-Centered Outcomes Research Institute, and the National MS Society; and currently serves as a voting member on the California Technology Assessment Forum, a core program of the Institute for Clinical and Economic Review (ICER). She has received sponsored and reimbursed travel from the ICER. The remaining authors declared no conflict of interest.

Citation: Langer-Gould A et al. Neurology. 2020 Apr 13. doi: 10.1212/WNL.0000000000009374.

Key clinical point: Most women diagnosed with multiple sclerosis (MS) can have children without incurring an increased risk of relapses and should be encouraged to breastfeed exclusively as this lowers the risk of postpartum relapses.

Major finding: The annualized relapse rates (ARRs) declined from 0.37 before pregnancy to 0.14 during pregnancy (P less than .0001), with no rebound disease activity in the postpartum period. ARR was found to be 0.27 at 3 months postpartum and 0.37 at 4-6 months, matching prepregnancy rates. Exclusive breastfeeding for at least 2 months after delivery reduced the risk of relapse in the first 6 months postpartum (adjusted hazard ratio, 0.37; P = .0093).

Study details: This study evaluated the electronic health records of 466 pregnancies among 375 women with MS and their infants at the Kaiser Permanente Southern and Northern California between 2008 and 2016.

Disclosures: This study was supported by the National Multiple Sclerosis Society. Annette Langer-Gould has received grant support and awards from the NIH, the Patient-Centered Outcomes Research Institute, and the National MS Society; and currently serves as a voting member on the California Technology Assessment Forum, a core program of the Institute for Clinical and Economic Review (ICER). She has received sponsored and reimbursed travel from the ICER. The remaining authors declared no conflict of interest.

Citation: Langer-Gould A et al. Neurology. 2020 Apr 13. doi: 10.1212/WNL.0000000000009374.

Key clinical point: Cognitive reserve (CR) is strongly associated with cognitive function in patients with multiple sclerosis (MS); CR along with disability and depressive symptoms explained up to roughly 23.7% of the cognitive performance.

Major finding: Cognitive impairment (CI) was detected in 202 (38.4%) patients. The CR Index questionnaire (CRIq) score was lower in patients with CI vs. those without (94.8±11.6 vs. 102.2±14.1; P less than .001). CRIq score significantly correlated with information-processing speed, verbal memory, and visuospatial memory (P less than .001 for all). Higher CRIq was associated with lower disability and depressive symptoms (P less than .001 for both). 

Study details: Cross-sectional study of 526 MS outpatients (70.9% female patients; mean age, 41.7±11.1 years); CR was assessed by the CRIq.

Disclosures: No study sponsor was identified. Dr. Bakirtzis and Prof. Grigoriadis reported receiving research funding and/or honoraria from multiple pharmaceutical companies. The remaining authors reported no conflict of interest.

Citation: Artemiadis A et al. Mult Scler Relat Disord. 2020 Mar 7. doi: 10.1016/j.msard.2020.102047. 

Key clinical point: Cognitive reserve (CR) is strongly associated with cognitive function in patients with multiple sclerosis (MS); CR along with disability and depressive symptoms explained up to roughly 23.7% of the cognitive performance.

Major finding: Cognitive impairment (CI) was detected in 202 (38.4%) patients. The CR Index questionnaire (CRIq) score was lower in patients with CI vs. those without (94.8±11.6 vs. 102.2±14.1; P less than .001). CRIq score significantly correlated with information-processing speed, verbal memory, and visuospatial memory (P less than .001 for all). Higher CRIq was associated with lower disability and depressive symptoms (P less than .001 for both). 

Study details: Cross-sectional study of 526 MS outpatients (70.9% female patients; mean age, 41.7±11.1 years); CR was assessed by the CRIq.

Disclosures: No study sponsor was identified. Dr. Bakirtzis and Prof. Grigoriadis reported receiving research funding and/or honoraria from multiple pharmaceutical companies. The remaining authors reported no conflict of interest.

Citation: Artemiadis A et al. Mult Scler Relat Disord. 2020 Mar 7. doi: 10.1016/j.msard.2020.102047. 

Key clinical point: Cognitive reserve (CR) is strongly associated with cognitive function in patients with multiple sclerosis (MS); CR along with disability and depressive symptoms explained up to roughly 23.7% of the cognitive performance.

Major finding: Cognitive impairment (CI) was detected in 202 (38.4%) patients. The CR Index questionnaire (CRIq) score was lower in patients with CI vs. those without (94.8±11.6 vs. 102.2±14.1; P less than .001). CRIq score significantly correlated with information-processing speed, verbal memory, and visuospatial memory (P less than .001 for all). Higher CRIq was associated with lower disability and depressive symptoms (P less than .001 for both). 

Study details: Cross-sectional study of 526 MS outpatients (70.9% female patients; mean age, 41.7±11.1 years); CR was assessed by the CRIq.

Disclosures: No study sponsor was identified. Dr. Bakirtzis and Prof. Grigoriadis reported receiving research funding and/or honoraria from multiple pharmaceutical companies. The remaining authors reported no conflict of interest.

Citation: Artemiadis A et al. Mult Scler Relat Disord. 2020 Mar 7. doi: 10.1016/j.msard.2020.102047. 

Key clinical point: The incidence of trigeminal neuralgia (TN) is 15-fold higher in patients with multiple sclerosis (MS) compared with the general neurological outpatient population.

Major finding: Concomitant diagnoses of MS and TN were verified in 55 patients, giving a prevalence of 2.1% for TN in patients with MS. Patients with MS had a significantly higher incidence of TN vs. general neurological outpatient population (149 vs. 9.9 per 100,000 person-years). A demyelinating lesion in the proximity of the trigeminal ganglia was observed in 26 (63%) of the 41 patients with a concomitant MS diagnosis and with magnetic resonance imaging scans available.

Study details: Single-center retrospective study included 2,575 patients with MS and 2,008 patients with a diagnosis of TN using data from the Finnish MS register.

Disclosures: The presenting author received fee for lecture from Merck; congress expenses from Roche, Merck. Funding for building the Finnish MS registry was received from Biogen Idec, Merck, Novartis, Sanofi-Genzyme, Roche, Teva, and Business Finland.

Citation: Laakso SM et al. Acta Neurol Scand. 2020 Mar 18. doi: 10.1111/ane.13243. 

Key clinical point: The incidence of trigeminal neuralgia (TN) is 15-fold higher in patients with multiple sclerosis (MS) compared with the general neurological outpatient population.

Major finding: Concomitant diagnoses of MS and TN were verified in 55 patients, giving a prevalence of 2.1% for TN in patients with MS. Patients with MS had a significantly higher incidence of TN vs. general neurological outpatient population (149 vs. 9.9 per 100,000 person-years). A demyelinating lesion in the proximity of the trigeminal ganglia was observed in 26 (63%) of the 41 patients with a concomitant MS diagnosis and with magnetic resonance imaging scans available.

Study details: Single-center retrospective study included 2,575 patients with MS and 2,008 patients with a diagnosis of TN using data from the Finnish MS register.

Disclosures: The presenting author received fee for lecture from Merck; congress expenses from Roche, Merck. Funding for building the Finnish MS registry was received from Biogen Idec, Merck, Novartis, Sanofi-Genzyme, Roche, Teva, and Business Finland.

Citation: Laakso SM et al. Acta Neurol Scand. 2020 Mar 18. doi: 10.1111/ane.13243. 

Key clinical point: The incidence of trigeminal neuralgia (TN) is 15-fold higher in patients with multiple sclerosis (MS) compared with the general neurological outpatient population.

Major finding: Concomitant diagnoses of MS and TN were verified in 55 patients, giving a prevalence of 2.1% for TN in patients with MS. Patients with MS had a significantly higher incidence of TN vs. general neurological outpatient population (149 vs. 9.9 per 100,000 person-years). A demyelinating lesion in the proximity of the trigeminal ganglia was observed in 26 (63%) of the 41 patients with a concomitant MS diagnosis and with magnetic resonance imaging scans available.

Study details: Single-center retrospective study included 2,575 patients with MS and 2,008 patients with a diagnosis of TN using data from the Finnish MS register.

Disclosures: The presenting author received fee for lecture from Merck; congress expenses from Roche, Merck. Funding for building the Finnish MS registry was received from Biogen Idec, Merck, Novartis, Sanofi-Genzyme, Roche, Teva, and Business Finland.

Citation: Laakso SM et al. Acta Neurol Scand. 2020 Mar 18. doi: 10.1111/ane.13243. 

Key clinical point: Exposure to passive smoking during adolescence is a strong risk factor for developing multiple sclerosis (MS) in later life.

Major finding: Among never smokers, female patients with MS more often than healthy control participants reported exposure to passive smoking between the age of 10 and 19 years (women: odds ratio [OR], 1.432; P = .037 and men: OR, 1.232; P = .390). Among active smokers aged 19 years or older, male MS patients more often than male control participants reported with passive smoking (men: OR, 1.593; P = .022 and women: OR, 1.102; P = .440).

Study details: The data come from a case-control study of 919 MS cases and 3,419 controls (never active smokers: 342/822 cases/controls; active smokers aged 19 years or older: 577/2,597 cases/controls).

Disclosures: This study was supported by grants from the Danish Multiple Sclerosis Society, the Danish Council for Strategic Research, Novartis, Biogen (Denmark), the Sofus Carl Emil Friis og Hustru Olga Doris Friis foundation, the Foundation for Research in Neurology, and the Director Einar Jonasson (Johnsen) and Wife foundation. Some of the authors reported receiving research support from various pharmaceutical companies.

Citation: Oturai DB et al. Mult Scler. 2020 Mar 23. doi: 10.1177/1352458520912500. 

Key clinical point: Exposure to passive smoking during adolescence is a strong risk factor for developing multiple sclerosis (MS) in later life.

Major finding: Among never smokers, female patients with MS more often than healthy control participants reported exposure to passive smoking between the age of 10 and 19 years (women: odds ratio [OR], 1.432; P = .037 and men: OR, 1.232; P = .390). Among active smokers aged 19 years or older, male MS patients more often than male control participants reported with passive smoking (men: OR, 1.593; P = .022 and women: OR, 1.102; P = .440).

Study details: The data come from a case-control study of 919 MS cases and 3,419 controls (never active smokers: 342/822 cases/controls; active smokers aged 19 years or older: 577/2,597 cases/controls).

Disclosures: This study was supported by grants from the Danish Multiple Sclerosis Society, the Danish Council for Strategic Research, Novartis, Biogen (Denmark), the Sofus Carl Emil Friis og Hustru Olga Doris Friis foundation, the Foundation for Research in Neurology, and the Director Einar Jonasson (Johnsen) and Wife foundation. Some of the authors reported receiving research support from various pharmaceutical companies.

Citation: Oturai DB et al. Mult Scler. 2020 Mar 23. doi: 10.1177/1352458520912500. 

Key clinical point: Exposure to passive smoking during adolescence is a strong risk factor for developing multiple sclerosis (MS) in later life.

Major finding: Among never smokers, female patients with MS more often than healthy control participants reported exposure to passive smoking between the age of 10 and 19 years (women: odds ratio [OR], 1.432; P = .037 and men: OR, 1.232; P = .390). Among active smokers aged 19 years or older, male MS patients more often than male control participants reported with passive smoking (men: OR, 1.593; P = .022 and women: OR, 1.102; P = .440).

Study details: The data come from a case-control study of 919 MS cases and 3,419 controls (never active smokers: 342/822 cases/controls; active smokers aged 19 years or older: 577/2,597 cases/controls).

Disclosures: This study was supported by grants from the Danish Multiple Sclerosis Society, the Danish Council for Strategic Research, Novartis, Biogen (Denmark), the Sofus Carl Emil Friis og Hustru Olga Doris Friis foundation, the Foundation for Research in Neurology, and the Director Einar Jonasson (Johnsen) and Wife foundation. Some of the authors reported receiving research support from various pharmaceutical companies.

Citation: Oturai DB et al. Mult Scler. 2020 Mar 23. doi: 10.1177/1352458520912500.