Plasma Neurofilament Light Chain and TNF-α Correlate with Motor Features in Isolated REM Sleep Behavior Disorder.

Background: Isolated RBD (iRBD) is a prominent early marker of Parkinson's disease and related disorders.

Objectives: Evaluate biomarkers of inflammation and axonal damage people with iRBD for disease progression.

Methods: Plasma samples from 27 video-polysomnography confirmed iRBD patients and 25 controls were analyzed for inflammatory biomarkers (CRP, IL-6, TNF-α, IFN-γ, IL-1β) and NfL using the Meso Scale Discovery platform.

Environmental risk factors for multiple sclerosis: a comprehensive systematic review and meta-analysis.

Background And Objectives: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Its etiology may involve both genetic and environmental factors, including vitamin D levels, body mass index, infections, and smoking. This is the first comprehensive systematic review with meta-analysis that synthesizes and explore the role of many environmental risk factors in the etiology of MS.

A comparison of JC virus assay performance provided with originator and biosimilar natalizumab.

Background: A rare complication of natalizumab treatment is progressive multifocal leukoencephalopathy (PML); risk can be stratified using JC virus (JCV) antibody status. Risk calculators to aid clinical decision-making use cohort data tested using the Stratify-JCV assay. Following concerns of an increased number of JCV seropositive results following the switch to biosimilar natalizumab and the associated test switch, we sought to understand the clinical implications.

Approach to JCV testing with natalizumab biosimilar: a UK consensus statement.

Biosimilars have an important role to play in healthcare, with the potential to reduce costs and widen access to treatment. We welcome the use of biosimilars in the treatment of multiple sclerosis. Serological testing for JC virus is mandated as part of safety monitoring in those treated with natalizumab.

Uveitis.

This review offers comprehensive insights into the presenting features, terminology, imaging techniques and management strategies associated with uveitis, specifically designed to help neurologists understand this complex condition. We have created a glossary of terms used in uveitis care and ocular imaging to help clarify terminology. We have ordered uveitis subtypes in an intuitive manner, focusing on those that neurologists are more likely to encounter.

The case for targeting latent and lytic Epstein-Barr virus infection in multiple sclerosis.

Epstein-Barr virus (EBV) is strongly associated with multiple sclerosis (MS). It is likely to play a causal role in the pathogenesis of MS, possibly via triggering autoimmunity through molecular mimicry, autoantigenic presentation or immune dysregulation. Alternatively, evidence supports a direct role for EBV in driving MS disease activity via latent-lytic infection cycling either within the CNS or the periphery.

Headache and progressive visual loss.

An 88-year-old woman developed persistent unilateral headache followed by bilateral sequential visual loss. She suffered progressive neurological deterioration before her death. This report documents the clinicopathological conference at the Association of British Neurologists Annual Meeting 2024.

The Importance of Lived Experience: A Scoping Review on the Value of Patient and Public Involvement in Health Research.

Background: Recently, patient and public involvement (PPI) in research has gained significant attention, particularly within the United Kingdom. Although there has been a growing focus on the impact of PPI on research outcomes, there remains an important gap in understanding its effects on the individuals involved and the value they gain from their participation.

Objective: This scoping review aims to critically examine how PPI benefits both people with lived experience and researchers, shedding light on the value of their involvement in shaping research.

Early presentations of dementia in a diverse population.

Introduction: Improved recognition of non-cognitive presentations of dementia could reduce inequalities in dementia diagnosis, particularly if sociocultural factors influence help-seeking for cognitive symptoms.

Methods: We conducted a nested case-control study using electronic healthcare records from primary care practices in East London, United Kingdom, to assess associations between prediagnostic presentations to primary care and subsequent dementia diagnosis.

Results: We included 4137 individuals with a dementia diagnosis and 15,754 controls in the matched analysis.

Multiple autoimmunity: neuromyelitis optica spectrum disorder with Lambert-Eaton myasthenic syndrome.

A 56-year-old woman with a background of neuromyelitis optica spectrum disorder associated with aquaporin-4 antibodies (AQ4-NMOSD) treated with azathioprine, presented with a 2-month history of declining mobility, weight loss and hoarse voice. She had a history of autoimmune thyrotoxicosis and treated hypertension. Given her smoking history, the initial clinical concern was of malignancy.

Depression and dementia: interrogating the causality of the relationship.

Background: Depression is often cited as a major modifiable risk factor for dementia, though the relative contributions of a true causal relationship, reverse causality and confounding factors remain unclear. This study applied a subset of the Bradford Hill criteria for causation to depression and dementia including strength of effect, specificity, temporality, biological gradient and coherence.

Methods: A total of 491 557 participants in UK Biobank aged between 40 and 69 at enrolment and followed up for a mean duration of 12.

Cost effectiveness of different treatment strategies with natalizumab for pregnant women with multiple sclerosis.

Background: The management of multiple sclerosis (MS) during pregnancy poses significant challenges. This study aimed to evaluate the cost-effectiveness of three natalizumab treatment strategies during pregnancy from the UK healthcare system's perspective.

Methods: A Markov model was developed to assess the health outcomes and costs associated with three treatment strategies: continuous natalizumab treatment throughout pregnancy, treatment until the first trimester followed by discontinuation, and discontinuation at conception with resumption post-pregnancy.

Pregnancy and Infant Outcomes in Women With Multiple Sclerosis Treated With Ocrelizumab.

Background And Objectives: Ocrelizumab labeling advises contraception for women during treatment and for 6-12 months thereafter. Because pregnancies may occur during this time, it is critical to understand pregnancy and infant outcomes in women with multiple sclerosis (MS) after ocrelizumab exposure.

Methods: Pregnancy cases reported to Roche global pharmacovigilance until 12 July 2023 were analyzed.

Assessing the landscape and charting paths: UK neurology trainees' opinions on neuroinflammation subspecialty.

Therapeutics of neuroinflammatory disorders including multiple sclerosis is one of the fastest growing areas in neurology. However, pressures on higher specialty training in neurology together with an expanding curriculum have led to challenges in adequately preparing trainees for a subspecialist career. In this study we set out to understand current perceptions and barriers to training in neuroinflammatory disorders among neurology trainees in the UK.

Cerebral cortical encephalitis in adults with myelin oligodendrocyte glycoprotein antibody-associated disease: A national case series.

Background And Purpose: Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a relatively recently described disease, most commonly presenting with optic neuritis and longitudinally extensive transverse myelitis. Cerebral cortical encephalitis is a rare manifestation of MOGAD.

Methods: We identified patients presenting with cerebral cortical encephalitis with positive MOG antibodies in serum across a large specialized service.

Using disease-modifying treatments in multiple sclerosis: Association of British Neurologists (ABN) 2024 guidance.

The Association of British Neurologists last published guidelines on disease-modifying treatment (DMT) in multiple sclerosis (MS) in 2015. Since then, additional DMTs have been licensed and approved for prescribing within the National Health Service for relapsing-remitting MS, early primary progressive MS and active secondary progressive MS. This updated guidance provides a consensus-based approach to using DMTs.

Genetic architecture of routinely acquired blood tests in a British South Asian cohort.

Understanding the genetic basis of routinely-acquired blood tests can provide insights into several aspects of human physiology. We report a genome-wide association study of 42 quantitative blood test traits defined using Electronic Healthcare Records (EHRs) of ~50,000 British Bangladeshi and British Pakistani adults. We demonstrate a causal variant within the PIEZO1 locus which was associated with alterations in red cell traits and glycated haemoglobin.

Differential diagnosis of suspected multiple sclerosis: considerations in people from minority ethnic and racial backgrounds in North America, northern Europe, and Australasia.

The differential diagnosis of suspected multiple sclerosis has been developed using data from North America, northern Europe, and Australasia, with a focus on White populations. People from minority ethnic and racial backgrounds in regions where prevalence of multiple sclerosis is high are more often negatively affected by social determinants of health, compared with White people in these regions. A better understanding of changing demographics, the clinical characteristics of people from minority ethnic or racial backgrounds, and the social challenges they face might facilitate equitable clinical approaches when considering a diagnosis of multiple sclerosis.

The relationship between ethnicity and multiple sclerosis characteristics in the United Kingdom: A UK MS Register study.

Background: Previous studies have suggested differences in multiple sclerosis (MS) severity according to ethnicity.

Methods: Data were obtained from the UK MS Register, a prospective longitudinal cohort study of persons with MS. We examined the association between self-reported ethnic background and age at onset, symptom of onset and a variety of participant-reported severity measures.

Diversity and representation within the literature on sexual dysfunction in multiple sclerosis: A systematic review.

Introduction: Sexual dysfunction (SD) is a common and distressing symptom for people living with multiple sclerosis (MS). Populations included in existing studies of SD may not fully reflect the diversity of people living with MS, with important implications for wider applicability. We aimed to evaluate reporting of sex, gender identity, sexual orientation, and ethnicity across studies of SD in MS.