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Leavitt VM, Tozlu C, Nelson KE, Boehme AK, Donnelly JE, Aguerre I, Spinner M, Riley CS, Stein J, Onomichi K. A randomized controlled trial of oral antipyretic treatment to reduce overheating during exercise in adults with multiple sclerosis. J Neurol 2024; 271:2207-2215. [PMID: 38413464 DOI: 10.1007/s00415-023-12147-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Some people with multiple sclerosis (pwMS) avoid exercise due to overheating. Evidence from a variety of cooling treatments shows benefits for pwMS. OBJECTIVE Conduct a randomized controlled trial of antipyretic treatment before exercise in pwMS. METHODS Adults over age 18 diagnosed with relapsing-remitting MS reporting heat sensitivity during exercise were randomly assigned to one of six sequences counterbalancing aspirin, acetaminophen, placebo. At each of three study visits separated by ≥ one week, participants received 650-millograms of aspirin, acetaminophen, or placebo before completing a maximal exercise test. Primary outcomes were body temperature change and total time-to-exhaustion (TTE), secondary outcomes were physiological and patient-reported outcomes (PROs). RESULTS Sixty participants were enrolled and assigned to treatment sequence; 37 completed ≥ one study visit. After controlling for order effects, we found that body temperature increase was reduced after aspirin (+ 0.006 ± 0.32 degrees Fahrenheit, p < 0.001) and after acetaminophen (+ 0.31 ± 0.35; p = 0.004) compared to placebo (+ 0.68 ± 0.35). TTE after aspirin (331.6 ± 76.6 s) and acetaminophen (578.2 ± 82.1) did not differ significantly from placebo (551.0 ± 78.4; p's > 0.05). Aspirin benefited all secondary outcomes compared to placebo (all p's < 0.001); acetaminophen showed broadly consistent benefits. CONCLUSION These results support antipyretic treatment as effective for reducing overheating during exercise in pwMS and failed to support antipyretics for increasing TTE in the context of a maximal exercise test. Benefits were shown for physiological markers of exercise productivity and PROs of fatigue, pain, and perceived exertion.
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Affiliation(s)
- Victoria M Leavitt
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, New York, NY, 10032, USA.
| | - Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Katherine E Nelson
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, USA
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Amelia K Boehme
- Department of Neurology and Epidemiology, Columbia University Irving Medical Center, New York, USA
| | - Jaime E Donnelly
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Ines Aguerre
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Michael Spinner
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, USA
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Joel Stein
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Kaho Onomichi
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, USA
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, USA
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Levine L, Son J, Yu A, Wesley S, De Jager PL, Moynihan E, Farber RS, Rosser M, Haque H, Riley CS. Inflammatory vaginitis in four B-cell suppressed women with Multiple Sclerosis. Mult Scler Relat Disord 2024; 82:105387. [PMID: 38134606 DOI: 10.1016/j.msard.2023.105387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
B-cell depleting therapies are effective in multiple sclerosis (MS) and are widely used (Hauser et al., 2017). Inflammatory vaginitis (IV), characterized by unexplained vaginal symptoms including mucopurulent discharge, pain, irritation, and dyspareunia, has been reported in one MS patient on ocrelizumab (Filikci and Jensen, 2022), and to be present in 3.5 % of women on rituximab for autoimmune diseases (Yockey et al., 2021). We report here four cases of IV in B cell depleted women with MS. B-cell reconstitution was temporally associated with improvement of IV symptoms. Further investigation and vigilance for this potential treatment emergent adverse event affecting sexual and reproductive health of women with MS is needed.
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Affiliation(s)
- Libby Levine
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Jiyeon Son
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Amy Yu
- Baptist Health South Florida, Marcus Neuroscience Institute, USA
| | - Sarah Wesley
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Philip L De Jager
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Erin Moynihan
- Department of Neurology, Columbia University Irving Medical Center, USA
| | | | - Mary Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA
| | - Hoosna Haque
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, USA.
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Anderson A, Rowles W, Poole S, Balan A, Bevan C, Brandstadter R, Ciplea AI, Cooper J, Fabian M, Hale TW, Jacobs D, Kakara M, Krysko KM, Longbrake EE, Marcus J, Repovic P, Riley CS, Romeo AR, Rutatangwa A, West T, Hellwig K, LaHue SC, Bove R. Anti-CD20 monoclonal antibody therapy in postpartum women with neurological conditions. Ann Clin Transl Neurol 2023; 10:2053-2064. [PMID: 37675826 PMCID: PMC10647007 DOI: 10.1002/acn3.51893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE Postpartum, patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) have increased risk for disease activity. Anti-CD20 IgG1 monoclonal antibodies (mAb) are increasingly used as disease-modifying therapies (DMTs). Patients may wish to both breastfeed and resume DMT postpartum. This study aimed to determine the transfer of anti-CD20 IgG1 mAbs, ocrelizumab, and rituximab (OCR/RTX), into mature breastmilk and describe maternal and infant outcomes. METHODS Fifty-seven cis-women receiving OCR/RTX after 59 pregnancies and their infants were enrolled and followed up to 12M postpartum or 90 days post-infusion. Breastmilk was collected pre-infusion and serially up to 90 days and assayed for mAb concentration. Medical records and patients' questionnaire responses were obtained to assess neurologic, breastfeeding, and infant development outcomes. RESULTS The median average concentration of mAb in breastmilk was low (OCR: 0.08 μg/mL, range 0.05-0.4; RTX: 0.03 μg/mL, range 0.005-0.3). Concentration peaked 1-7 days post-infusion in most (77%) and was nearly undetectable after 90 days. Median average relative infant dose was <1% (OCR: 0.1%, range 0.07-0.7; RTX: 0.04%, range 0.005-0.3). Forty-three participants continued to breastfeed post-infusion. At 8-12 months, the proportion of infants' growth between the 3rd and 97th World Health Organization percentiles did not differ for breastfed (36/40) and non-breastfed (14/16, p > 0.05) infants; neither did the proportion with normal development (breastfed: 37/41, non-breastfed: 11/13; p > 0.05). After postpartum infusion, two mothers experienced a clinical relapse. INTERPRETATION These confirm minimal transfer of mAb into breastmilk. Anti-CD20 mAb therapy stabilizes MS activity before conception to the postpartum period, and postpartum treatments appears to be safe and well-tolerated for both mother and infant.
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Affiliation(s)
- Annika Anderson
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - William Rowles
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Shane Poole
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Ayushi Balan
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Carolyn Bevan
- Department of NeurologyNorthwestern UniversityChicagoIllinoisUSA
| | - Rachel Brandstadter
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | | | | | - Thomas W. Hale
- Texas Tech University Health Sciences CenterAmarilloTexasUSA
| | - Dina Jacobs
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Mihir Kakara
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Kristen M. Krysko
- Division of Neurology, Department of Medicine, St Michael's HospitalUniversity of TorontoTorontoONCanada
- Li Ka Shing Knowledge InstituteUniversity of TorontoTorontoONCanada
| | | | - Jacqueline Marcus
- Department of NeurologyKaiser Permanente San FranciscoSan FranciscoCaliforniaUSA
| | - Pavle Repovic
- Department of NeurologySwedish Medical CenterSeattleWashingtonUSA
| | - Claire S. Riley
- Department of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Andrew R. Romeo
- Department of NeurologyUniversity of MichiganAnn ArborMichiganUSA
| | - Alice Rutatangwa
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | | | | | - Sara C. LaHue
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Buck Institute for Research on AgingNovatoCaliforniaUSA
| | - Riley Bove
- UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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Anderson JR, Fitzgerald KC, Murrough JW, Katz Sand IB, Sorets TR, Krieger SC, Riley CS, Fabian MT, Sumowski JF. Depression symptoms and cognition in multiple sclerosis: Longitudinal evidence of a specific link to executive control. Mult Scler 2023; 29:1632-1645. [PMID: 37772495 DOI: 10.1177/13524585231198746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Depression symptoms are prevalent in multiple sclerosis (MS) and associated with poorer cognition in cross-sectional studies; it is unknown whether changes in depression symptoms track with cognitive changes longitudinally. OBJECTIVE Investigate whether changes in depression symptoms correspond with cognitive changes over time in MS, and identify specific cognitive functions related to depression symptoms. METHOD Persons with early relapse-onset MS (n = 165) completed a depression questionnaire (Beck Depression Inventory FastScreen) and tests of cognitive speed, executive control, and memory at baseline and 3-year follow-up. One-way ANOVAs assessed differences in cognitive change across participants with worsened, stable, or improved depression symptoms from baseline to year 3. RESULTS Change in depression symptoms was related to change in executive control (p = 0.001, ηp2 = 0.08; worsened mood with worsened executive control; improved mood with improved executive control), even when adjusting for cognitive speed (p = 0.002, ηp2 = 0.08). There were no links to cognitive speed (p = 0.826) or memory (p = 0.243). Regarding individual depression symptoms, executive control was related to loss of pleasure and suicidal thoughts. CONCLUSIONS Executive control tracks with depression symptoms, raising hope that management of mood may improve executive control. The specific link between executive control and anhedonia implicates dysfunctional reward processing as a key component of MS depression.
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Affiliation(s)
- Jordyn R Anderson
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kathryn C Fitzgerald
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilana B Katz Sand
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tali R Sorets
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Stephen C Krieger
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claire S Riley
- Columbia University Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Michelle T Fabian
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James F Sumowski
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Touil H, Roostaei T, Calini D, Diaconu C, Epstein S, Raposo C, Onomichi K, Thakur KT, Craveiro L, Callegari I, Bryois J, Riley CS, Menon V, Derfuss T, De Jager PL, Malhotra D. A structured evaluation of cryopreservation in generating single-cell transcriptomes from cerebrospinal fluid. Cell Rep Methods 2023; 3:100533. [PMID: 37533636 PMCID: PMC10391561 DOI: 10.1016/j.crmeth.2023.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/28/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023]
Abstract
Single-cell transcriptomics allows characterization of cerebrospinal fluid (CSF) cells at an unprecedented level. Here, we report a robust cryopreservation protocol adapted for the characterization of fragile CSF cells by single-cell RNA sequencing (RNA-seq) in moderate- to large-scale studies. Fresh CSF was collected from twenty-one participants at two independent sites. Each CSF sample was split into two fractions: one was processed fresh, while the second was cryopreserved for months and profiled after thawing. B and T cell receptor sequencing was also performed. Our comparison of fresh and cryopreserved data from the same individuals demonstrates highly efficient recovery of all known CSF cell types. We find no significant difference in cell type proportions and cellular transcriptomes between fresh and cryopreserved cells. Results were comparable at both sites and with different single-cell sequencing chemistries. Cryopreservation did not affect recovery of T and B cell clonotype diversity. Our CSF cell cryopreservation protocol provides an important alternative to fresh processing of fragile CSF cells.
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Affiliation(s)
- Hanane Touil
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Tina Roostaei
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Daniela Calini
- Neuroscience and Rare Diseases (NRD), F. Hoffmann-La Roche, Ltd., Grenzacherstrasse, 4070 Basel, Switzerland
| | - Claudiu Diaconu
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Samantha Epstein
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Catarina Raposo
- gRED OMNI-Biomarker Development, F. Hoffmann-La Roche, Ltd., Grenzacherstrasse, Basel, Switzerland
| | - Kaho Onomichi
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Kiran T. Thakur
- Program in Neuroinfectious Diseases, Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Licinio Craveiro
- Product Development Medical Affairs (PDMA) Neuroscience, F. Hoffmann-La Roche, Ltd., Grenzacherstrasse, 4070 Basel, Switzerland
| | - Ilaria Callegari
- University Hospital Basel, Department of Neurology and Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Julien Bryois
- Neuroscience and Rare Diseases (NRD), F. Hoffmann-La Roche, Ltd., Grenzacherstrasse, 4070 Basel, Switzerland
| | - Claire S. Riley
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Vilas Menon
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Tobias Derfuss
- University Hospital Basel, Department of Neurology and Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Philip L. De Jager
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Dheeraj Malhotra
- Neuroscience and Rare Diseases (NRD), F. Hoffmann-La Roche, Ltd., Grenzacherstrasse, 4070 Basel, Switzerland
- MS Research Unit, Biogen, Cambridge, MA 02142, USA
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Wilkins SR, Yu AW, Steigerwald C, Tanji K, Iglesias AD, Hirano M, Kister I, Riley CS, Abreu NJ. Two cases of MT-ND5-related mitochondrial disorder misdiagnosed as seronegative neuromyelitis optica spectrum disorder. Mult Scler 2023:13524585231172947. [PMID: 37227101 DOI: 10.1177/13524585231172947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease primarily affecting the optic nerves and spinal cord, which is usually associated with anti-aquaporin-4 antibodies. Here, we present two individuals who were negative for anti-aquaporin-4 antibodies and were initially diagnosed with seronegative NMOSD. Each patient's clinical course and radiographic features raised suspicion for an alternative disease process. Both individuals were found to have pathogenic variants of MT-ND5, encoding subunit 5 of mitochondrial complex I, ultimately leading to a revised diagnosis of a primary mitochondrial disorder. These cases illustrate the importance of biochemical and genetic testing in atypical cases of NMOSD.
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Affiliation(s)
- Sophie R Wilkins
- New York University Grossman School of Medicine, New York, NY, USA
| | - Amy W Yu
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Connolly Steigerwald
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Kurenai Tanji
- Department of Pathology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Alejandro D Iglesias
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michio Hirano
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Ilya Kister
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Nicolas J Abreu
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
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Buyukturkoglu K, Dworkin JD, Leiva V, Provenzano FA, Guevara P, De Jager PL, Leavitt VM, Riley CS. Brain volumetric correlates of remotely versus in-person administered symbol digit modalities test in multiple sclerosis. Mult Scler Relat Disord 2022; 68:104247. [PMID: 36274283 DOI: 10.1016/j.msard.2022.104247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/25/2022] [Accepted: 10/15/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prior studies in multiple sclerosis (MS) support reliability of telehealth-delivered cognitive batteries, although, to date, none have reported relationships of cognitive test performance to neural correlates across administration modalities. In this study we aimed to compare brain-behavior relationships, using the Symbol Digit Modalities Test (SDMT), the most reliable and sensitive cognitive measure in MS, measured from patients seen via telehealth versus in-person. METHODS SDMT was administered to individuals with MS either in-person (N=60, mean age=39.7) or remotely via video conference (N=51, mean age=47.4). Magnetic resonance imaging (MRI) data was collected in 3-Tesla scanners. Using 3-dimensional T1 images cerebral, cortical, deep gray, cerebral white matter and thalamic nuclei volumes were calculated. Using a meta-analysis approach with an interaction term for participant group, individual regression models were run for each MRI measure having SDMT scores as the outcome variable in each model. In addition, the correlation and average difference between In-person and Remote group associations across the MRI measures were calculated. Finally, for each MRI variable I2 score was quantified to test the heterogeneity between the groups. RESULTS Administration modality did not affect the association of SDMT performance with MRI measures. Brain tissue volumes showing high associations with the SDMT scores in one group also showed high associations in the other (r = 0.83; 95% CI = [0.07, 0.86]). The average difference between the In-person and the Remote group associations was not significant (βRemote - βIn-person = 0.14, 95% CI = [-0.04, 0.34]). Across MRI measures, the average I2 value was 14%, reflecting very little heterogeneity in the relationship of SDMT performance to brain volume. CONCLUSION We found consistent relationships to neural correlates across in-person and remote SDMT administration modalities. Hence, our study extended the findings of the previous studies demonstrating the feasibility of remote administration of the SDMT.
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Affiliation(s)
- Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA; The Center for Translational and Computational Neuroimmunology, NY, USA; Columbia University MS Center, NY, USA.
| | - Jordan D Dworkin
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, NY, USA
| | - Victor Leiva
- Department of Biomedical Engineering, Universidad de Concepción, Santiago, Chile
| | - Frank A Provenzano
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA
| | - Pamela Guevara
- Department of Biomedical Engineering, Universidad de Concepción, Santiago, Chile
| | - Philip L De Jager
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA; The Center for Translational and Computational Neuroimmunology, NY, USA; Columbia University MS Center, NY, USA
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA; The Center for Translational and Computational Neuroimmunology, NY, USA; Columbia University MS Center, NY, USA
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Jakimovski D, Kavak KS, Longbrake EE, Levit E, Perrone CM, Bar-Or A, Benedict RHB, Riley CS, De Jager PL, Venkatesh S, Walker EL, Xia Z, Weinstock-Guttman B. Impact of resilience, social support, and personality traits in patients with neuroinflammatory diseases during the COVID-19 pandemic. Mult Scler Relat Disord 2022; 68:104235. [PMID: 36283322 PMCID: PMC9548342 DOI: 10.1016/j.msard.2022.104235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/30/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic negatively impacted the well-being of persons with neuroinflammatory diseases (pwNID). Identifying factors that influence the response to challenging conditions could guide supportive care. METHODS 2185 pwNID and 1079 healthy controls (HCs) from five US centers completed an online survey regarding the effects of the COVID-19 pandemic on physical and psychological well-being. Survey instruments included resilience (Connor-Davidson Resilience Scale, CD-RISC), loneliness (UCLA Loneliness Scale), social support (modified social support survey, MSSS-5), personality traits (NEO-Five Factor Inventory, NEO-FFI), and disability (Patient-Determined Disability Steps (PDDS). Step-wise regression models and mediation analyses assessed whether the level of self-reported resilience, size of the social support, and specific personality traits (study predictors) were associated with self-reported disability and/or loneliness (study outcomes). RESULTS The response rate varied significantly between the questionnaires. While, all pwNID completed the demographic questionnaire, 78.8% completed the loneliness questionnaire and 49.7% completed the NEO-FFI. Based on 787 responses, greater neuroticism (standardized β = 0.312, p < 0.001), less social support (standardized β = -0.242, p < 0.001), lower extraversion (standardized β = -0.083, p=0.017), lower agreeableness (standardized β = -0.119, p < 0.001), and lower resilience (standardized β = -0.125, p = 0.002) were associated with the feeling of loneliness. Social support and resilience modestly but significantly mediated the association between personality traits and loneliness. Older age (standardized β = 0.165, p < 0.001) and lower conscientiousness (standardized β = -0.094, p = 0.007) were associated with worse disability (higher PDDS scores). There were no differences in outcomes between pwNID and HCs. CONCLUSION Greater social support potentially attenuates the association between neuroticism and the feeling of loneliness in pwNID during the COVID-19 pandemic. Assessment of personality traits may identify pwNID that are in greater need of social support and guide targeted interventions.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY, United States,Department of Neurology, Jacobs School of Medicine and Biomedical Science Center, University of Buffalo, State University of New York, 1010 Main Street, Buffalo, NY 14202, United States
| | - Katelyn S Kavak
- Department of Neurology, Jacobs School of Medicine and Biomedical Science Center, University of Buffalo, State University of New York, 1010 Main Street, Buffalo, NY 14202, United States
| | - Erin E. Longbrake
- Department of Neurology, Yale University, New Haven, CT, United States
| | - Elle Levit
- Department of Neurology, Yale University, New Haven, CT, United States
| | - Christopher M Perrone
- Center for Neuroinflammation and Experimental Therapeutics and Division of MS and Related Disorders, University of Pennsylvania, Philadelphia, PA, United States
| | - Amit Bar-Or
- Center for Neuroinflammation and Experimental Therapeutics and Division of MS and Related Disorders, University of Pennsylvania, Philadelphia, PA, United States
| | - Ralph HB Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Science Center, University of Buffalo, State University of New York, 1010 Main Street, Buffalo, NY 14202, United States
| | - Claire S Riley
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia Multiple Sclerosis Center, New York NY, United States
| | - Philip L De Jager
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia Multiple Sclerosis Center, New York NY, United States
| | - Shruthi Venkatesh
- Department of Neurology, University of Pittsburgh, Pittsburgh PA, United States
| | | | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Pittsburgh PA, United States
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Science Center, University of Buffalo, State University of New York, 1010 Main Street, Buffalo, NY 14202, United States.
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Riley CS, Venkatesh S, Dhand A, Doshi N, Kavak K, Levit EE, Perrone C, Weinstock-Guttman B, Longbrake EE, De Jager PL, Xia Z. Impact of the COVID-19 Pandemic on Personal Networks and Neurological Outcomes of People with Multiple Sclerosis: A Case-Control Cross-sectional and Longitudinal Analysis. medRxiv 2022:2022.08.17.22278896. [PMID: 36203554 PMCID: PMC9536025 DOI: 10.1101/2022.08.17.22278896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The COVID-19 pandemic has negatively impacted the social fabric of people with multiple sclerosis (pwMS). Objective To evaluate the associations between personal social network environment and neurological function in pwMS and controls during the COVID-19 pandemic and compare with the pre-pandemic baseline. Methods We first analyzed data collected from 8 cohorts of pwMS and control participants during the COVID-19 pandemic (March-December 2020). We then leveraged data collected between 2017-2019 in 3 of the 8 cohorts for longitudinal comparison. Participants completed a questionnaire that quantified the structure and composition of their personal social network, including the health behaviors of network members. We assessed neurological disability using three interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale â€" Revised (MSRS-R), and Patient Reported Outcomes Measurement Information System (PROMIS)-Physical Function. We identified the network features associated with neurologic disability using paired t-tests and covariate-adjusted regressions. Results In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 control participants, higher percent of network members with a perceived negative health influence was associated with greater neurological symptom burden in pwMS (MSRS-R: Beta[95% CI]=2.181[1.082, 3.279], p<.001) and worse physical function in controls (PROMIS-Physical Function: Beta[95% CI]=-5.707[-7.405, -4.010], p<.001). In the longitudinal analysis of 230 pwMS and 136 control participants, the networks of both pwMS and controls experienced an increase in constraint (pwMS p=.006, control p=.001) as well as a decrease in network size (pwMS p=.003, control p<.001), effective size (pwMS p=.007, control p=.013), maximum degree (pwMS p=.01, control p<.001), and percent contacted weekly or less (pwMS p<.001, control p<.001), suggesting overall network contraction during the COVID-19 pandemic. There was also an increase in percentage of kin (p=.003) in the networks of pwMS but not controls during the COVID-19 pandemic when compared to the pre-pandemic baseline. These changes in personal social network due to the pandemic were not associated with worsening neurological disability during the pandemic. Conclusions Our findings suggest that perceived negative health influences in personal social networks are associated with worse disability in all participants during the COVID-19 pandemic. Despite the perturbation in social environment and connections during the pandemic, the stability in neurological function among pwMS suggests potential resilience.
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10
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Kever A, Aguerre IM, Vargas W, Straus Farber R, Levine L, Riley CS, Vasquez M, Leavitt VM. Feasibility trial of a telehealth support group intervention to reduce anxiety in multiple sclerosis. Clin Rehabil 2022; 36:1305-1313. [PMID: 35673256 DOI: 10.1177/02692155221107077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Anxiety is common among persons with MS (PwMS), but widely accepted treatments are lacking. Group-based interventions delivered via telehealth are an accessible treatment option requiring clinical trial evidence to support feasibility and initial efficacy. We conducted a pilot feasibility trial of an online support group intervention to reduce anxiety in PwMS. METHODS A non-randomized, parallel arm clinical trial was conducted. A total of 31 PwMS were enrolled: 20 completed a 12-week telehealth-delivered support group intervention and 11 were assigned to a survey-only control group. Primary feasibility outcomes were adherence and completion rates. Primary efficacy outcome was anxiety, secondary outcomes were depression, loneliness, distress, self-efficacy, stress, and quality of life. RESULTS Twenty-six participants completed the study. Intervention group adherence (75%) and completion (85%) rates were acceptable. Results indicated a medium size between-group effect, suggesting a greater reduction in anxiety in the intervention group compared to the control group [U = 39.50, p = 0.045, r = 0.39]. No group differences in other outcomes were observed. CONCLUSION A telehealth-delivered support group intervention appears feasible for further study and shows initial efficacy for the reduction of anxiety in PwMS.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, 21611Columbia University Irving Medical Center, New York, NY, USA
| | - Ines M Aguerre
- Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Center for Translational & Computational Neuroimmunology, 21611Columbia University Irving Medical Center, New York, New York, USA
| | - Wendy Vargas
- Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Center for Translational & Computational Neuroimmunology, 21611Columbia University Irving Medical Center, New York, New York, USA
| | - Rebecca Straus Farber
- Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Center for Translational & Computational Neuroimmunology, 21611Columbia University Irving Medical Center, New York, New York, USA
| | - Libby Levine
- Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA
| | - Claire S Riley
- Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Center for Translational & Computational Neuroimmunology, 21611Columbia University Irving Medical Center, New York, New York, USA
| | - Minnelly Vasquez
- Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, 21611Columbia University Irving Medical Center, New York, NY, USA.,Department of Neurology, Multiple Sclerosis Center, 21611Columbia University Irving Medical Center, New York, New York, USA
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11
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Leavitt VM, Dworkin JD, Buyukturkoglu K, Riley CS, Ritchey M. Summary metrics of memory subnetwork functional connectivity alterations in multiple sclerosis. Mult Scler 2022; 28:1963-1972. [PMID: 35658737 DOI: 10.1177/13524585221099169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Memory dysfunction is common in multiple sclerosis (MS); mechanistic understanding of its causes is lacking. Large-scale network resting-state functional connectivity (RSFC) is sensitive to memory dysfunction. OBJECTIVE We derived and tested summary metrics of memory network RSFC. METHODS Cognitive data and 3T magnetic resonance imaging (MRI) scans were collected from 235 MS patients and 35 healthy controls (HCs). Index scores were calculated as RSFC within (anteriority index, AntI) and between (integration index, IntI) dorsomedial anterior temporal and medial temporal memory subnetworks. Group differences in index expression were evaluated. Associations between index scores and memory/non-memory cognition were evaluated; relationships between T2 lesion volume (T2LV) and index scores were assessed. RESULTS Index scores were related to memory and T2LV in MS patients, who showed marginally elevated AntI relative to HC (p = 0.06); no group differences were found for IntI. Better memory was associated with higher AntI (β = 0.15, p = 0.018) and IntI (β = 0.16, p = 0.014). No associations were found for non-memory cognition. Higher T2LV was associated with higher AntI and IntI; exploratory mediation analysis revealed significant inconsistent mediation, that is, higher index scores partially suppressed the negative association between T2LV and memory. CONCLUSION Summary, within-subject metrics permit replication and circumvent challenges of traditional (incommensurate) RSFC variables to advance development of mechanistic models of memory dysfunction in MS.
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Affiliation(s)
- Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Jordan D Dworkin
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
| | - Korhan Buyukturkoglu
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Maureen Ritchey
- Department of Psychology, Boston College, Chestnut Hill, MA, USA
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12
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Breneman AN, Eber AE, Haque H, Levine L, Askanase A, Riley CS, Pomeranz MK, Hassan D, Mancebo SE, Polin M, Melamed A, Bordone LA, Rosser M, Gockley A, Gallitano SM. Vulvovaginal Pyoderma Gangrenosum in a Patient Treated With Ocrelizumab for Multiple Sclerosis. J Low Genit Tract Dis 2022; 26:189-191. [PMID: 35256568 DOI: 10.1097/lgt.0000000000000661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Alyssa N Breneman
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Ariel E Eber
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY
| | - Hoosna Haque
- Division of Gynecology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Libby Levine
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY
| | - Anca Askanase
- Department of Rheumatology, Columbia University Irving Medical Center, New York, NY
| | - Claire S Riley
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY
| | - Miriam Keltz Pomeranz
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Dahlia Hassan
- Department of Rheumatology, Columbia University Irving Medical Center, New York, NY
| | - Silvia E Mancebo
- Department of Dermatology, Weill Medical College of Cornell University, New York, NY
| | - Melanie Polin
- Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Alexander Melamed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Lindsey A Bordone
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY
| | - Mary Rosser
- Division of Gynecology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Allison Gockley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
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13
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Kever A, Walker EL, Riley CS, Heyman RA, Xia Z, Leavitt VM. Association of personality traits with physical function, cognition, and mood in multiple sclerosis. Mult Scler Relat Disord 2022; 59:103648. [PMID: 35134623 PMCID: PMC8986589 DOI: 10.1016/j.msard.2022.103648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/16/2021] [Accepted: 01/29/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growing literature supports the hypothesis that personality influences health outcomes. Few studies have examined the association between personality traits and key clinical manifestations in persons with multiple sclerosis (pwMS). OBJECTIVE To investigate whether personality traits are associated with physical function, cognition, and depression in persons with MS. METHODS In this cross-sectional study, we analyzed data from two cohorts (UPMC, n = 365 and CUIMC, n = 129). Participants completed a personality scale (assessing neuroticism, extraversion, openness, agreeableness, and conscientiousness) and validated surveys measuring physical function, cognition, and depression. Stepwise linear regressions were used to evaluate associations between personality traits and outcome measures. RESULTS Consistently across cohorts, higher extraversion was associated with better physical function, whereas higher neuroticism was associated with worse depression. In the first cohort, higher extraversion was associated with better cognition, while higher neuroticism was associated with greater risk for memory impairment in the second cohort. Relationships were independent of age and disease duration. CONCLUSION Findings suggest a potentially protective role of extraversion, and a harmful role of neuroticism, in MS-specific patient-reported clinical outcomes. Increased understanding of the interplay between personality and health outcomes may inform risk models for physical decline, cognitive impairment, and depression in pwMS.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, 10032 NY, USA
| | | | - Claire S. Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, 10032 NY, USA
| | - Rock A. Heyman
- Department of Neurology, University of Pittsburgh, Pittsburgh, 15260 PA, USA
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Pittsburgh, 15260 PA, USA
| | - Victoria M. Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, 10032 NY, USA.,Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, 10032 NY, USA
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14
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Kever A, Riley CS, Leavitt VM. Diagnosis concealment is associated with psychosocial outcomes in persons with multiple sclerosis. Mult Scler 2022; 28:1311-1314. [PMID: 35034518 DOI: 10.1177/13524585211070496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Persons with multiple sclerosis (pwMS) frequently conceal their diagnosis, fearing professional and personal repercussions of disclosing. Associations of concealment behavior and expected consequences of disclosure with psychosocial outcomes were examined in 90 pwMS who completed validated self-report measures of diagnosis concealment, loneliness, social support, and self-efficacy. More frequent concealment was related to worse loneliness (rp = 0.213, p = 0.045) and lower social support (rp = -0.211, p = 0.047), controlling for depression. Higher anticipated negative consequences of disclosure were associated with worse loneliness (rp = 0.263, p = 0.013), lower social support (rp = -0.338, p < 0.001), and lower self-efficacy (rp = -0.350, p < 0.001). Findings hold implications for the development of psychological support strategies addressing concealment/disclosure issues and their psychosocial consequences.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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15
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Buyukturkoglu K, Vergara C, Fuentealba V, Tozlu C, Dahan JB, Carroll BE, Kuceyeski A, Riley CS, Sumowski JF, Guevara Oliva C, Sitaram R, Guevara P, Leavitt VM. Machine learning to investigate superficial white matter integrity in early multiple sclerosis. J Neuroimaging 2022; 32:36-47. [PMID: 34532924 PMCID: PMC8752496 DOI: 10.1111/jon.12934] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND PURPOSE This study aims todetermine the sensitivity of superficial white matter (SWM) integrity as a metric to distinguish early multiple sclerosis (MS) patients from healthy controls (HC). METHODS Fractional anisotropy and mean diffusivity (MD) values from SWM bundles across the cortex and major deep white matter (DWM) tracts were extracted from 29 early MS patients and 31 age- and sex-matched HC. Thickness of 68 cortical regions and resting-state functional-connectivity (RSFC) among them were calculated. The distribution of structural and functional metrics between groups were compared using Wilcoxon rank-sum test. Utilizing a machine learning method (adaptive boosting), 6 models were built based on: 1-SWM, 2-DWM, 3-SWM and DWM, 4-cortical thickness, or 5-RSFC measures. In model 6, all features from previous models were incorporated. The models were trained with nested 5-folds cross-validation. Area under the receiver operating characteristic curve (AUCroc ) values were calculated to evaluate classification performance of each model. Permutation tests were used to compare the AUCroc values. RESULTS Patients had higher MD in SWM bundles including insula, inferior frontal, orbitofrontal, superior and medial temporal, and pre- and post-central cortices (p < .05). No group differences were found for any other MRI metric. The model incorporating SWM and DWM features provided the best classification (AUCroc = 0.75). The SWM model provided higher AUCroc (0.74), compared to DWM (0.63), cortical thickness (0.67), RSFC (0.63), and all-features (0.68) models (p < .001 for all). CONCLUSION Our results reveal a non-random pattern of SWM abnormalities at early stages of MS even before pronounced structural and functional alterations emerge.
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Affiliation(s)
- Korhan Buyukturkoglu
- Columbia University Irving Medical Center, Department of Neurology. New York, NY. USA
| | | | | | - Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Jacob B. Dahan
- Columbia University Irving Medical Center, Department of Neurology. New York, NY. USA
| | - Britta E. Carroll
- Columbia University Irving Medical Center, Department of Neurology. New York, NY. USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Claire S. Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - James F. Sumowski
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, NY. USA
| | | | - Ranganatha Sitaram
- Diagnostic Imaging Department, St. Jude Children’s Research Hospital, Memphis TN. USA
| | | | - Victoria M. Leavitt
- Columbia University Irving Medical Center, Department of Neurology. New York, NY. USA
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16
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Epstein S, Xia Z, Lee AJ, Dahl M, Edwards K, Levit E, Longbrake EE, Perrone C, Kavak K, Weinstock-Guttman B, Diallo F, Ricci A, Riley CS, De Jager PL, Farber R, Wesley SF. Vaccination Against SARS-CoV-2 in Neuroinflammatory Disease: Early Safety/Tolerability Data. Mult Scler Relat Disord 2021; 57:103433. [PMID: 34923427 PMCID: PMC8638239 DOI: 10.1016/j.msard.2021.103433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 11/27/2021] [Indexed: 01/10/2023]
Abstract
Background Patients with autoimmune disease and on immunotherapy were largely excluded from seminal anti-SARS-CoV-2 vaccine trials. This has led to significant vaccine hesitancy in patients with neuroinflammatory diseases (NID); including, but not limited to: multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), neurosarcoidosis and myelin oligodendrocyte antibody-mediated disease (MOG-AD). Data is urgently needed to help guide clinical care in the NID population. Methods This was a cross-sectional observational study evaluating adults with a neurologist-confirmed diagnosis of a neuroinflammatory disease (NID) and a neurologically asymptomatic control population. Participants were recruited from multiple academic centers participating in the MS Resilience to COVID-19 Collaborative study. We analyzed participant responses from a vaccine-specific questionnaire collected between February and May 2021. Results 1164 participants with NID and 595 controls completed the vaccine survey. Hesitancy rates were similar between NID and control groups (n = 134, 32.7% NID vs. n = 56, 30.6% control; p = 0.82). The most common reasons for hesitancy in NID participants were lack of testing in the autoimmune population and fear of demyelinating/neurologic events. Unvaccinated patients who had discussed vaccination with their doctor were less likely to be hesitant (n=184, 73.6% vs. n=83, 59.7%; p = 0.007). 634 NID patients and 332 controls had received at least one dose of a vaccine against SARS-CoV-2 at the time of survey completion. After adjusting for age, BMI, and comorbidities, there was no difference in self-reported side effects (SE) between groups with the first dose (n = 256, 42.2% NID vs. 141, 45.3% control; p = 0.20) or second dose (n = 246, 67.0% NID vs. n = 114, 64.8% control, p = 0.85) of the mRNA vaccines nor with the viral-vector vaccines (n = 6, 46% NID vs. n = 8, 66% control; p = 0.39). All reported SEs fell into the expected SE profile. There was no difference in report of new/recurrent neurologic symptoms (n = 110, 16.2% vaccinated vs. 71, 18.2% unvaccinated; p = 0.44) nor radiologic disease activity (n = 40, 5.9% vaccinated vs. n = 30, 7.6% unvaccinated) between vaccinated and unvaccinated NID participants. Conclusions We found no difference in patient-reported vaccine side effects and no evidence of NID worsening after vaccination. Large-scale real-world evidence is needed for further validation.
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Affiliation(s)
- Samantha Epstein
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA.
| | - Zongqi Xia
- University of Pittsburgh; Department of Neurology; Pittsburgh, PA, USA
| | - Annie J Lee
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
| | - Megan Dahl
- University of Pittsburgh; Department of Neurology; Pittsburgh, PA, USA
| | - Keith Edwards
- The Multiple Sclerosis Center of Northeastern New York; Latham, NY, USA
| | - Elle Levit
- Yale University School of Medicine; Department of Neurology; New Haven, CT, USA
| | - Erin E Longbrake
- Yale University School of Medicine; Department of Neurology; New Haven, CT, USA
| | - Christopher Perrone
- University of Pennsylvania School of Medicine; Department of Neurology; Philadelphia, PA, USA
| | - Katelyn Kavak
- State University of New York at Buffalo; Department of Neurology; Buffalo, NY, USA
| | | | - Fatoumata Diallo
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
| | - Adelle Ricci
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
| | - Rebecca Farber
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
| | - Sarah F Wesley
- Multiple Sclerosis Center and the Center For Translational & Computational Neuroimmunology, Columbia University Irving Medical Center; Department of Neurology. New York, NY, USA
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17
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Thakur KT, Epstein S, Bilski A, Balbi A, Boehme AK, Brannagan TH, Wesley SF, Riley CS. Neurologic Safety Monitoring of COVID-19 Vaccines: Lessons From the Past to Inform the Present. Neurology 2021; 97:767-775. [PMID: 34475124 DOI: 10.1212/wnl.0000000000012703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022] Open
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a global effort to rapidly develop and deploy effective and safe coronavirus disease 2019 (COVID-19) vaccinations. Vaccination has been one of the most effective medical interventions in human history, although potential safety risks of novel vaccines must be monitored, identified, and quantified. Adverse events must be carefully assessed to define whether they are causally associated with vaccination or coincidence. Neurologic adverse events following immunizations are overall rare but with significant morbidity and mortality when they occur. Here, we review neurologic conditions seen in the context of prior vaccinations and the current data to date on select COVID-19 vaccines including mRNA vaccines and the adenovirus-vector COVID-19 vaccines, ChAdOx1 nCOV-19 (AstraZeneca) and Ad26.COV2.S Johnson & Johnson (Janssen/J&J).
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Affiliation(s)
- Kiran Teresa Thakur
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York.
| | - Samantha Epstein
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Amanda Bilski
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Alanna Balbi
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Amelia K Boehme
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Thomas H Brannagan
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Sarah Flanagan Wesley
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Claire S Riley
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
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18
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Leavitt VM, Aguerre IM, Lee N, Riley CS, De Jager PL, Bloom S. RCT of a Telehealth Group-Based Intervention to Increase Physical Activity in Multiple Sclerosis: eFIT. Neurol Clin Pract 2021; 11:291-297. [PMID: 34484928 DOI: 10.1212/cpj.0000000000001039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022]
Abstract
Objective To conduct a pilot randomized controlled trial to determine whether participation in a group-based structured telehealth intervention increases physical activity in people with multiple sclerosis (MS). Methods In this parallel-arms trial, all study procedures were administered remotely. Adults diagnosed with MS (any subtype) were randomized to one of two 12-week (1 h/wk) active conditions: eFIT, online moderated structured groups; or eJournal, online independent journaling. For comparison, a treatment-as-usual (TAU; i.e., no eFIT/eJournal) group was enrolled. The primary outcome was feasibility (completion and adherence). The secondary efficacy outcomes included self-reported physical activity level (International Physical Activity Questionnaire, IPAQ). Results Participants were 37 adults with MS. The sample was diverse: 66.7% female; age range 23-64 years; 17.5% Hispanic, 12.5% Black; and progressive and relapsing-remitting disease subtypes. Regarding feasibility, 70.7% completed; average adherence was 74.9%. Physical activity in active groups increased by 34.2% (baseline IPAQ = 2,406.8 ± 1,959.7, follow-up = 3,229.4 ± 2,575.2) and decreased in the TAU group by 17.4% (baseline = 2,519.9 ± 1,500.1, follow-up = 2,081.2 ± 1,814.9); group × time interaction was not statistically significant [F(2,25) = 1.467, p = 0.250; partial η2 = 0.105]. Conclusions Telehealth represents an accessible, acceptable vehicle to deliver targeted behavioral treatments to a neurologic population. eFIT may be an effective intervention for increasing physical activity, a historically intractable treatment target, in individuals with MS. In addition, these results provide evidence for feasibility of conducting fully remote clinical trial research. Classification of Evidence This study provides Class II evidence that for people with MS, participation in a group-based structured telehealth intervention compared with TAU resulted in a (non-significant) increase in self-reported physical activity level. The percentage of participants who completed follow-up questionnaires did not differ between groups. The trial was registered at ClinicalTrials.gov (NCT03829267).
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Affiliation(s)
- Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Ines M Aguerre
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Nancy Lee
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Claire S Riley
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Philip L De Jager
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Sharonna Bloom
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
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19
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Leavitt VM, Aguerre IM, Lee N, Riley CS, De Jager PL, Bloom S. RCT of a Telehealth Group-Based Intervention to Increase Physical Activity in Multiple Sclerosis: eFIT. Neurol Clin Pract 2021. [PMID: 34484928 DOI: 10.1212/cpj.0000000000001039.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To conduct a pilot randomized controlled trial to determine whether participation in a group-based structured telehealth intervention increases physical activity in people with multiple sclerosis (MS). Methods In this parallel-arms trial, all study procedures were administered remotely. Adults diagnosed with MS (any subtype) were randomized to one of two 12-week (1 h/wk) active conditions: eFIT, online moderated structured groups; or eJournal, online independent journaling. For comparison, a treatment-as-usual (TAU; i.e., no eFIT/eJournal) group was enrolled. The primary outcome was feasibility (completion and adherence). The secondary efficacy outcomes included self-reported physical activity level (International Physical Activity Questionnaire, IPAQ). Results Participants were 37 adults with MS. The sample was diverse: 66.7% female; age range 23-64 years; 17.5% Hispanic, 12.5% Black; and progressive and relapsing-remitting disease subtypes. Regarding feasibility, 70.7% completed; average adherence was 74.9%. Physical activity in active groups increased by 34.2% (baseline IPAQ = 2,406.8 ± 1,959.7, follow-up = 3,229.4 ± 2,575.2) and decreased in the TAU group by 17.4% (baseline = 2,519.9 ± 1,500.1, follow-up = 2,081.2 ± 1,814.9); group × time interaction was not statistically significant [F(2,25) = 1.467, p = 0.250; partial η2 = 0.105]. Conclusions Telehealth represents an accessible, acceptable vehicle to deliver targeted behavioral treatments to a neurologic population. eFIT may be an effective intervention for increasing physical activity, a historically intractable treatment target, in individuals with MS. In addition, these results provide evidence for feasibility of conducting fully remote clinical trial research. Classification of Evidence This study provides Class II evidence that for people with MS, participation in a group-based structured telehealth intervention compared with TAU resulted in a (non-significant) increase in self-reported physical activity level. The percentage of participants who completed follow-up questionnaires did not differ between groups. The trial was registered at ClinicalTrials.gov (NCT03829267).
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Affiliation(s)
- Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Ines M Aguerre
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Nancy Lee
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Claire S Riley
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Philip L De Jager
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Sharonna Bloom
- Translational Cognitive Neuroscience Laboratory (VML), Multiple Sclerosis Center (VML, IMA, CSR, PLDJ, SB), Center for Translational & Computational Neuroimmunology (IMA, CSR, PLDJ), Department of Neurology, Columbia University Irving Medical Center; and Department of Rehabilitation and Regenerative Medicine (NL), Columbia University Vagelos College of Physicians and Surgeons, New York
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20
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Sumowski JF, Horng S, Brandstadter R, Krieger S, Leavitt VM, Katz Sand I, Fabian M, Klineova S, Graney R, Riley CS, Lublin FD, Miller AE, Varga AW. Sleep disturbance and memory dysfunction in early multiple sclerosis. Ann Clin Transl Neurol 2021; 8:1172-1182. [PMID: 33951348 PMCID: PMC8164863 DOI: 10.1002/acn3.51262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Sleep-dependent memory processing occurs in animals including humans, and disturbed sleep negatively affects memory. Sleep disturbance and memory dysfunction are common in multiple sclerosis (MS), but little is known about the contributions of sleep disturbance to memory in MS. We investigated whether subjective sleep disturbance is linked to worse memory in early MS independently of potential confounders. METHODS Persons with early MS (n = 185; ≤5.0 years diagnosed) and demographically matched healthy controls (n = 50) completed four memory tests to derive a memory composite, and four speeded tests to derive a cognitive efficiency composite. Z-scores were calculated relative to healthy controls. Sleep disturbance was defined by the Insomnia Severity Index score ≥ 10. ANCOVAs examined differences in memory and cognitive efficiency between patients with and without sleep disturbance controlling for potential confounds (e.g., mood, fatigue, disability, T2 lesion volume, gray matter volume). Comparisons were made to healthy controls. RESULTS Seventy-four (40%) patients reported sleep disturbance. Controlling for all covariates, patients with sleep disturbance had worse memory (z = -0.617; 95% CI: -0.886, -0.348) than patients without disturbance (z = -0.171, -0.425, 0.082, P = .003). Cognitive efficiency did not differ between groups. Relative to healthy controls, memory was worse among patients with sleep disturbance, but not among patients without sleep disturbance. INTERPRETATION Sleep disturbance contributes to MS memory dysfunction, which may help explain differential risk for memory dysfunction in persons with MS, especially since sleep disturbance is common in MS. Potential mechanisms linking sleep disturbance and memory are discussed, as well as recommendations for further mechanistic and interventional research.
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Affiliation(s)
- James F. Sumowski
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sam Horng
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Rachel Brandstadter
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Stephen Krieger
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Victoria M. Leavitt
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Ilana Katz Sand
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Michelle Fabian
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sylvia Klineova
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robin Graney
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Claire S. Riley
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Fred D. Lublin
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Aaron E. Miller
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Andrew W. Varga
- Icahn School of Medicine at Mount SinaiDivision of PulmonaryCritical Care and Sleep MedicineNew YorkNew YorkUSA
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21
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Kever A, Buyukturkoglu K, Levin SN, Riley CS, De Jager P, Leavitt VM. Associations of social network structure with cognition and amygdala volume in multiple sclerosis: An exploratory investigation. Mult Scler 2021; 28:228-236. [PMID: 34037495 DOI: 10.1177/13524585211018349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Humans are inherently social, biologically programmed to connect with others. Social connections are known to impact mental and physical health. OBJECTIVE The aim of this study was to test whether social network structure is linked to cognition, mood, fatigue, and regional brain volumes in persons with multiple sclerosis (MS). METHODS A questionnaire quantifying individual-level social network structure (size, density, effective size, and constraint), a comprehensive battery of neuropsychological tests, and magnetic resonance imaging (MRI) was administered to 51 persons with relapsing-remitting MS. Linear regressions assessed associations of network variables to cognition, depression, fatigue, and structural brain volumes. RESULTS Higher network density and constraint, indicating stronger connections among network members, were associated with worse language functions. Conversely, larger network effective size, a measure of non-redundant network members, was associated with better language functions. No relationships of network structure to depression or fatigue were found. Larger network size was related to larger amygdala volume. CONCLUSION Findings suggest that social network structure is linked to language function and amygdala volume in persons with MS. Patients with close-knit networks showed worse language function than those with open networks. Longitudinal studies with larger samples are warranted to evaluate potential causal links between social network structure and MS-related cognitive impairment.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Korhan Buyukturkoglu
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Seth N Levin
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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22
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Katz Sand IB, Fitzgerald KC, Gu Y, Brandstadter R, Riley CS, Buyukturkoglu K, Leavitt VM, Krieger S, Miller A, Lublin F, Klineova S, Fabian M, Sumowski JF. Dietary factors and MRI metrics in early Multiple Sclerosis. Mult Scler Relat Disord 2021; 53:103031. [PMID: 34077830 DOI: 10.1016/j.msard.2021.103031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite significant interest in diet by the MS community, research on this topic is limited; there are no published studies evaluating associations between diet and neuroimaging in MS. METHODS We utilized baseline data from the RADIEMS cohort of early MS (diagnosed <5.0 years, n=180). Participants underwent brain MRIs to derive normalized total gray and thalamic volumes, T2 lesion volume, and white matter microstructural integrity of normal appearing white matter (NAWM). Participants completed food frequency questionnaires (FFQ) from which we calculated adherence scores to pre-specified dietary patterns including the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. We evaluated intake of the following pre-specified dietary components: fruits, vegetables, legumes, nuts, whole grains, dairy, fried foods, processed meats, and fat intake. We used multivariable-adjusted linear regression to evaluate MRI metrics versus dietary measures. RESULTS MIND diet score was associated with thalamic volume; individuals in the highest quartile of MIND diet scores had greater thalamic volumes versus those in the lowest quartile (Q4 vs. Q1: 1.03mL; 95%CI: 0.26mL, 1.79mL; p<0.01). For individual food/nutrients, higher intakes of full-fat dairy were associated with lower T2 lesion volumes (Q4 vs. Q1: -0.93mL; 95%CI: -1.51mL, -0.35ml; p<0.01). Higher intakes of marine omega-3 fatty acids were associated with greater NAWM microstructural integrity (Q4 vs. Q1: 0.40; 95%CI: 0.03, 0.76; p=0.04). Other foods/nutrients were not associated with MRI outcomes. CONCLUSIONS In this first study focused on neuroimaging and diet in MS, we note significant associations in a cross-sectional early MS cohort. Longitudinal follow-up of imaging/clinical outcomes will provide additional insights.
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Affiliation(s)
- I B Katz Sand
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States.
| | - Kathryn C Fitzgerald
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Yian Gu
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States; Department of Neurology, Department of Epidemiology, The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, United States
| | - Rachel Brandstadter
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States; Department of Neurology, University of Pennsylvania, United States
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States
| | - Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, New York City, United States
| | - Stephen Krieger
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Aaron Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Sylvia Klineova
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - Michelle Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
| | - James F Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, United States
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23
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Levin SN, Venkatesh S, Nelson KE, Li Y, Aguerre I, Zhu W, Masown K, Rimmer KT, Diaconu CI, Onomichi KB, Leavitt VM, Levine LL, Strauss-Farber R, Vargas WS, Banwell B, Bar-Or A, Berger JR, Goodman AD, Longbrake EE, Oh J, Weinstock-Guttman B, Thakur KT, Edwards KR, Riley CS, Xia Z, De Jager PL. Manifestations and impact of the COVID-19 pandemic in neuroinflammatory diseases. Ann Clin Transl Neurol 2021; 8:918-928. [PMID: 33616290 PMCID: PMC8013889 DOI: 10.1002/acn3.51314] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/21/2020] [Accepted: 01/18/2021] [Indexed: 12/28/2022] Open
Abstract
Objective To report initial results of a planned multicenter year‐long prospective study examining the risk and impact of COVID‐19 among persons with neuroinflammatory disorders (NID), particularly multiple sclerosis (MS). Methods In April 2020, we deployed online questionnaires to individuals in their home environment to assess the prevalence and potential risk factors of suspected COVID‐19 in persons with NID (PwNID) and change in their neurological care. Results Our cohort included 1115 participants (630 NID, 98% MS; 485 reference) as of 30 April 2020. 202 (18%) participants, residing in areas with high COVID‐19 case prevalence, met the April 2020 CDC symptom criteria for suspected COVID‐19, but only 4% of all participants received testing given testing shortages. Among all participants, those with suspected COVID‐19 were younger, more racially diverse, and reported more depression and liver disease. PwNID had the same rate of suspected COVID‐19 as the reference group. Early changes in disease management included telemedicine visits in 21% and treatment changes in 9% of PwNID. After adjusting for potential confounders, increasing neurological disability was associated with a greater likelihood of suspected COVID‐19 (ORadj = 1.45, 1.17–1.84). Interpretations Our study of real‐time, patient‐reported experience during the COVID‐19 pandemic complements physician‐reported MS case registries which capture an excess of severe cases. Overall, PwNID seem to have a risk of suspected COVID‐19 similar to the reference population.
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Affiliation(s)
- Seth N Levin
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,New York Presbyterian Hospital, New York, New York, USA
| | - Shruthi Venkatesh
- Program in Translational Neuroimmunology, Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Katie E Nelson
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
| | - Yi Li
- Program in Translational Neuroimmunology, Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ines Aguerre
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
| | - Wen Zhu
- Program in Translational Neuroimmunology, Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Karman Masown
- Program in Translational Neuroimmunology, Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathryn T Rimmer
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,New York Presbyterian Hospital, New York, New York, USA
| | - Claudiu I Diaconu
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,New York Presbyterian Hospital, New York, New York, USA
| | - Kaho B Onomichi
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
| | - Victoria M Leavitt
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
| | - Libby L Levine
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
| | - Rebecca Strauss-Farber
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
| | - Wendy S Vargas
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,New York Presbyterian Hospital, New York, New York, USA
| | - Brenda Banwell
- Department of Neurology, Children's Hospital of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amit Bar-Or
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joseph R Berger
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andrew D Goodman
- Department of Neurology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
| | - Erin E Longbrake
- Department of Neurology, Yale University, New Haven, Connecticut, USA
| | - Jiwon Oh
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Multiple Sclerosis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | | | - Keith R Edwards
- The Multiple Sclerosis Center of Northeastern New York, Latham, New York, USA
| | - Claire S Riley
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,New York Presbyterian Hospital, New York, New York, USA
| | - Zongqi Xia
- Program in Translational Neuroimmunology, Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Philip L De Jager
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.,New York Presbyterian Hospital, New York, New York, USA
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24
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Kever A, Buyukturkoglu K, Riley CS, De Jager PL, Leavitt VM. Social support is linked to mental health, quality of life, and motor function in multiple sclerosis. J Neurol 2021; 268:1827-1836. [PMID: 33392637 DOI: 10.1007/s00415-020-10330-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate associations of social support to psychological well-being, cognition, and motor functioning in patients with multiple sclerosis (MS). Secondarily, we were interested in exploring sex differences in these relationships, based on a bioevolutionary theoretical justification. METHODS Social support was assessed in 185 recently diagnosed patients (RADIEMS cohort), and in an independent validation sample (MEMCONNECT cohort, n = 62). Patients also completed a comprehensive neurobehavioral evaluation including measures of mental health, fatigue, quality of life, cognition, and motor function. Correlations tested links between social support and these variables, along with potential gender differences. RESULTS In both samples, higher social support was associated with better mental health, quality of life, subjective cognitive function, and less fatigue. In the RADIEMS cohort, higher social support was associated with better motor functions, particularly grip strength and gait endurance in women. CONCLUSIONS These findings highlight associations of social support to overall psychological health and motor functioning in persons with MS, underlining the potential opportunity of evaluating and promoting social engagement in novel treatment strategies.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032, USA
| | - Korhan Buyukturkoglu
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.,Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032, USA. .,Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
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25
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Glukhovsky L, Kurz D, Brandstadter R, Leavitt VM, Krieger S, Fabian M, Katz Sand I, Klineova S, Riley CS, Lublin FD, Miller AE, Sumowski JF. Depression and cognitive function in early multiple sclerosis: Multitasking is more sensitive than traditional assessments. Mult Scler 2020; 27:1276-1283. [PMID: 33196404 PMCID: PMC10375894 DOI: 10.1177/1352458520958359] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Persons with multiple sclerosis (MS) and depression symptoms report real-world cognitive difficulties that may be missed by laboratory cognitive tests. OBJECTIVE To examine the relationship of depressive symptoms to cognitive monotasking versus multitasking in early MS. METHOD Persons with early MS (n = 185; ⩽5 years diagnosed) reported mood, completed monotasking and multitasking cognitive tests, and received high-resolution 3.0 T magnetic resonance imaging (MRI). Partial correlations analyzed associations between mood and cognition, controlling for age, sex, estimated premorbid IQ, T2 lesion volume, and normalized gray matter volume. RESULTS Depression symptoms were more related to worse cognitive multitasking (-0.353, p < 0.001) than monotasking (r = -0.189, p = 0.011). There was a significant albeit weaker link to cognitive efficiency composite score (r = -0.281, p < 0.001), but not composite memory (r = -0.036, p > 0.50). Findings were replicated with a second depression measure. Multitasking was worse in patients with at least mild depression than both patients with no/minimal depression and healthy controls. Multitasking was not related to mood in healthy controls. CONCLUSIONS Depression symptoms are linked to cognitive multitasking in early MS; standard monotasking cognitive assessments appear less sensitive to depression-related cognition. Further investigation should determine directionality and mechanisms of this relationship, with the goal of enhancing treatment for cognitive dysfunction and depression in MS.
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Affiliation(s)
- Lisa Glukhovsky
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Kurz
- Department of Neurology. Maimonides Medical Center, New York, NY, USA
| | | | - Victoria M Leavitt
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Stephen Krieger
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michelle Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilana Katz Sand
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sylvia Klineova
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Fred D Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron E Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James F Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kever A, Nelson KE, Aguerre IM, Riley CS, Boehme A, Lee NW, Strauss Farber R, Levin SN, Stein J, Leavitt VM. ASPIRE trial: study protocol for a double-blind randomised controlled trial of aspirin for overheating during exercise in multiple sclerosis. BMJ Open 2020; 10:e039691. [PMID: 33191260 PMCID: PMC7668379 DOI: 10.1136/bmjopen-2020-039691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The many benefits of exercise for persons with multiple sclerosis (MS) are well established, yet patients often refrain from exercise due to overheating and exhaustion. The present randomised controlled trial tests aspirin (acetylsalicylic acid (ASA)) as a convenient method to prevent overheating and improve exercise performance in persons with MS. The effects of ASA are compared with those of acetaminophen (APAP) and placebo. METHODS AND ANALYSIS Participants are seen for a laboratory maximal exercise test on 3 separate days separated by at least 1 week. At each session, body temperature is measured before oral administration of a standard adult dose (650 mg) of ASA, APAP or placebo. One hour after drug administration, participants perform a maximal ramp test on a cycle ergometer. Primary outcomes are (a) time to exhaustion (that is, time spent cycling to peak exertion) and (b) body temperature change. Crossover analyses will include tests for effects of treatment, period, treatment-period interaction (carryover effect) and sequence. ETHICS AND DISSEMINATION Ethical approval was granted by the institutional review board at Columbia University Irving Medical Center (reference: AAAS2529). Results of the trial will be published in peer-reviewed scientific journals and presented at national and international conferences. Neurologists, physiatrists, primary care physicians and physiotherapists are important stakeholders and will be targeted during dissemination. Positive trial results have the potential to promote aspirin therapy, an inexpensive and readily available treatment, to reduce overheating and allow more persons with MS to benefit from exercise. TRIAL REGISTRATION NUMBER NCT03824938.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Katherine E Nelson
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ines M Aguerre
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Amelia Boehme
- Department of Neurology and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Nancy W Lee
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, USA
| | - Rebecca Strauss Farber
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Seth N Levin
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Joel Stein
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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27
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Buyukturkoglu K, Zeng D, Bharadwaj S, Tozlu C, Mormina E, Igwe KC, Lee S, Habeck C, Brickman AM, Riley CS, De Jager PL, Sumowski JF, Leavitt VM. Classifying multiple sclerosis patients on the basis of SDMT performance using machine learning. Mult Scler 2020; 27:107-116. [DOI: 10.1177/1352458520958362] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: To build a model to predict cognitive status reflecting structural, functional, and white matter integrity changes in early multiple sclerosis (MS). Methods: Based on Symbol Digit Modalities Test (SDMT) performance, 183 early MS patients were assigned “lower” or “higher” performance groups. Three-dimensional (3D)-T2, T1, diffusion weighted, and resting-state magnetic resonance imaging (MRI) data were acquired in 3T. Using Random Forest, five models were trained to classify patients into two groups based on 1—demographic/clinical, 2—lesion volume/location, 3—local/global tissue volume, 4—local/global diffusion tensor imaging, and 5—whole-brain resting-state-functional-connectivity measures. In a final model, all important features from previous models were concatenated. Area under the receiver operating characteristic curve (AUC) values were calculated to evaluate classifier performance. Results: The highest AUC value (0.90) was achieved by concatenating all important features from neuroimaging models. The top 10 contributing variables included volumes of bilateral nucleus accumbens and right thalamus, mean diffusivity of left cingulum-angular bundle, and functional connectivity among hubs of seven large-scale networks. Conclusion: These results provide an indication of a non-random brain pattern mostly compromising areas involved in attentional processes specific to patients who perform worse in SDMT. High accuracy of the final model supports this pattern as a potential neuroimaging biomarker of subtle cognitive changes in early MS.
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Affiliation(s)
- Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Dana Zeng
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Srinidhi Bharadwaj
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Enricomaria Mormina
- Department of Clinical and Experimental Medicine, Policlinico Universitario “G. Martino,” University of Messina, Messina, Italy/Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Kay C Igwe
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Seonjoo Lee
- Department of Biostatistics, Columbia University, New York, NY, USA/Mental Health Data Science, Research Foundation for Mental Hygiene, Inc, New York State Psychiatric Institute, New York, NY, USA
| | - Christian Habeck
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Adam M Brickman
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - James F Sumowski
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, NY, USA
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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28
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Leavitt VM, Brandstadter R, Fabian M, Sand IK, Klineova S, Krieger S, Lewis C, Lublin F, Miller A, Pelle G, Buyukturkoglu K, Jager PLD, Li P, Riley CS, Tsapanou A, Sumowski JF. Dissociable cognitive patterns related to depression and anxiety in multiple sclerosis. Mult Scler 2020; 26:1247-1255. [PMID: 31233379 PMCID: PMC6928451 DOI: 10.1177/1352458519860319] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Individuals with multiple sclerosis (MS) frequently present with depression and anxiety, as well as cognitive impairment, challenging clinicians to disentangle interrelationships among these symptoms. OBJECTIVE To identify cognitive functions associated with anxiety and depression in MS. METHODS Mood and cognition were measured in 185 recently diagnosed patients (Reserve Against Disability in Early Multiple Sclerosis (RADIEMS) cohort), and an independent validation sample (MEM CONNECT cohort, n = 70). Partial correlations evaluated relationships of cognition to anxiety and depression controlling for age, sex, education, and premorbid verbal intelligence. RESULTS In RADIEMS cohort, lower anxiety was associated with better nonverbal memory (rp = -0.220, p = 0.003) and lower depression to better attention/processing speed (rp = -0.241, p = 0.001). Consistently, in MEM CONNECT cohort, lower anxiety was associated with better nonverbal memory (rp = -0.271, p = 0.028) and lower depression to better attention/processing speed (rp = -0.367, p = 0.002). Relationships were unchanged after controlling for T2 lesion volume and fatigue. CONCLUSION Consistent mood-cognition relationships were identified in two independent cohorts of MS patients, suggesting that cognitive correlates of anxiety and depression are separable. This dissociation may support more precise models to inform treatment development. Treatment of mood symptoms may mitigate effects on cognition and/or treatment of cognition may mitigate effects on mood.
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Affiliation(s)
- Victoria M. Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, New York
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Rachel Brandstadter
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Michelle Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Ilana Katz Sand
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Sylvia Klineova
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Stephen Krieger
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Christina Lewis
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Aaron Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Gabrielle Pelle
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
| | - Korhan Buyukturkoglu
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, New York
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Phillip L. De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center
| | - Peipei Li
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, New York
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Claire S. Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Angeliki Tsapanou
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - James F. Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, New York
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29
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Rimmer K, Farber R, Thakur K, Braverman G, Podolsky D, Sutherland L, Migliore C, Ryu YK, Levin S, De Jager PL, Vargas W, Levine L, Riley CS. Fatal COVID-19 in an MS patient on natalizumab: A case report. Mult Scler J Exp Transl Clin 2020; 6:2055217320942931. [PMID: 32850133 PMCID: PMC7425275 DOI: 10.1177/2055217320942931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/22/2020] [Indexed: 01/20/2023] Open
Abstract
We report a fatal case of COVID-19 in a 51-year-old African American woman with multiple sclerosis on natalizumab. She had multiple risk factors for severe COVID-19 disease including race, obesity, hypertension, and elevated inflammatory markers, but the contribution of natalizumab to her poor outcome remains unknown. We consider whether altered dynamics of peripheral immune cells in the context of natalizumab treatment could worsen the cytokine storm syndrome associated with severe COVID-19. We discuss extended interval dosing as a risk-reduction strategy for multiple sclerosis patients on natalizumab, and the use of interleukin-6 inhibitors in such patients who contract COVID-19.
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Affiliation(s)
- Kathryn Rimmer
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | - Rebecca Farber
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | - Kiran Thakur
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | | | - Dina Podolsky
- New York Presbyterian Hospital, United States of America
| | | | | | - Yun Kyoung Ryu
- New York Presbyterian Hospital, United States of America
| | - Seth Levin
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | - Philip L De Jager
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | - Wendy Vargas
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | - Libby Levine
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
| | - Claire S Riley
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.,New York Presbyterian Hospital, United States of America
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30
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Levin SN, Riley CS, Dhand A, White CC, Venkatesh S, Boehm B, Nassif C, Socia L, Onomichi K, Leavitt VM, Levine L, Heyman R, Farber RS, Vargas WS, Xia Z, De Jager PL. Association of social network structure and physical function in patients with multiple sclerosis. Neurology 2020; 95:e1565-e1574. [PMID: 32769139 DOI: 10.1212/wnl.0000000000010460] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/18/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To test the association between physical function and the social environment in multiple sclerosis (MS), we quantified personal social networks. METHODS In this cross-sectional study, we analyzed data from 2 academic MS centers, with center 1 serving as a discovery group and center 2 as the extension group. We performed a meta-analysis of the centers to extend the analysis. We used responses from a questionnaire to map the structure and health habits of participants' social networks as well as the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) physical function scale (0-100, mean 50 for US general population) as the primary outcome. We applied multivariable models to test the association between network metrics and physical function. RESULTS The discovery cohort included 263 patients with MS: 81% were women, 96% non-Hispanic European, 78% had relapsing MS, average age was 50 (12.4) years, and mean disease duration was 17 (12.3) years. The extension group included 163 patients, who were younger, more racially diverse, and less physically disabled, and had shorter disease duration. In the meta-analysis, higher network constraint, a measure of tightly bound networks, was associated with worse physical function (β = -0.163 ± 0.047, p < 0.001), while larger network effective size, a measure of clustered groups in the network, correlated with better physical function (β = 0.134 ± 0.046, p = 0.003). CONCLUSIONS Our study highlights personal networks as an important environmental factor associated with physical function in MS. Patients with close-knit networks had worse function than those with more open networks. Longitudinal studies are warranted to evaluate a causal relationship between network structure and physical impairment.
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Affiliation(s)
- Seth N Levin
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Claire S Riley
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Amar Dhand
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Charles C White
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Shruthi Venkatesh
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Blake Boehm
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Caren Nassif
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Lauren Socia
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Kaho Onomichi
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Victoria M Leavitt
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Libby Levine
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Rock Heyman
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Rebecca S Farber
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Wendy S Vargas
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Zongqi Xia
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Philip L De Jager
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA.
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Glukhovsky L, Brandstadter R, Leavitt VM, Krieger S, Buyukturkoglu K, Fabian M, Sand IK, Klineova S, Riley CS, Lublin FD, Miller AE, Sumowski JF. Hippocampal volume is more related to patient-reported memory than objective memory performance in early multiple sclerosis. Mult Scler 2020; 27:568-578. [PMID: 32567468 DOI: 10.1177/1352458520922830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND When persons with multiple sclerosis (MS) report memory decline but objective memory performance is normal, there is a bias toward believing objective test results. OBJECTIVE Investigate whether subjective memory decline or objective memory performance is more related to hippocampal and hippocampal subfield volumes in early MS. METHODS Persons with early MS (n = 185; ⩽5.0 years diagnosed) completed a subjective memory questionnaire; an objective memory composite was derived from four memory tests. Total hippocampal and subfield volumes were derived from high-resolution 3.0 T magnetic resonance images (MRIs). Partial correlations assessed links between hippocampal volumes and both subjective and objective memory, controlling for age, sex, mood, and pre-morbid intelligence quotient (IQ). RESULTS Lower total hippocampal and CA1 volumes were related to worse subjective memory but not objective memory (controlling for multiple comparisons). Correlations between subjective memory and both CA1 and subiculum were significantly stronger than were correlations between objective memory and these subfields. Patients in the worst tertile of subjective memory complaints (but not objective memory) had lower hippocampal volumes than 35 demographically similar healthy controls. CONCLUSION Patient-report is inherently a longitudinal assessment of within-person memory change in everyday life, which may be more sensitive to subtle disease-related changes than cross-sectional objective tests. Findings align with the aging literature.
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Affiliation(s)
- Lisa Glukhovsky
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Stephen Krieger
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Michelle Fabian
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilana Katz Sand
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sylvia Klineova
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Fred D Lublin
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron E Miller
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James F Sumowski
- The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Levin SN, Ezuma C, Levine L, Vargas WS, Farber RS, De Jager PL, Riley CS. Switching from natalizumab to ocrelizumab in patients with multiple sclerosis. Mult Scler 2020; 26:1964-1965. [PMID: 32552363 DOI: 10.1177/1352458520927631] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Seth N Levin
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Chimere Ezuma
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Libby Levine
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Wendy S Vargas
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Rebecca S Farber
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Department of Neurology and Multiple Sclerosis Center, Columbia University Irving Medical Center, New York, NY, USA
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Brandstadter R, Ayeni O, Krieger SC, Harel NY, Escalon MX, Katz Sand I, Leavitt VM, Fabian MT, Buyukturkoglu K, Klineova S, Riley CS, Lublin FD, Miller AE, Sumowski JF. Detection of subtle gait disturbance and future fall risk in early multiple sclerosis. Neurology 2020; 94:e1395-e1406. [PMID: 32102980 DOI: 10.1212/wnl.0000000000008938] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/05/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To test the hypothesis that higher-challenge gait and balance tasks are more sensitive than traditional metrics to subtle patient-reported gait dysfunction and future fall risk in early multiple sclerosis (MS). METHODS Persons with early MS (n = 185; ≤5 years diagnosed) reported gait function (MS Walking Scale) and underwent traditional disability metrics (Expanded Disability Status Scale [EDSS], Timed 25 Foot Walk). Patients and healthy controls (n = 50) completed clinically feasible challenge tasks of gait endurance (2-Minute Walk Test), standing balance (NIH Toolbox), and dynamic balance (balance boards; tandem walk on 2 ten-foot boards of different widths, 4.5 and 1.5 in). MRI assessed global and regional brain volumes, total T2 lesion volume (T2LV), infratentorial T2LVs and counts, and cervical cord lesion counts. Falls, near falls, and fall-related injuries were assessed after 1 year. We examined links between all tasks and patient-reported gait, MRI markers, and fall data. RESULTS Patients performed worse on higher challenge balance, but not gait, tasks compared with healthy controls. Worse patient-reported gait disturbance was associated with worse performance on all tasks, but only dynamic balance was sensitive to mild patient-reported gait difficulty. Balance tasks were more correlated with MRI metrics than were walking tasks or EDSS score. Thirty percent of patients reported either a fall or near fall after 1 year, with poor dynamic balance as the only task independently predicting falls. CONCLUSIONS Balance plays a leading role in gait dysfunction early in MS. Clinically feasible higher-challenge balance tasks were most sensitive to patient-reported gait, MRI disease markers, and risk of future falls, highlighting potential to advance functional outcomes in clinical practice and trials.
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Affiliation(s)
- Rachel Brandstadter
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Oluwasheyi Ayeni
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Stephen C Krieger
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Noam Y Harel
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Miguel X Escalon
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Ilana Katz Sand
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Victoria M Leavitt
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Michelle T Fabian
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Korhan Buyukturkoglu
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Sylvia Klineova
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Claire S Riley
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Fred D Lublin
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Aaron E Miller
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - James F Sumowski
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY.
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Brandstadter R, Fabian M, Leavitt VM, Krieger S, Yeshokumar A, Katz Sand I, Klineova S, Riley CS, Lewis C, Pelle G, Lublin FD, Miller AE, Sumowski JF. Word-finding difficulty is a prevalent disease-related deficit in early multiple sclerosis. Mult Scler 2019; 26:1752-1764. [PMID: 31741430 DOI: 10.1177/1352458519881760] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Persons with multiple sclerosis (MS) commonly report word-finding difficulty clinically, yet this language deficit remains underexplored. OBJECTIVE To investigate the prevalence and nature of word-finding difficulty in persons with early MS on three levels: patient report, cognitive substrates, and neuroimaging. METHODS Two samples of early MS patients (n = 185 and n = 55; ⩽5 years diagnosed) and healthy controls (n = 50) reported frequency/severity of cognitive deficits and underwent objective assessment with tasks of rapid automatized naming (RAN), measuring lexical access speed, memory, word generation, and cognitive efficiency. High-resolution brain magnetic resonance imaging (MRI) derived measurements of regional cortical thickness, global and deep gray matter volume, and T2 lesion volume. Relationships among patient-reported word-finding difficulty, cognitive performance, and neural correlates were examined. RESULTS Word-finding difficulty was the most common cognitive complaint of MS patients and the only complaint reported more by patients than healthy controls. Only RAN performance discriminated MS patients with subjective word-finding deficits from those without subjective complaints and from healthy controls. Thinner left parietal cortical gray matter independently predicted impaired RAN performance, driven primarily by the left precuneus. CONCLUSION Three levels of evidence (patient-report, objective behavior, regional gray matter) support word-finding difficulty as a prevalent, measurable, disease-related deficit in early MS linked to left parietal cortical thinning.
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Affiliation(s)
- Rachel Brandstadter
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michelle Fabian
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Stephen Krieger
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anusha Yeshokumar
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilana Katz Sand
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sylvia Klineova
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Christina Lewis
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gabrielle Pelle
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fred D Lublin
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron E Miller
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James F Sumowski
- The Corinne Goldsmith Dickinson Center for MS, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Krysko KM, LaHue SC, Anderson A, Rutatangwa A, Rowles W, Schubert RD, Marcus J, Riley CS, Bevan C, Hale TW, Bove R. Minimal breast milk transfer of rituximab, a monoclonal antibody used in neurological conditions. Neurol Neuroimmunol Neuroinflamm 2019; 7:7/1/e637. [PMID: 31719115 PMCID: PMC6857908 DOI: 10.1212/nxi.0000000000000637] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/01/2019] [Indexed: 12/31/2022]
Abstract
Objective To determine the transfer of rituximab, an anti-CD20 monoclonal antibody widely used for neurologic conditions, into mature breast milk. Methods Breast milk samples were collected from 9 women with MS who received rituximab 500 or 1,000 mg intravenous once or twice while breastfeeding from November 2017 to April 2019. Serial breast milk samples were collected before infusion and at 8 hours, 24 hours, 7 days, and 18–21 days after rituximab infusion in 4 patients. Five additional patients provided 1–2 samples at various times after rituximab infusion. Results The median average rituximab concentration in mature breast milk was low at 0.063 μg/mL (range 0.046–0.097) in the 4 patients with serial breast milk collection, with an estimated median absolute infant dose of 0.0094 mg/kg/d and a relative infant dose (RID) of 0.08% (range 0.06%–0.10%). Most patients had a maximum concentration at 1–7 days after infusion. The maximum concentration occurred in a woman with a single breast milk sample and was 0.29 μg/mL at 11 days postinfusion, which corresponds with an estimated RID of 0.33%. Rituximab concentration in milk was virtually undetectable by 90 days postinfusion. Conclusions We determined minimal transfer of rituximab into mature breast milk. The RID for rituximab was less than 0.4% and well below theoretically acceptable levels of less than 10%. Low oral bioavailability would probably also limit the absorption of rituximab by the newborn. In women with serious autoimmune neurologic conditions, monoclonal antibody therapy may afford an acceptable benefit to risk ratio, supporting both maternal treatment and breastfeeding.
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Affiliation(s)
- Kristen M Krysko
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Sara C LaHue
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Annika Anderson
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Alice Rutatangwa
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - William Rowles
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Ryan D Schubert
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Jacqueline Marcus
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Claire S Riley
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo.
| | - Carolyn Bevan
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Thomas W Hale
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo
| | - Riley Bove
- From the Department of Neurology (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), University of California, San Francisco; Weill Institute for Neurosciences (K.M.K., S.C.L., A.A., A.R., W.R., R.D.S., R.B.), Department of Neurology, University of California, San Francisco; Department of Neurology (J.M.), Kaiser Permanente, San Francisco; Department of Neurology (C.S.R.), Columbia University, New York, New York; Department of Neurology (C.B.), Northwestern University, Chicago, Illinois; and Department of Pediatrics (T.W.H.), Texas Tech University School of Medicine, Amarillo.
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Leavitt VM, Riley CS, De Jager PL, Bloom S. eSupport: Feasibility trial of telehealth support group participation to reduce loneliness in multiple sclerosis. Mult Scler 2019; 26:1797-1800. [PMID: 31668134 DOI: 10.1177/1352458519884241] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Loneliness is a risk factor for increased morbidity and mortality. Persons with multiple sclerosis (pwMS) are at increased risk for loneliness. Support groups facilitate meaningful social connections. OBJECTIVE To conduct a feasibility trial of eSupport: online support groups. METHODS Participants engaged in 1 hour/week eSupport or eJournal (active control). Primary outcome was feasibility (completion and adherence). We evaluated loneliness and depressive symptoms for preliminary efficacy. RESULTS Feasibility outcomes were met: completion rate was 96.4%; 88.9% were adherent. Loneliness and depression showed trend-level decreases in both conditions. CONCLUSION Feasibility of telehealth support group participation for pwMS was supported. eSupport is accessible, affordable, acceptable, and scalable. Results warrant a randomized controlled trial to support efficacy.
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Affiliation(s)
- Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Cognitive Neuroscience Division, Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Sharonna Bloom
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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Cook LJ, Rose JW, Alvey JS, Jolley AM, Kuhn R, Marron B, Pederson M, Enriquez R, Yearley J, McKechnie S, Han MH, Tomczak AJ, Levy M, Mealy MA, Coleman J, Bennett JL, Johnson R, Barnes-Garcia M, Traboulsee AL, Carruthers RL, Lee LE, Schubert JJ, McMullen K, Kister I, Rimler Z, Reid A, Sicotte NL, Planchon SM, Cohen JA, Ivancic D, Sedlak JL, Sand IK, Repovic P, Amezcua L, Pruitt A, Amundson E, Chitnis T, Mullin DS, Klawiter EC, Russo AW, Riley CS, Onomichi KB, Levine L, Nelson KE, Nealon NM, Engel C, Kruse-Hoyer M, Marcille M, Tornes L, Rumpf A, Greer A, Kenneally Behne M, Rodriguez RR, Behne DW, Blackway DW, Coords B, Blaschke TF, Sheard J, Smith TJ, Behne JM, Yeaman MR. Collaborative International Research in Clinical and Longitudinal Experience Study in NMOSD. Neurol Neuroimmunol Neuroinflamm 2019; 6:e583. [PMID: 31355319 PMCID: PMC6624150 DOI: 10.1212/nxi.0000000000000583] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/17/2019] [Indexed: 12/15/2022]
Abstract
Objective To develop a resource of systematically collected, longitudinal clinical data and biospecimens for assisting in the investigation into neuromyelitis optica spectrum disorder (NMOSD) epidemiology, pathogenesis, and treatment. Methods To illustrate its research-enabling purpose, epidemiologic patterns and disease phenotypes were assessed among enrolled subjects, including age at disease onset, annualized relapse rate (ARR), and time between the first and second attacks. Results As of December 2017, the Collaborative International Research in Clinical and Longitudinal Experience Study (CIRCLES) had enrolled more than 1,000 participants, of whom 77.5% of the NMOSD cases and 71.7% of the controls continue in active follow-up. Consanguineous relatives of patients with NMOSD represented 43.6% of the control cohort. Of the 599 active cases with complete data, 84% were female, and 76% were anti-AQP4 seropositive. The majority were white/Caucasian (52.6%), whereas blacks/African Americans accounted for 23.5%, Hispanics/Latinos 12.4%, and Asians accounted for 9.0%. The median age at disease onset was 38.4 years, with a median ARR of 0.5. Seropositive cases were older at disease onset, more likely to be black/African American or Hispanic/Latino, and more likely to be female. Conclusions Collectively, the CIRCLES experience to date demonstrates this study to be a useful and readily accessible resource to facilitate accelerating solutions for patients with NMOSD.
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Affiliation(s)
- Lawrence J Cook
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - John W Rose
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jessica S Alvey
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Anna Marie Jolley
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Renee Kuhn
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Brie Marron
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Melissa Pederson
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Rene Enriquez
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jeff Yearley
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Stephen McKechnie
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - May H Han
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Anna J Tomczak
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Michael Levy
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Maureen A Mealy
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jessica Coleman
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jeffrey L Bennett
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Ruth Johnson
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Myka Barnes-Garcia
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Anthony L Traboulsee
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Robert L Carruthers
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Lisa Eunyoung Lee
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Julia J Schubert
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Katrina McMullen
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Ilya Kister
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Zoe Rimler
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Allyson Reid
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Nancy L Sicotte
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Sarah M Planchon
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jeffrey A Cohen
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Diane Ivancic
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jennifer L Sedlak
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Ilana Katz Sand
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Pavle Repovic
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Lilyana Amezcua
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Ana Pruitt
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Erika Amundson
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Tanuja Chitnis
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Devin S Mullin
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Eric C Klawiter
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Andrew W Russo
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Claire S Riley
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Kaho B Onomichi
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Libby Levine
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Katherine E Nelson
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Nancy M Nealon
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Casey Engel
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Mason Kruse-Hoyer
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Melanie Marcille
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Leticia Tornes
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Anne Rumpf
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Angela Greer
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Megan Kenneally Behne
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Renee R Rodriguez
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Daniel W Behne
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Derek W Blackway
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Brian Coords
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Terrence F Blaschke
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Judy Sheard
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Terry J Smith
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Jacinta M Behne
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
| | - Michael R Yeaman
- University of Utah School of Medicine (L.J.C., J.W.R., J.S.A., A.M.J., R.K., B.M., M.P., R.E., J.Y., S.M.), Salt Lake City; Division of Neuroimmunology and Multiple Sclerosis Center (M.H.H.), Department of Neurology and Neurological Sciences, Stanford University; Department of Neurology and Neurological Sciences (A.J.T.), Stanford School of Medicine, CA; Department of Neurology, Johns Hopkins University School of Medicine (M.L., M.A.M., J.C.), Baltimore, MD; Departments of Neurology and Ophthalmology (J.L.B., R.J., M.B.-G.), University of Colorado School of Medicine, Aurora; Department of Medicine & Neurology (A.L.T., R.L.C., L.E.L., J.J.S., K.M.), University of British Columbia, Vancouver, Canada; NYU Langone Health (I.K., Z.R., A.R.), New York; Department of Neurology, Cedars-Sinai Medical Center (N.L.S.), Los Angeles, CA; Mellen Center for MS Treatment and Research (S.M.P., J.A.C., D.I., J.L.S.), Neurological Institute, Cleveland Clinic, OH; Icahn School of Medicine at Mount Sinai (I.K.S.), New York; Multiple Sclerosis Center (P.R.), Swedish Neuroscience Institute, Seattle, WA; Department of Neurology (L.A., A.P., E.A.), Keck School of Medicine, University of Southern California, Los Angeles; Department of Neurology (T.C., D.S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (E.C.K., A.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (C.S.R., K.B.O., L.L., K.E.N.), Columbia University Medical Center; Weill Cornell Medicine (M.M.N., C.E., M.K.-H., M.M.), New York; Department of Neurology (L.T.), Division of Multiple Sclerosis, University of Miami Miller School of Medicine, FL; PPD (A.R., A.G.), Wilmington, NC; The Guthy-Jackson Charitable Foundation (M.K.B., R.R.R., D.W. Behne., D.W. Blackway, B.C., J.S., J.M.B.), Beverly Hills; Departments of Medicine and of Molecular Pharmacology (T.F.B.), Stanford University School of Medicine, CA; Kellogg Eye Center (T.J.S.), University of Michigan Medical School, Ann Arbor; Department of Medicine, University of California, Los Angeles (M.R.Y.); and Harbor-UCLA Medical Center/LABioMed (M.R.Y.), Torrance, CA
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Klineova S, Brandstadter R, Fabian MT, Sand IK, Krieger S, Leavitt VM, Lewis C, Riley CS, Lublin F, Miller AE, Sumowski JF. Psychological resilience is linked to motor strength and gait endurance in early multiple sclerosis. Mult Scler 2019; 26:1111-1120. [PMID: 31172846 DOI: 10.1177/1352458519852725] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psychologically resilient persons persist despite obstacles and bounce back after adversity, leading to better outcomes in non-neurologic populations. It is unknown whether psychological resilience relates to objective functional outcomes in multiple sclerosis (MS). OBJECTIVE To determine whether psychological resilience explains differential objective cognitive and motor functioning in persons with early MS. METHODS Psychological resilience was assessed in 185 patients with early MS and 50 matched healthy controls with the Connors-Davidson Resilience Scale (CDRS-10). Subjects completed the MS Functional Composite (MSFC) and a comprehensive neurobehavioral evaluation. Correlations assessed links between CDRS-10 and MSFC, motor indices (Total, Fine Motor, Gross Motor), and cognitive indices (Total, Cognitive Efficiency, Memory). RESULTS Higher CDRS-10 among patients was linked to better MSFC and motor outcomes (but not cognition), with the most robust relationships for gross motor function (grip strength, gait endurance). Findings were independent of mood and fatigue. CDRS-10 was unrelated to MS disease burden. CDRS-10 was also specifically linked to motor outcomes in healthy controls. CONCLUSION Functional outcomes vary across persons with MS, even when disease burden and neurologic disability are low. These findings identify high psychological resilience as a non-disease-specific contributor to motor strength and endurance, which may explain differential outcomes across patients.
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Affiliation(s)
- Sylvia Klineova
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Brandstadter
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michelle T Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilana Katz Sand
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Krieger
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Christina Lewis
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron E Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James F Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Buyukturkoglu K, Mormina E, De Jager PL, Riley CS, Leavitt VM. The Impact of MRI T1 Hypointense Brain Lesions on Cerebral Deep Gray Matter Volume Measures in Multiple Sclerosis. J Neuroimaging 2019; 29:458-462. [PMID: 30892794 DOI: 10.1111/jon.12611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Deep gray matter (DGM) atrophy has been shown at early stages of multiple sclerosis (MS) and reported as an informative marker of cognitive dysfunction and clinical progression. Therefore, accurate measurement of DGM structure volume is a key priority in MS research. Findings from prior studies have shown that hypointense T1 lesions may impact the accuracy of global brain volume measures; however, literature on the effects of hypointense T1 lesions on DGM structure volumes is sparse. METHODS We explored the effects of hypointense T1 lesions on data from 54 relapsing remitting MS patients. Lesions were segmented both manually and with a freely available automatic lesion segmentation/in-painting algorithm (Lesion Segmentation Tool-LST). Volumes of 14 DGM structures were calculated from non-in-painted and in-painted images and compared via paired t-tests, intraclass correlation coefficient, and Dice similarity coefficient. RESULTS There were no significant differences in DGM structural volumes between non-in-painted and in-painted images. Automatic lesion-segmentation/in-painting tool provided similar results to manual segmentation/in-painting. CONCLUSIONS Our results suggest that lesion in-painting has a negligible impact on DGM structure volume measurement although some regions are more vulnerable to the impact of lesions than others. Furthermore, manual lesion segmentation/in-painting can be replaced by an automatic segmentation/in-painting process.
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Affiliation(s)
- Korhan Buyukturkoglu
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY.,Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Enricomaria Mormina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Philip L De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY.,Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY.,Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY
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Fox RJ, Coffey CS, Conwit R, Cudkowicz ME, Gleason T, Goodman A, Klawiter EC, Matsuda K, McGovern M, Naismith RT, Ashokkumar A, Barnes J, Ecklund D, Klingner E, Koepp M, Long JD, Natarajan S, Thornell B, Yankey J, Bermel RA, Debbins JP, Huang X, Jagodnik P, Lowe MJ, Nakamura K, Narayanan S, Sakaie KE, Thoomukuntla B, Zhou X, Krieger S, Alvarez E, Apperson M, Bashir K, Cohen BA, Coyle PK, Delgado S, Dewitt LD, Flores A, Giesser BS, Goldman MD, Jubelt B, Lava N, Lynch SG, Moses H, Ontaneda D, Perumal JS, Racke M, Repovic P, Riley CS, Severson C, Shinnar S, Suski V, Weinstock-Guttman B, Yadav V, Zabeti A. Phase 2 Trial of Ibudilast in Progressive Multiple Sclerosis. N Engl J Med 2018; 379:846-855. [PMID: 30157388 PMCID: PMC6172944 DOI: 10.1056/nejmoa1803583] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There are limited treatments for progressive multiple sclerosis. Ibudilast inhibits several cyclic nucleotide phosphodiesterases, macrophage migration inhibitory factor, and toll-like receptor 4 and can cross the blood-brain barrier, with potential salutary effects in progressive multiple sclerosis. METHODS We enrolled patients with primary or secondary progressive multiple sclerosis in a phase 2 randomized trial of oral ibudilast (≤100 mg daily) or placebo for 96 weeks. The primary efficacy end point was the rate of brain atrophy, as measured by the brain parenchymal fraction (brain size relative to the volume of the outer surface contour of the brain). Major secondary end points included the change in the pyramidal tracts on diffusion tensor imaging, the magnetization transfer ratio in normal-appearing brain tissue, the thickness of the retinal nerve-fiber layer, and cortical atrophy, all measures of tissue damage in multiple sclerosis. RESULTS Of 255 patients who underwent randomization, 129 were assigned to ibudilast and 126 to placebo. A total of 53% of the patients in the ibudilast group and 52% of those in the placebo group had primary progressive disease; the others had secondary progressive disease. The rate of change in the brain parenchymal fraction was -0.0010 per year with ibudilast and -0.0019 per year with placebo (difference, 0.0009; 95% confidence interval, 0.00004 to 0.0017; P=0.04), which represents approximately 2.5 ml less brain-tissue loss with ibudilast over a period of 96 weeks. Adverse events with ibudilast included gastrointestinal symptoms, headache, and depression. CONCLUSIONS In a phase 2 trial involving patients with progressive multiple sclerosis, ibudilast was associated with slower progression of brain atrophy than placebo but was associated with higher rates of gastrointestinal side effects, headache, and depression. (Funded by the National Institute of Neurological Disorders and Stroke and others; NN102/SPRINT-MS ClinicalTrials.gov number, NCT01982942 .).
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Affiliation(s)
- Robert J Fox
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Christopher S Coffey
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Robin Conwit
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Merit E Cudkowicz
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Trevis Gleason
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Andrew Goodman
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Eric C Klawiter
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Kazuko Matsuda
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Michelle McGovern
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Robert T Naismith
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Akshata Ashokkumar
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Janel Barnes
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Dixie Ecklund
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Elizabeth Klingner
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Maxine Koepp
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Jeffrey D Long
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Sneha Natarajan
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Brenda Thornell
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Jon Yankey
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Robert A Bermel
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Josef P Debbins
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Xuemei Huang
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Patricia Jagodnik
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Mark J Lowe
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Kunio Nakamura
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Sridar Narayanan
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Ken E Sakaie
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Bhaskar Thoomukuntla
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Xiaopeng Zhou
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Stephen Krieger
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Enrique Alvarez
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Michelle Apperson
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Khurram Bashir
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Bruce A Cohen
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Patricia K Coyle
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Silvia Delgado
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - L Dana Dewitt
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Angela Flores
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Barbara S Giesser
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Myla D Goldman
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Burk Jubelt
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Neil Lava
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Sharon G Lynch
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Harold Moses
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Daniel Ontaneda
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Jai S Perumal
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Michael Racke
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Pavle Repovic
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Claire S Riley
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Christopher Severson
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Shlomo Shinnar
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Valerie Suski
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Bianca Weinstock-Guttman
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Vijayshree Yadav
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
| | - Aram Zabeti
- From the Mellen Center for Multiple Sclerosis, Neurological Institute (R.J.F., S. Natarajan, R.A.B., D.O.), the Imaging Institute (X.H., M.J.L., K.E.S., X.Z.), and the Department of Biomedical Engineering (P.J., K.N., B. Thoomukuntla), Cleveland Clinic, Cleveland, Ohio State University, Columbus (M.R.), and University of Cincinnati, Cincinnati (A.Z.) - all in Ohio; the Data Coordinating Center, Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), University of Iowa, Iowa City (C.S.C., J.B., D.E., E.K., M.K., J.D.L., J.Y.); the National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.); the Clinical Coordinating Center, NeuroNEXT, Massachusetts General Hospital, Neurological Clinical Research Institute, Harvard Partners (M.E.C., M.M., A.A., B. Thornell), the Department of Neurology, Massachusetts General Hospital, Harvard Medical School (E.C.K.), and Brigham and Women's Hospital (C.S.), Boston; patient advocate (T.G.) and Swedish Medical Center at Seattle (P.R.), Seattle; University of Rochester Medical Center, Rochester (A.G.), Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center (S.K.), Weill Cornell Medical College (J.S.P.), Columbia University Medical Center (C.S.R.), and Montefiore Medical Center, Albert Einstein College of Medicine (S.S.), New York, State University of New York (SUNY) at Stony Brook, Stony Brook (P.K.C.), SUNY Upstate Medical University, Syracuse (B.J.), and SUNY at Buffalo, Buffalo (B.W.-G.) - all in New York; MediciNova, La Jolla (K.M.), University of California at Davis, Sacramento (M.A.), and University of California at Los Angeles, Los Angeles (B.S.G.) - all in California; Washington University School of Medicine, St. Louis (R.T.N.); Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (J.P.D.); NeuroRx Research, Montreal (S. Narayanan); the School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN (X.Z.); University of Colorado Denver, Aurora (E.A.); University of Alabama at Birmingham, Birmingham (K.B.); Feinberg School of Medicine, Northwestern University, Chicago (B.A.C.); University of Miami Miller School of Medicine, Miami (S.D.); University of Utah, Salt Lake City (L.D.D.); University of Texas Southwestern Medical Center, Dallas (A.F.); University of Virginia at Charlottesville, Charlottesville (M.D.G.); Emory University, Atlanta (N.L.); University of Kansas Medical Center, Kansas City (S.G.L.); Vanderbilt University, Nashville (H.M.); University of Pittsburgh Medical Center, Pittsburgh (V.S.); and Oregon Health and Science University, Portland (V.Y.)
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Leavitt VM, Tosto G, Riley CS. Cognitive phenotypes in multiple sclerosis. J Neurol 2018; 265:562-566. [DOI: 10.1007/s00415-018-8747-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 01/22/2023]
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Riley CS. Patient Management Problem—Preferred Responses. Continuum (Minneap Minn) 2016; 22:1003-11. [DOI: 10.1212/con.0000000000000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Riley CS, Vargas W. Multiple Sclerosis in the Elderly: Considerations in the Geriatric Population for Diagnosis and Management. Curr Geri Rep 2015. [DOI: 10.1007/s13670-015-0128-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Klufas MA, Dinkin MJ, Bhaleeya SD, Chapman KO, Riley CS, Kiss S. Ultra-Widefield Fluorescein Angiography Reveals Retinal Phlebitis in Susac’s Syndrome. Ophthalmic Surg Lasers Imaging Retina 2014; 45:335-7. [DOI: 10.3928/23258160-20140617-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 02/11/2014] [Indexed: 11/20/2022]
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Kostianovsky A, Maskin P, Noriega MM, Soler C, Bonelli I, Riley CS, O'Connor KC, Saubidet CNL, Alvarez PA. Acute demyelinating disease after oral therapy with herbal extracts. Case Rep Neurol 2011; 3:141-6. [PMID: 21738505 PMCID: PMC3130893 DOI: 10.1159/000329734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Central nervous system demyelinating processes such as multiple sclerosis and acute disseminated encephalomyelitis constitute a group of diseases not completely understood in their physiopathology. Environmental and toxic insults are thought to play a role in priming autoimmunity. The aim of the present report is to describe a case of acute demyelinating disease with fatal outcome occurring 15 days after oral exposure to herbal extracts.
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Affiliation(s)
- Alex Kostianovsky
- Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas 'Norberto Quirno', CEMIC, Buenos Aires, Argentina
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