Background: Neuromyelitis optica spectrum disorder (NMOSD) is a commonly misdiagnosed condition. Driven by cost-consciousness and technological fluency, distinct generations may gravitate towards healthcare alternatives, including artificial intelligence (AI) models, such as ChatGPT (Generative Pre-trained Transformer). Our objective was to evaluate the speed and accuracy of ChatGPT-3.
View Article and Find Full Text PDFAn expansion in the availability of generic specialty disease modifying therapies (DMTs) for treatment of multiple sclerosis (MS) has increased recently. Generic specialty medications aim to provide greater access to molecules that alter the disease trajectory at lower costs. The US Food and Drug Administration requires generic products to contain between 90% and 110% of the stated active ingredient and an 80%-125% bioequivalence range.
View Article and Find Full Text PDFBackground And Purpose: The study of T2-weighted hyperintense lesions resulting from autoimmune inflammatory injury and associated volumes within the CNS remains fundamental to the diagnosis and disease surveillance of multiple sclerosis (MS). We investigated the dynamic changes of individual T2-weighted hyperintense MS lesions on MRI and hypothesized that variations may be present below the threshold of visual perception when evaluating longitudinal data.
Materials And Methods: A retrospective study was performed of people with MS, incorporating data from three consecutive MRI time points acquired within a single academic center.
Background: Those receiving the diagnosis of multiple sclerosis (MS) over the next ten years will predominantly be part of Generation Z (Gen Z). Recent observations within our clinic suggest that younger people with MS utilize online generative artificial intelligence (AI) platforms for personalized medical advice prior to their first visit with a specialist in neuroimmunology. The use of such platforms is anticipated to increase given the technology driven nature, desire for instant communication, and cost-conscious nature of Gen Z.
View Article and Find Full Text PDFMult Scler Relat Disord
August 2024
The use of generic specialty medications amongst individuals with multiple sclerosis (MS) has expanded due to an increase in the number of available agents. We describe a woman who was denied continued use of brand name teriflunomide (Aubagio), despite being clinically stable for 2.5 years, and switched to generic teriflunomide.
View Article and Find Full Text PDFBackground And Purpose: The first randomized placebo-controlled therapeutic trial in radiologically isolated syndrome (RIS), ARISE, demonstrated that treatment with dimethyl fumarate (DMF) delayed the onset of a first clinical event related to CNS demyelination and was associated with a significant reduction in new and/or newly enlarging T2-weighted hyperintense lesions. The purpose of this study was to explore the effect of DMF on volumetric measures, including whole brain, thalamic, and subcortical gray matter volumes, brainstem and upper cervical spine three-dimensional (3D) volumes, and brainstem and upper cervical spine surface characteristics.
Methods: Standardized 3T MRIs including 3D isotropic T1-weighted gradient echo images were acquired at baseline and end-of-study according to the ARISE study protocol.
Mult Scler Relat Disord
November 2023
Background: People with neuromyelitis optica spectrum disorder (PwNMOSD) commonly switch between disease modifying therapies, yet the consequence of transitions remains unknown. We aimed to understand if treatment transitions due to medical, non-medical, and tolerability reasons were related to disease progression.
Methods: A retrospective study of medical records for PwNMOSD was performed between 2008 and 2022.
Background: People with neuromyelitis optica spectrum disorder (pwNMOSD) experience debilitating neurological attacks, resulting in permanent disability.
Objective: To evaluate if high-efficacy treatment was better than traditional agents at preventing disease advancement in pwNMOSD.
Methods: A retrospective study of pwNMOSD at one academic center was performed.
Mult Scler Relat Disord
February 2023
Background: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition that is associated with severe disability. Approximately 40% of individuals are misdiagnosed with multiple sclerosis (MS) or other diseases. We aimed to define factors that influence the misdiagnosis of people with NMOSD and provide strategies for reducing error rates.
View Article and Find Full Text PDFBackground: We evaluated imaging features suggestive of neurodegeneration within the brainstem and upper cervical spinal cord (UCSC) in non-progressive multiple sclerosis (MS).
Methods: Standardized 3-Tesla three-dimensional brain magnetic resonance imaging (MRI) studies were prospectively acquired. Rates of change in volume, surface texture, curvature were quantified at the pons and medulla-UCSC.
Background And Purpose: The timely and accurate diagnosis of neuromyelitis optica spectrum disorder (NMOSD) is essential and exposure to multiple sclerosis (MS) disease-modifying therapies may result in permanent neurological disability.
Methods: Standardized 3-Tesla 3-dimensional brain MRI studies were retrospectively studied from people with NMOSD, MS, other CNS neurological diseases, and healthy control subjects. Comparisons of surface texture characteristics at the area postrema involving absolute introverted planar triangle counts, representing more complex and concave tissue topography, along with the spatial dissemination pattern of these triangles were performed cross-sectionally and longitudinally.
Background: The rising costs associated with multiple sclerosis (MS) disease modifying therapies (DMTs) creates challenges for patients and the healthcare system in the United States (U.S.).
View Article and Find Full Text PDFBackground And Purpose: Differentiating between multiple sclerosis (MS) and small vessel disease (SVD) lesions represents a key challenge in the day-to-day management of patients. We aimed to distinguish between MS and SVD by identifying the dynamics of lesion movement patterns between enlarging and contracting foci from two MRI time points.
Methods: Standardized 3-Tesla 3-dimensional brain magnetic resonance imaging (MRI) studies were performed at two time points on enrolled MS and SVD patients.
The accurate recognition of multiple sclerosis (MS) lesions is challenged by the high sensitivity and imperfect specificity of MRI. To examine whether longitudinal changes in volume, surface area, 3-dimensional (3D) displacement (i.e.
View Article and Find Full Text PDFObjective: To compare the temporal changes in the 3-dimensional (3D) structure of the medulla-upper cervical spinal cord region in African American (AA) and white multiple sclerosis (MS) patients to identify early patterns of anatomical change prior to progressive symptom development.
Methods: Standardized 3-Tesla 3D brain MRI studies were performed at two time points on AA and white MS patients along with controls. Longitudinal changes in volume, surface area, tissue compliance, and surface texture measured in total and within ventral and dorsal compartments were studied.
Multiple sclerosis (MS) diagnostic criteria are based upon clinical presentation and presence of white matter hyperintensities on two-dimensional magnetic resonance imaging (MRI) views. Such criteria, however, are prone to false-positive interpretations due to the presence of similar MRI findings in non-specific white matter disease (NSWMD) states such as migraine and microvascular disease. The coexistence of age-related changes has also been recognized in MS patients, and this comorbidity further poses a diagnostic challenge.
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