BrainAgeNeXt: Advancing Brain Age Modeling for Individuals with Multiple Sclerosis.

Aging is associated with structural brain changes, cognitive decline, and neurodegenerative diseases. Brain age, an imaging biomarker sensitive to deviations from healthy aging, offers insights into structural aging variations and is a potential prognostic biomarker in neurodegenerative conditions. This study introduces BrainAgeNeXt, a novel convolutional neural network inspired by the MedNeXt framework, designed to predict brain age from T1-weighted magnetic resonance imaging (MRI) scans.

Phonemic processing is below expectations and linked to word-finding difficulty in multiple sclerosis.

Background: Word-finding difficulty is prevalent but poorly understood in persons with relapsing-remitting multiple sclerosis (RRMS).

Objective: The objective was to investigate our hypothesis that phonological processing ability is below expectations and related to word-finding difficulty in patients with RRMS.

Method: Data were analyzed from patients with RRMS ( = 50) on patient-reported word-finding difficulty (PR-WFD) and objective performance on Wechsler Individual Achievement Test, Fourth Edition (WIAT-4) Phonemic Proficiency (PP; analysis of phonemes within words), Word Reading (WR; proxy of premorbid literacy and verbal ability), and Sentence Repetition (SR; auditory processing of word-level information).

Depression symptoms and cognition in multiple sclerosis: Longitudinal evidence of a specific link to executive control.

Background: Depression symptoms are prevalent in multiple sclerosis (MS) and associated with poorer cognition in cross-sectional studies; it is unknown whether changes in depression symptoms track with cognitive changes longitudinally.

Objective: Investigate whether changes in depression symptoms correspond with cognitive changes over time in MS, and identify specific cognitive functions related to depression symptoms.

Method: Persons with early relapse-onset MS ( = 165) completed a depression questionnaire (Beck Depression Inventory FastScreen) and tests of cognitive speed, executive control, and memory at baseline and 3-year follow-up.

In-person and remote administrations of the symbol digit modalities test are interchangeable among persons with multiple sclerosis.

Background: Remote administration of the Symbol Digit Modalities Test (SDMT) requires validation.

Objectives: Examine interchangeability of remote and in-person SDMT administrations in persons with MS.

Methods: After in-person baseline administration, follow-up administration was either performed in-person (n = 72) or remotely via videoconferencing (n = 143).

Mediterranean diet is linked to less objective disability in multiple sclerosis.

Background: The multiple sclerosis (MS) community is highly interested in diet as a potential protective factor against disability, but empirical evidence remains limited.

Objective: Evaluate associations between patient-reported Mediterranean diet alignment and objective disability in a real-world MS cohort.

Methods: Data were analyzed from persons with MS, aged 18-65, who completed the Mediterranean Diet Adherence Screener (MEDAS), MS Functional Composite (MSFC; primary disability metric), and patient-reported outcomes (PROs; disability, gait disturbance, fatigue, anxiety, and depression) as part of our Comprehensive Annual Assessment Program.

Pattern of thalamic nuclei atrophy in early relapse-onset multiple sclerosis.

Background: Thalamic atrophy is prominent in multiple sclerosis; however, it is unclear which thalamic nuclei are most vulnerable, especially early in disease.

Introduction: To investigate which thalamic nuclei differ between patients in early stages of relapsing-remitting multiple sclerosis (RRMS) versus healthy controls and examine the relationship between thalamic nuclei volume and T2 lesion volume.

Methods: We derived 15 thalamic subfields from high-resolution 3T magnetic resonance images in 182 patients with early RRMS (diagnosed ≤5.

EDSS 0 is not normal: Multiple sclerosis disease burden below the clinical threshold.

Little to no above-threshold deficits may be evident in early multiple sclerosis (MS). The Expanded Disability Status Scale (EDSS) is a standard measure of neurologic function, with an EDSS score of 0 defined as "neurologically normal." The topographical model of MS proposes that sub-threshold disease is compensated for by functional reserve.

Differential antibody response to COVID-19 vaccines across immunomodulatory therapies for multiple sclerosis.

Background: Prior studies suggest reduced humoral response to COVID-19 vaccination in immunosuppressed populations. Disease modifying therapies (DMTs) for multiple sclerosis (MS) have variable immunomodulatory effects, and limited data are available for all DMTs. We aimed to determine the impact of DMTs on antibody response to COVID-19 vaccination among MS patients.

Machine learning to investigate superficial white matter integrity in early multiple sclerosis.

Background And Purpose: This study aims todetermine the sensitivity of superficial white matter (SWM) integrity as a metric to distinguish early multiple sclerosis (MS) patients from healthy controls (HC).

Methods: Fractional anisotropy and mean diffusivity (MD) values from SWM bundles across the cortex and major deep white matter (DWM) tracts were extracted from 29 early MS patients and 31 age- and sex-matched HC. Thickness of 68 cortical regions and resting-state functional-connectivity (RSFC) among them were calculated.

Fatigue in Survivors of Autoimmune Encephalitis.

Background And Objectives: To evaluate the impact of fatigue after autoimmune encephalitis, determine associations with patients' characteristics, and identify factors that contribute to its development.

Methods: In a first cohort recruited via several encephalitis support organizations, self-reported questionnaires were used to evaluate fatigue, depression, and sleep quality in adults after autoimmune encephalitis. In a second cohort where more in-depth clinical characterization could be performed, adults with encephalitis from 2 tertiary hospitals were evaluated using the same questionnaires.

Dietary factors and MRI metrics in early Multiple Sclerosis.

Background: Despite significant interest in diet by the MS community, research on this topic is limited; there are no published studies evaluating associations between diet and neuroimaging in MS.

Methods: We utilized baseline data from the RADIEMS cohort of early MS (diagnosed <5.0 years, n=180).

Sleep disturbance and memory dysfunction in early multiple sclerosis.

Objective: Sleep-dependent memory processing occurs in animals including humans, and disturbed sleep negatively affects memory. Sleep disturbance and memory dysfunction are common in multiple sclerosis (MS), but little is known about the contributions of sleep disturbance to memory in MS. We investigated whether subjective sleep disturbance is linked to worse memory in early MS independently of potential confounders.

The Symbol Digit Modalities Test (SDMT) is sensitive but non-specific in MS: Lexical access speed, memory, and information processing speed independently contribute to SDMT performance.

Background: The Symbol Digit Modalities Test (SDMT) is the most sensitive metric of neurocognitive function in multiple sclerosis (MS), and is consistently interpreted as a measure of information processing speed (IPS).

Objective: To evaluate the cognitive psychometric profile captured by the SDMT to identify whether different cognitive processes independently underlie performance.

Methods: Three samples of MS patients (total n=661; 185 research patients at MS center; 370 clinical patients at MS center; 106 persons with MS from the community) completed objective assessments of neuropsychological function across cognitive domains.

Depression and cognitive function in early multiple sclerosis: Multitasking is more sensitive than traditional assessments.

Background: Persons with multiple sclerosis (MS) and depression symptoms report real-world cognitive difficulties that may be missed by laboratory cognitive tests.

Objective: To examine the relationship of depressive symptoms to cognitive monotasking versus multitasking in early MS.

Method: Persons with early MS ( = 185; ⩽5 years diagnosed) reported mood, completed monotasking and multitasking cognitive tests, and received high-resolution 3.

Hippocampal volume is more related to patient-reported memory than objective memory performance in early multiple sclerosis.

Background: When persons with multiple sclerosis (MS) report memory decline but objective memory performance is normal, there is a bias toward believing objective test results.

Objective: Investigate whether subjective memory decline or objective memory performance is more related to hippocampal and hippocampal subfield volumes in early MS.

Methods: Persons with early MS ( = 185; ⩽5.

Detection of subtle gait disturbance and future fall risk in early multiple sclerosis.

Objective: To test the hypothesis that higher-challenge gait and balance tasks are more sensitive than traditional metrics to subtle patient-reported gait dysfunction and future fall risk in early multiple sclerosis (MS).

Methods: Persons with early MS (n = 185; ≤5 years diagnosed) reported gait function (MS Walking Scale) and underwent traditional disability metrics (Expanded Disability Status Scale [EDSS], Timed 25 Foot Walk). Patients and healthy controls (n = 50) completed clinically feasible challenge tasks of gait endurance (2-Minute Walk Test), standing balance (NIH Toolbox), and dynamic balance (balance boards; tandem walk on 2 ten-foot boards of different widths, 4.

Word-finding difficulty is a prevalent disease-related deficit in early multiple sclerosis.

Background: Persons with multiple sclerosis (MS) commonly report word-finding difficulty clinically, yet this language deficit remains underexplored.

Objective: To investigate the prevalence and nature of word-finding difficulty in persons with early MS on three levels: patient report, cognitive substrates, and neuroimaging.

Methods: Two samples of early MS patients ( = 185 and  = 55; ⩽5 years diagnosed) and healthy controls ( = 50) reported frequency/severity of cognitive deficits and underwent objective assessment with tasks of rapid automatized naming (RAN), measuring lexical access speed, memory, word generation, and cognitive efficiency.

Beyond rehabilitation: A prevention model of reserve and brain maintenance in multiple sclerosis.

Persons with multiple sclerosis (MS) experience cognitive and physical decline despite more effective disease-modifying therapies (DMTs), and symptomatic treatments currently have limited efficacy. The best treatment of MS disability may, therefore, be prevention of decline. Here, we present a working model of and , with a focus on modifiable risk and protective factors.

Dissociable cognitive patterns related to depression and anxiety in multiple sclerosis.

Background: Individuals with multiple sclerosis (MS) frequently present with depression and anxiety, as well as cognitive impairment, challenging clinicians to disentangle interrelationships among these symptoms.

Objective: To identify cognitive functions associated with anxiety and depression in MS.

Methods: Mood and cognition were measured in 185 recently diagnosed patients (Reserve Against Disability in Early Multiple Sclerosis (RADIEMS) cohort), and an independent validation sample (MEM CONNECT cohort,  = 70).

Psychological resilience is linked to motor strength and gait endurance in early multiple sclerosis.

Background: Psychologically resilient persons persist despite obstacles and bounce back after adversity, leading to better outcomes in non-neurologic populations. It is unknown whether psychological resilience relates to objective functional outcomes in multiple sclerosis (MS).

Objective: To determine whether psychological resilience explains differential objective cognitive and motor functioning in persons with early MS.