Addressing LGBTQ+ health equity and disparities in multiple sclerosis: A call for research and action.

Multiple sclerosis (MS) research has largely overlooked the experiences of the LGBTQ+ community, leaving significant gaps in understanding and addressing their unique health equity challenges. Despite widespread recognition of LGBTQ+ health disparities, particularly in neurology, research at the intersection of sexual orientation, gender identity, and MS remains limited. LGBTQ+ individuals encounter systemic barriers such as discrimination and lack of culturally competent care, exacerbating disparities in MS management and outcomes.

Podcast on the Challenges and Recommendations to Address Unmet Needs in MS for LGBTQ+ Populations in the United States.

In general, individuals who are lesbian, gay, bisexual, transgender, queer or questioning, plus other identities (LGBTQ+) living with multiple sclerosis (MS) have less favorable healthcare experiences and poorer overall health than cisgendered heterosexual individuals. They may experience further challenges in addition to managing their MS, including psychological or emotional problems, and an increased risk of comorbid diseases and substance abuse. Transgender individuals specifically face additional unique challenges, including high rates of mental health distress and effects from long-term exogenous hormone use and gender affirmation surgery.

Tixagevimab and Cilgavimab (Evusheld) boosts antibody levels to SARS-CoV-2 in patients with multiple sclerosis on b-cell depleters.

Background And Objectives: B-cell-depleting therapies may affect the development of a protective immune response following vaccination against SARS-CoV-2. It is important to have a different strategy for creating immunity in this patient population. The objective of this study was to evaluate whether Evusheld (tixagevimab co-packaged with cilgavimab) affects the antibody response to SARS-CoV-2 following an attenuated response to the vaccines against SARS-CoV-2 in patients on b-cell depleters who have multiple sclerosis.

B-cell depleters attenuate the humoral response to SARS-CoV-2 vaccines in multiple sclerosis patients: A case-control study.

Background: B-cell depleting agents are FDA approved for the treatment of RRMS (ocrelizumab (OCR) and ofatumumab (OFA)) and PPMS (OCR).  In the case of OCR, prior studies have raised concerns about patients' ability to form antibodies in response to various antigens, especially SARS-CoV-2. In addition, emerging data have shown an attenuated humoral response to vaccines against SARS-CoV-2.

Attenuation of antibody response to SARS-CoV-2 infection in patients with multiple sclerosis on ocrelizumab: A case-control study.

Objective: Ocrelizumab (OCR) is a monoclonal antibody directed at B-cells that is FDA approved for treatment of RRMS and PPMS. Prior studies have raised concerns about patients' ability to form antibodies in response to various antigens, especially SARS-CoV-2. The objective of this study is to determine whether OCR attenuates the antibody response to SARS-CoV-2 in patients with MS as compared with other disease modifying therapies.

Herpes Simplex Virus 2 Meningoencephalitis-Associated Bilateral Optic Neuritis and Radiculitis.

The most common ocular complication of herpes simplex virus (HSV) is acute retinal necrosis. We present a rare case of a patient with HSV-2 meningoencephalitis that developed severe vision-threatening optic neuritis. The patient was treated with steroids and IVIG, which allowed a rapid improvement in her vision.

Reduction in ocrelizumab-induced infusion reactions by a modified premedication protocol.

Background: Ocrelizumab is a monoclonal antibody directed against CD20+ B cells that is approved for MS. The most common side effect is infusion-associated reactions (IARs). This study examines whether a modified premedication protocol reduces incidence of IARs and further examines predictors of IARs.

The efficacy of the fluorescent conjugates of cholera toxin subunit B for multiple retrograde tract tracing in the central nervous system.

Cholera toxin subunit B (CTB) is a sensitive neuroanatomical tracer that generally transports retrogradely in the nervous system, and has been used extensively in brightfield microscopy. Recently, Alexa Fluor (AF) conjugates of CTB have been made available, which now allows multiple tracing with CTB. In this study, we examined the efficacy of these new AF-CTB conjugates when injected into the brain, and compared the results to our previous experiences using fluorescent 3k dextran amines.

Multiple neuroanatomical tract-tracing using fluorescent Alexa Fluor conjugates of cholera toxin subunit B in rats.

Cholera toxin subunit B (CTB) is a highly sensitive retrograde neuroanatomical tracer. With the new availability of fluorescent Alexa Fluor (AF) conjugates of CTB, multiple neuroanatomical connections can be reliably studied and compared in the same animal. Here we provide a protocol that describes the use of AF-CTB for studying connections in the central nervous system of rats.

Cortical connections of the rat lateral posterior thalamic nucleus.

Spatial processing related to directed attention is thought to be mediated by a specific cortical-basal ganglia-thalamic-cortical network in the rat. Key components of this network are associative cortical areas medial agranular cortex (AGm) and posterior parietal cortex (PPC), dorsocentral striatum (DCS), and lateral posterior (LP) thalamic nucleus, all of which are interconnected. Previously, we found that thalamostriatal projections reaching DCS arise from separate populations of neurons of the mediorostral part of LP (LPMR).

Topography in the projections of lateral posterior thalamus with cingulate and medial agranular cortex in relation to circuitry for directed attention and neglect.

In the rat, the lateral posterior thalamic nucleus (LP) has reciprocal connections with areas of the cortex and the striatum involved in directed attention and its dysfunctional counterpart, contralateral neglect. It has also been shown that the medial portion of the mediorostral part of LP (mLPMR) is of special interest because it has connections with the dorsocentral striatum, a key node in this circuitry. In the present study we used neuroanatomical tracers to map the specific connections and topography of LP with the anterior cingulate cortex (ACC) and medial agranular cortex (AGm).