Publications by authors named "Carlos Nos"

Background And Objectives: Early treatment of multiple sclerosis (MS) reduces disease activity and the risk of long-term disease progression. Effectiveness of ocrelizumab is established in relapsing MS (RMS); however, data in early RMS are lacking. We evaluated the 4-year effectiveness and safety of ocrelizumab as a first-line therapy in treatment-naive patients with recently diagnosed relapsing-remitting MS (RRMS).

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Background: Alemtuzumab is administered intravenously (IV) for relapsing-remitting multiple sclerosis (RRMS), with limited studies of subcutaneous (SC) treatment.

Objectives: We sought to evaluate the pharmacodynamics (PD), pharmacokinetics (PK), and safety profile of SC-administered alemtuzumab in people with progressive multiple sclerosis (PMS).

Design: SCALA was a phase I, open-label, randomized, parallel-group study with two 12-month periods and a safety monitoring phase to 60 months.

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Introduction: Ocrelizumab is an approved intravenously administered anti-CD20 antibody for multiple sclerosis (MS). The safety profile and patient preference for conventional versus shorter ocrelizumab infusions were investigated in the ENSEMBLE PLUS study.

Methods: ENSEMBLE PLUS was a randomized, double-blind substudy to the single-arm ENSEMBLE study (NCT03085810), comparing outcomes in patients with early-stage relapsing-remitting MS receiving ocrelizumab 600 mg over the approved 3.

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Background: Limited data exist regarding treatment response prediction to oral disease-modifying therapies (DMTs) in multiple sclerosis (MS).

Objectives: We assessed the capacity of available scoring systems to anticipate disease activity parameters in naïve relapsing-remitting MS (RRMS) patients initiating daily oral DMTs, hypothesizing that they exhibit different predictive potentials.

Methods: We conducted a retrospective study and applied the Rio Score (RS), modified Rio Score (mRS), and MAGNIMS Score 12 months after DMT initiation.

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Article Synopsis
  • Multiple sclerosis (MS) is a significant cause of disability in young adults, and traditional clinical assessments may miss subtle changes in a patient's condition over time.
  • The RADAR-CNS study involved 400 MS patients monitored over 24 months using both clinical evaluations and remote data from wearable devices like Fitbits.
  • Results indicated that while some patients showed disability progression based on standard scales, there wasn't a significant decline in daily steps compared to stable patients, suggesting that continuous activity monitoring could be a more sensitive measure for tracking disability in MS.
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Background: The combination of anatomical MRI and deep learning-based methods such as convolutional neural networks (CNNs) is a promising strategy to build predictive models of multiple sclerosis (MS) prognosis. However, studies assessing the effect of different input strategies on model's performance are lacking.

Purpose: To compare whole-brain input sampling strategies and regional/specific-tissue strategies, which focus on a priori known relevant areas for disability accrual, to stratify MS patients based on their disability level.

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Objective: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) distinguish multiple sclerosis (MS) from MOG-associated disease in most cases. However, studies analyzing MOG-Ab at the time of a first demyelinating event suggestive of MS in adults are lacking. We aimed to (1) evaluate the prevalence of MOG-Ab in a first demyelinating event suggestive of MS and (2) compare clinical and paraclinical features between seropositive (MOG-Ab+) and seronegative (MOG-Ab-) patients.

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Article Synopsis
  • Early treatment after a first demyelinating event is linked to improved long-term outcomes in patients with multiple sclerosis (MS), but MR findings are often overlooked when evaluating these outcomes.
  • The study analyzed data from 580 patients between 1994 and 2021, categorizing them based on how soon they received disease-modifying drugs (DMDs) after their first event, creating a 5-point MR score (MRS) to assess disability risk.
  • Results showed that very early treatment significantly reduced the risk of developing severe disability and secondary progressive MS compared to those who started treatment later, highlighting the importance of timely intervention and MR score in treatment decisions.
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The aim of this study was to investigate the feasibility of automatically assessing the 2-Minute Walk Distance (2MWD) for monitoring people with multiple sclerosis (pwMS). For 154 pwMS, MS-related clinical outcomes as well as the 2MWDs as evaluated by clinicians and derived from accelerometer data were collected from a total of 323 periodic clinical visits. Accelerometer data from a wearable device during 100 home-based 2MWD assessments were also acquired.

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The aim of this study was to evaluate the association between changes in the autonomic control of cardiorespiratory system induced by walk tests and outcome measures in people with Multiple Sclerosis (pwMS). Electrocardiogram (ECG) recordings of 148 people with Relapsing-Remitting MS (RRMS) and 58 with Secondary Progressive MS (SPMS) were acquired using a wearable device before, during, and after walk test performance from a total of 386 periodical clinical visits. A subset of 90 participants repeated a walk test at home.

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The application of convolutional neural networks (CNNs) to MRI data has emerged as a promising approach to achieving unprecedented levels of accuracy when predicting the course of neurological conditions, including multiple sclerosis, by means of extracting image features not detectable through conventional methods. Additionally, the study of CNN-derived attention maps, which indicate the most relevant anatomical features for CNN-based decisions, has the potential to uncover key disease mechanisms leading to disability accumulation. From a cohort of patients prospectively followed up after a first demyelinating attack, we selected those with T1-weighted and T2-FLAIR brain MRI sequences available for image analysis and a clinical assessment performed within the following six months (N = 319).

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Importance: Progression independent of relapse activity (PIRA) is the main event responsible for irreversible disability accumulation in relapsing multiple sclerosis (MS).

Objective: To investigate clinical and neuroimaging predictors of PIRA at the time of the first demyelinating attack and factors associated with long-term clinical outcomes of people who present with PIRA.

Design, Setting, And Participants: This cohort study, conducted from January 1, 1994, to July 31, 2021, included patients with a first demyelinating attack from multiple sclerosis; patients were recruited from 1 study center in Spain.

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Article Synopsis
  • The methionine-valine polymorphic codon 129 of the prion protein gene (PRNP) is crucial in the development and expression of sporadic Creutzfeldt-Jakob disease (sCJD), influencing susceptibility and the types of prion strains that emerge.
  • Experiments using humanized transgenic mice isolated five prion strains which vary based on the conformations of the pathogenic prion proteins, with certain strains only found in specific codon 129 genotypes, including a new subtype identified in patients with the MV genotype.
  • A study identified six cases of sCJD in Catalonia and Italy showing unique clinical and neuropathological features that resemble the VV1 subtype, suggesting that these cases might
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  • Intrathecal production of kappa free light chains, measurable by the kappa free light chain index, is significant in diagnosing multiple sclerosis and may be easier and more sensitive than traditional methods like oligoclonal bands and the IgG index.
  • A study involving 214 patients assessed various diagnostic indices and found strong concordance between oligoclonal bands and different kappa free light chain cut-offs (specifically 5.9 and 6.6).
  • The addition of kappa free light chain indexes to existing diagnostic criteria increased the number of confirmed multiple sclerosis cases, with the kappa free light chain-5.9 cut-off adding the most diagnoses.
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  • The study investigates how disease-modifying therapies, specifically anti-CD20 treatments and sphingosine 1-phosphate receptor modulators (S1PRM), affect immune responses to SARS-CoV-2 vaccines in patients with multiple sclerosis (MS) and other autoimmune diseases.
  • Researchers enrolled 457 patients and measured both humoral (antibody) and cellular (T-cell) immune responses before and after vaccination, finding that responses varied based on treatment type and duration.
  • Results indicate that while anti-CD20 and S1PRM treatments can reduce antibody responses, anti-CD20 patients may still generate T-cell responses even without detectable antibodies, highlighting the complexities of vaccine response in these populations.
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Background And Objectives: Information about humoral and cellular responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and antibody persistence in convalescent (COVID-19) patients with multiple sclerosis (PwMS) is scarce. The objectives of this study were to investigate factors influencing humoral and cellular responses to SARS-CoV-2 and its persistence in convalescent COVID-19 PwMS.

Methods: This is a retrospective study of confirmed COVID-19 convalescent PwMS identified between February 2020 and May 2021 by SARS-CoV-2 antibody testing.

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Introduction: To evaluate the impact of the COVID-19 pandemic on (1) number of clinical visits, (2) magnetic resonance (MR) scans, and (3) treatment prescriptions in a multiple sclerosis (MS) referral centre.

Methods: Retrospective study covering January 2018 to May 2021.

Results: The monthly mean (standard deviation [SD]) of visits performed in 2020 (814[137.

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This study proposes a contrastive convolutional auto-encoder (contrastive CAE), a combined architecture of an auto-encoder and contrastive loss, to identify individuals with suspected COVID-19 infection using heart-rate data from participants with multiple sclerosis (MS) in the ongoing RADAR-CNS mHealth research project. Heart-rate data was remotely collected using a Fitbit wristband. COVID-19 infection was either confirmed through a positive swab test, or inferred through a self-reported set of recognised symptoms of the virus.

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Background And Objectives: Different treatment response scoring systems in treated MS patients exist. The objective was to assess the long-term predictive value of these systems in RRMS patients treated with self-injectable DMTs.

Methods: RRMS-treated patients underwent brain MRI before the onset of therapy and 12 months thereafter, and neurological assessments every 6 months.

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Background And Objectives: To explore whether time to diagnosis, time to treatment initiation, and age to reach disability milestones have changed in patients with clinically isolated syndrome (CIS) according to different multiple sclerosis (MS) diagnostic criteria periods.

Methods: This retrospective study was based on data collected prospectively from the Barcelona-CIS cohort between 1994 and 2020. Patients were classified into 5 periods according to different MS criteria, and the times to MS diagnosis and treatment initiation were evaluated.

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Background And Purpose: To evaluate the effect of menopause on disability accumulation in women followed from their clinically isolated syndrome (CIS).

Methods: We examined the longitudinal changes in Expanded Disability Status Scale (EDSS) scores from CIS until the last follow-up in women belonging to the Barcelona CIS prospective cohort, followed through their menopausal transition. The analysis is based on 13,718 EDSS measurements, with an average of 28 EDSS measurements per patient.

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Article Synopsis
  • The study investigated how often multiple sclerosis (MS) is misdiagnosed and the factors involved in such cases at the Multiple Sclerosis Centre of Catalonia.
  • Out of 354 new patients, 8 were misdiagnosed with MS, representing 7.1% misdiagnosis rate, and these cases often had non-specific MRI findings and more comorbidities.
  • Overall, the research concluded that while misdiagnosis is relatively low, certain MRI characteristics and the presence of other health issues may increase the risk of incorrectly diagnosing MS.
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Background And Purpose: Information regarding multiple sclerosis (MS) patients with the 2019 novel coronavirus disease (COVID-19) is scarce. The study objective was to describe the incidence and characteristics of MS patients with COVID-19, to identify susceptibility and severity risk factors and to assess the proportion of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologies according to disease-modifying treatments.

Methods: This was a retrospective study of an MS cohort analysing data collected between February and May 2020.

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