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This study re-evaluates the classical model that processing speed is the primary cognitive deficit in MS by examining patients diagnosed and treated in the modern era (2001-2025). Early relapsing-remitting MS patients showed memory deficits but normal cognitive speed, contradicting the traditional speed-centric model and suggesting disease-modifying therapies may have altered the cognitive profile of MS.
This cross-sectional study found that patients with relapsing-remitting MS have reduced cerebrovascular reactivity (measured by Breath-Holding Index) compared to healthy controls, independent of demographic factors. Lower cerebrovascular reactivity was independently associated with greater neurological disability and slower processing speed on cognitive testing.
A woman in her 50s with confirmed Huntington's disease developed right-sided sensory symptoms and was diagnosed with relapsing-remitting MS based on MRI findings of demyelinating lesions, oligoclonal bands in cerebrospinal fluid, and McDonald diagnostic criteria. The case underscores the importance of evaluating new neurological symptoms in patients with neurodegenerative conditions rather than attributing all manifestations to a single disease process.
BTK inhibitors represent an emerging oral therapeutic class for MS that can target both adaptive and innate immune pathways, with some agents crossing the blood-brain barrier to address progressive MS pathology resistant to current treatments. Phase 2 and 3 trial data show promise, particularly for agents like tolebrutinib in secondary progressive MS disability progression.
This retrospective study compared brain MRI changes between 34 MS patients who tested positive for SARS-CoV-2 and 67 matched negative controls over approximately two years. No significant differences were found between groups in new lesions, enlarging lesions, gadolinium-enhancing lesions, or brain volume loss, suggesting COVID-19 does not accelerate radiological MS progression.