Comparative real-world evidence on device-aided therapy (DAT) persistence in Parkinson’s disease (PD) is limited. We assessed discontinuation, reasons, optimization time, and associated factors. We analyzed the prospective multicenter DATs-PD GETM Spanish Registry (January 2024–May 2026), including deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion (CSAI), foslevodopa/foscarbidopa (fLD/fCD), levodopa–carbidopa intestinal gel (LCIG), and levodopa–entacapone–carbidopa intestinal gel (LECIG). Persistence and associated factors were examined using Kaplan–Meier and Cox regression analyses. Among 565 patients receiving 591 DATs, 170 (28.8
Rituximab (RTX) is the most widely used treatment for anti-myelin-associated glycoprotein (MAG) neuropathy, although its efficacy has not been demonstrated in controlled trials. Clarifying the optimal use of RTX in anti-MAG neuropathy remains clinically important. We conducted a multicenter retrospective study of 149 French patients treated with RTX monotherapy, focusing on long-term clinical outcomes and predictors of treatment response. Patients with anti-MAG antibody titers > 10,000 BTU were included. Clinical outcomes were assessed using the Overall Neuropathy Limitation Scale (ONLS) at baseline, 1 year, 2 years, and the last follow-up. Treatment success was defined as an improvement of ≥ 1 point in the ONLS score compared with baseline. The mean follow-up was 4 years (range 1–19 years). RTX treatment was associated with ONLS improvement in 60/146 patients (41
People with multiple sclerosis (pwMS) often experience disability progression even when receiving disease-modifying therapies that effectively suppress relapses. This phenomenon is commonly referred to as progression independent of relapse activity (PIRA). Currently, it is challenging to characterize pwMS who are experiencing disability progression in clinical practice. Existing definitions of PIRA rely primarily on the Expanded Disability Status Scale (EDSS), which is biased towards ambulation and does not effectively capture the gradual accumulation of symptoms and signs across other clinical areas associated with disability progression. Here, we propose a step-by-step approach that neurologists can use in clinical practice to identify pwMS experiencing disability progression irrespective of age, EDSS, or disease duration. By using this approach, neurologists can assess the presence or absence of specific variables to help determine if disability is stable or progressing. This could enable appropriate treatments to be implemented in a timely manner, particularly as new disability-targeting therapies become available.
Amyotrophic Lateral Sclerosis (ALS) shows substantial heterogeneity in clinical presentation and white matter involvement, but conventional diffusion tensor imaging analyses provide limited information on whether tract-level abnormalities follow distinct patient level patterns. This retrospective secondary analysis included 73 patients with ALS and 30 healthy controls. Fractional anisotropy (FA) and mean diffusivity (MD) from 11 predefined tracts were used as SuStaIn biomarkers, with healthy controls providing the normative reference for Z-score standardization. SuStaIn subtypes and stages were examined against Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R), King’s stage, and peak width of skeletonized mean diffusivity (PSMD). The three-subtype model classified patients into cingulate callosal motor mixed subtype (n = 34), hippocampal cingulum posterior projection subtype (n = 32), and posterior callosal projection, MD predominant subtype (n = 7). Exploratory comparisons showed lower PSMD in subtype 0 than subtypes 1 and 2 (both p = 0.026), lower ALSFRS-R in subtype 2 than subtype 1 (p = 0.026), and higher SuStaIn stage in subtype 2 than subtype 0 (p = 0.025). Higher SuStaIn stage correlated with higher King’s stage (rho = 0.318, p = 0.006) and lower ALSFRS-R (rho = − 0.289, p = 0.013). After adjustment, higher SuStaIn stage remained associated with lower ALSFRS-R (β = − 0.333, p = 0.013) and more advanced King’s stage (odds ratio = 1.181, p < 0.001). Tract-level diffusion SuStaIn identified anatomically interpretable patterns of white matter involvement in ALS and provided patient-level stage estimates associated with clinical disease burden.
