Publications by authors named "Joaquin Castillo"

Article Synopsis
  • - Organizing pneumonia (OP) has been identified in patients with inflammatory demyelinating diseases (IDDs) after COVID-19, particularly those treated with anti-CD20 therapies, but comprehensive data is scarce.
  • - This study analyzed 19 patients with conditions like multiple sclerosis and neuromyelitis optica who developed COVID-19-associated OP; symptoms included intermittent fever, and most required hospitalization, but none died.
  • - After about 1.5 years of follow-up, most lung issues resolved, although many patients experienced long-COVID symptoms; the study suggests that OP should be considered in anti-CD20-treated patients exhibiting specific CT findings and fever.
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Importance: Vaccination in patients with highly active multiple sclerosis (MS) requiring prompt treatment initiation may result in impaired vaccine responses and/or treatment delay.

Objective: To assess the immunogenicity and safety of inactivated vaccines administered during natalizumab treatment.

Design, Setting, And Participants: This self-controlled, prospective cohort study followed adult patients with MS from 1 study center in Spain from September 2016 to February 2022.

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Background And Objectives: We aimed to assess the presence of retinal neurodegeneration independent of optic neuritis (ON) in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and to investigate the development of trans-synaptic anterograde degeneration in these patients after ON.

Methods: Cross-sectional, retrospective study of 34 adult patients with MOGAD and 23 healthy controls (HC). Clinical, optical coherence tomography (OCT), and MRI data were collected.

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Background And Objectives: The optic nerve is not one of the areas of the CNS that can be used to demonstrate dissemination in space (DIS) within the 2017 McDonald criteria for the diagnosis of multiple sclerosis (MS). Objectives were (1) to assess whether optic nerve-MRI (ON-MRI), optical coherence tomography (OCT), and visual evoked potentials (VEP) detect optic nerve involvement in clinically isolated syndrome (CIS) and (2) to evaluate the contribution of the optic nerve topography to the current diagnostic criteria in a prospective, multicenter cohort.

Methods: MAGNIMS centers were invited to provide prospective data on patients with CIS who underwent a visual assessment with at least 2 of 3 investigations (ON-MRI, OCT, or VEP) within 6 months of onset.

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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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Background And Purpose: The aim was to evaluate whether magnetic resonance imaging (MRI) phenotypes defined by inflammation and neurodegeneration markers correlate with serum levels of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in relapsing-remitting multiple sclerosis (RRMS) patients; and to explore the role of radiological phenotypes and biomarker levels on treatment response and long-term prognostic outcomes.

Methods: Magnetic resonance imaging scans from 80 RRMS patients were classified at baseline of interferon-beta (IFNβ) treatment into radiological phenotypes defined by high and low inflammation and high and low neurodegeneration, based on the number of contrast-enhancing lesions, brain parenchymal fraction and the relative volume of non-enhancing black holes on T1-weighted images. Serum levels of NfL and GFAP were measured at baseline with single molecule array (Simoa) assays.

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Background: Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized.

Objectives: To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS.

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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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Introduction: Prospective data on the risk of hepatitis B reactivation (HBVr) among patients with resolved HBV infection undergoing anti-CD20 antibodies monotherapy is scarce. We aimed to assess the risk of HBVr in patients with resolved HBV infection treated with rituximab or ocrelizumab in monotherapy for multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD) without antiviral prophylaxis.

Methods: HEBEM is a prospective study that included all consecutive adults HBsAg-negative/anti-HBc-positive who initiated anti-CD20 antibodies for MS or NMOSD at Cemcat.

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Background: Colonoscopy is the gold standard for colorectal cancer (CRC) diagnosis and screening, but endoscopy services are usually overburdened. This study aims to investigate the usefulness of fecal hemoglobin (fHb) and calprotectin (FC) for the identification of patients with high probability of CRC who need urgent referral.

Methods: In a multicenter prospective study, we enrolled symptomatic patients referred from primary care for colonoscopy.

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Background And Objectives: Early treatment is associated with better long-term outcomes in patients with a first demyelinating event and early multiple sclerosis (MS). However, magnetic resonance (MR) findings are not usually integrated to construct propensity scores (PSs) when evaluating outcomes. We assessed the association of receiving very early treatment with the risk of long-term disability including an MR score (MRS) in patients with a first demyelinating event.

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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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Background & Aims: The COVID-19 pandemic has had a major negative impact on health systems and many chronic diseases globally. We aimed to evaluate the impact of the first year of the pandemic on the outcomes of people with NAFLD cirrhosis.

Methods: We conducted a before-after study in four University hospitals in Catalonia, Spain.

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Article Synopsis
  • 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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Article Synopsis
  • 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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Article Synopsis
  • The study aimed to determine if the use of oral contraceptives (OCs) affects the risk of a second attack and disability progression in women with clinically isolated syndrome (CIS) and early multiple sclerosis (MS).
  • Researchers analyzed data from a cohort of 495 women in Barcelona, focusing on their OC usage, and found that OC use did not significantly impact the risk of having a second attack or increased disability.
  • The conclusion suggests that oral contraceptive use does not alter the risk of relapse or disability in these patients, even when considering various factors that could influence the results.
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Human spatial memory research has significantly progressed since the development of computerized tasks, with many studies examining sex-related performances. However, few studies explore the underlying electrophysiological correlates according to sex. In this study event-related potentials were compared between male and female participants during the performance of an allocentric spatial recognition task.

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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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Background: Multiple sclerosis (MS) misdiagnosis may cause physical and emotional damage to patients.

Objectives: The objective of this study is to determine the frequency and characteristics of MS misdiagnosis in patients referred to the Multiple Sclerosis Centre of Catalonia.

Methods: We designed a prospective study including all new consecutive patients referred to our centre between July 2017 and June 2018.

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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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