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Articles

A recent study presented at the 2025 AD/PD Conference identified key modifiers of Alzheimer disease onset in amyloid precursor protein duplication carriers. 

Genetic Risk Factors Influence Age at Onset in Autosomal Dominant Alzheimer Disease

A phase 2a biomarker trial of xanamem presented at AD/PD 2025 suggests the drug may help slow clinical decline in patients with Alzheimer who have elevated levels of plasma pTau181.

Xanamem Shows Potential in Slowing Alzheimer Progression in Patients With Elevated Plasma pTau181

A recent study reported that silmitasertib, an investigational drug currently in development for cancer, may help reduce motor deficits and neuropathology in a Huntington disease.

Therapeutic Potential of Silmitasertib Observed in Huntington Disease Mouse Model

Although valiltramiprosate failed to distinguish itself from placebo on the primary end point, the drug performed significantly better among mild MCI participants vs those with mild Alzheimer disease.

Valiltramiprosate Demonstrates Greater Promise in Milder Forms of Alzheimer Disease, Phase 3 APOLLOE4 Study Shows

Senior vice president of research at The ALS Association. 

Videos

The senior vice president of research at The ALS Association talked about a multidisciplinary session presented at the 2025 MDA Conference that highlighted diverse strategies for neural repair, from pharmacological targets to noninvasive brain stimulation. [WATCH TIME: 6 minutes]

Exploring Multimodal Approaches to Neural Regeneration: Kuldip Dave, PhD

Marco Meglio, Assistant Managing Editor for 

, has been with the team since October 2019. Follow him on Twitter 

In this final episode, neurologists discuss the role of advanced imaging, like OCT, in diagnosing and managing MS, emphasizing the need for further research to optimize its clinical application. [WATCH TIME: 2 minutes]

Bridging Neurology and Ophthalmology in Multiple Sclerosis Research

A pair of neurologists provide clinical insight on the difficulties with identifying and differentiating optic neuritis in various autoimmune conditions like multiple sclerosis and neuromyelitis optica spectrum disorder. [WATCH TIME: 4 minutes]

Challenges in Diagnosing Optic Neuritis in MS and MOGAD

In this third episode, experts delve into the evolving role of optic neuritis and the central vein sign in refining multiple sclerosis diagnosis, highlighting their significance in distinguishing MS from other conditions and ensuring accurate patient care. [WATCH TIME: 3 minutes]

Educating the Clinical Community on Changes to MS Diagnostic Criteria

The multiple sclerosis condition center is a resource for clinical news on the diagnosis, treatment, and management of multiple sclerosis. | NeurologyLive.


Multiple Sclerosis | Clinical Neurology News | NeurologyLive

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 MS Disease Spotlight page offers specific updates and coverage on the latest expert conversations and data readouts related to the treatment and management of patients with multiple sclerosis and demyelinating disorders.

Marketed as Mayzent, the selective sphingosine 1-phosphate receptor modulator is the first treatment for patients with active secondary progressive multiple sclerosis in almost 15 years.

Siponimod Cleared for Treatment of Secondary Progressive MS

If approved, siponimod would be the first oral disease-modifying therapy with the potential to delay secondary progressive multiple sclerosis progression.

Siponimod NDA Accepted by FDA for Secondary Progressive MS

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The Mind Moments podcast features exclusive interviews with leaders in the field discussing the latest research and disease management strategies across the breadth of neurology, including epilepsy, multiple sclerosis, Parkinson disease, dementia, sleep disorders, and more.

In this episode, "Understanding Major Changes to New McDonald Criteria for Multiple Sclerosis," Daniel Ontaneda, MD, PhD, a staff member of the Cleveland Clinic Mellen Center for Multiple Sclerosis, provided an in-depth overview on the new McDonald criteria to diagnose multiple sclerosis (MS), which was presented at the 

40th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)

. Ontaneda, who also serves as an assistant professor of neurology, discussed the most notable changes to the criteria and how it may help towards improving rates of misdiagnosis and missed diagnosis. He spoke on the incorporation of new biomarkers, such as central vein sign and paramagnetic rim lesions, and the ability to diagnose MS in stages before clinical presentation shows. Furthermore, Ontaneda gave some perspective on the areas of the new criteria that will take some time to adjust to, as well as how these criteria may change the philosophical perspective of the disease as a whole.


The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here:

Potential Regulatory Submission for Inebilizumab in Myasthenia Gravis Following Positive Phase 3 MINT Data

Parkinson Agent Tavapadon Meets Primary and Secondary End Points as Monotherapy in Phase 3 TEMPO-1 Trial

Sage Therapeutics and Biogen Officially Announce Ending of SAGE-324 Program in Essential Tremor

 – Focus and direction of new diagnostic criteria

 – Overviewing specific changes to McDonald criteria

 – Approach to diagnosing pre-MS; treating radiologically isolated syndrome earlier

 – Incorporation of new biomarkers, central vein sign, paramagnetic rim lesions, OCT

 – Unanswered questions/challenges left out of the diagnostic criteria

 to subscribe to the Mind Moments podcast. Be sure to leave a rating and review for the show. Thanks for listening!

Hoping to listen on your favorite podcast app? See below:

European Committee for Treatment and Research in Multiple Sclerosis Congress (ECTRIMS)

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Daniel Ontaneda, MD, PhD. [LISTEN TIME: 27 minutes]

Episode 125: Understanding Major Changes to New McDonald Criteria for Multiple Sclerosis

The Mind Moments podcast features exclusive interviews with leaders in the field discussing the latest research and disease management strategies across the breadth of neurology, including epilepsy, multiple sclerosis (MS), Parkinson disease, dementia, sleep disorders, and more.

Episode 47, "Incorporating Physical Therapy Into MS Care," features an exclusive interview with Patricia Bobryk, MHS, PT, MSCS, ATP, physical therapist, UC Health, and cochair, 

International Organization of MS Rehabilitation Therapists (IOMSRT)

. Bobryk shared her insight into the clinical care of MS from the perspective of a rehabilitative specialist, and the importance of including physical therapy approaches as part of the multidisciplinary approach to care as early as possible to ensure more beneficial long-term outcomes for patients, also speaking to the latest advances and developments in rehabilitative medicine.

The stories feature in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here:

Noncontact Boxing Exercise Assessed for Parkinson Disease Benefit

Opicapone Demonstrates Small Benefit for Sleep in Parkinson Disease

Amylyx Announces Plans to Submit NDA for AMX0035 for ALS

Episode Breakdown

"Mind Moments," a podcast from NeurologyLive, brings you an exclusive interview with Patricia Bobryk, MHS, PT, MSCS, ATP.

Episode 47: Incorporating Physical Therapy Into MS Care

Episode 38, "Advancing MS Care and Awareness," features an interview with Barry Hendin, MD, clinical professor, University of Arizona; director, Multiple Sclerosis Clinic, Banner University Medical Center; and chief medical officer, Multiple Sclerosis Association of America. He shared his perspective on the recent World MS Day on May 30, the impact awareness efforts have had on care, and how treatment has evolved during his time as a multiple scleorsis (MS) physician.

"Mind Moments," a podcast from NeurologyLive, brings you an exclusive interview with Barry Hendin, MD.

Episode 38: Advancing MS Care and Awareness

Take 5 minutes to catch up on NeurologyLive®'s highlights from the week ending March 14, 2025. 

NeurologyLive® Friday 5 — March 14, 2025

A post-hoc analysis of patients from the CHAMPION-NMOSD trial revealed that the majority received their initial meningococcal vaccination within 6-months of their last rituximab dose. 

Pretreatment Meningococcal Vaccination Rates High Among Patients With NMOSD Transitioning From Rituximab to Ravulizumab

Take 5 minutes to catch up on NeurologyLive®'s highlights from the week ending March 7, 2025. 

NeurologyLive® Friday 5 — March 7, 2025

A late-breaking study presented at the 2025 ACTRIMS Forum reported that a modified Atkins diet reduced inflammation and altered immune cell metabolism in multiple sclerosis. 

Ketogenic Diet Shows Potential for Modulating Immune Response in Multiple Sclerosis

A new phase 1 study will investigate the safety and biological effects of light therapy as a potential approach to alleviating fatigue in patients with progressive multiple sclerosis.

Innovative Trial to Test Effect of Light Therapy on Progressive MS-Related Fatigue

The assistant professor in the department of neurology at Mount Sinai discussed distinguishing cognitive impairment in MS from AD emphasizing orientation as a key differentiator. 

Differentiating Cognitive Decline in Multiple Sclerosis and Alzheimer Disease: Sarah Levy, PhD

"Orientation seems to be a key differentiator in the cognitive profile between [patients with multiple sclerosis and patients with Alzheimer disease]."

Cognitive impairment is a common concern among older adults with multiple sclerosis (MS), often affecting quality of life and independence. However, distinguishing whether cognitive decline is because of MS or other conditions, such as Alzheimer disease (AD), remains challenging. The Montreal Cognitive Assessment (MoCA) is a widely used screening tool for cognitive impairment across neurological disorders, including MS, and thus, comparing MoCA performance patterns between patients with MS and those with AD may offer valuable insights for diagnostic accuracy. Recent research has also suggested that MS may provide a protective effect against AD, potentially reducing the likelihood of co-occurrence.

A recently conducted study aimed to analyze MoCA performance in older adults with MS to identify specific cognitive patterns that differentiate MS-related impairment from AD-related decline. The retrospective analysis included 100 patients with MS over age 60, comparing MoCA scores with normative data from cognitively normal (NC) individuals and patients with AD. All told, the overall MS group had a mean MoCA score of 23.7, lower than the NC group (27.4) but higher than the AD group (16.2). Among patients with MS with impaired scores (n = 19), performance resembled the AD group on tasks such as Trails, Cube Copy, Clock Drawing, Fluency, and Abstraction. However, key differences emerged: patients with MS performed worse on Sentence Repetition, whereas those with AD showed greater impairment in Naming and Orientation. Notably, 90% of impaired patients with MS retained near-perfect Orientation scores. These findings suggest that distinct cognitive profiles reflected differing underlying pathologies, potentially helping to differentiate MS-related cognitive changes from AD. Additionally, they support the notion that MS may confer some protective advantage against AD-related cognitive decline.

These insights were recently presented by coauthor 

, clinical neuropsychologist and assistant professor at 

2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum

, held February 27 to March 1, in West Palm Beach, Florida. During the Forum, Levy sat down for an interview with 

 to discuss how cognitive impairment presents in older adults with MS and how it can sometimes mimic AD. She emphasized that although both conditions may involve deficits in language and episodic memory, orientation remains a distinguishing factor—patients with MS tended to retain awareness of time and place, whereas those with AD often did not. The conversation also highlighted the importance of objective biomarkers, such as blood-based tests and amyloid PET scans, to better differentiate between MS-related cognitive impairment and AD. Additionally, Levy discussed the MS Cognitive Scale, a patient-reported questionnaire designed to track cognitive deficits in MS.

Click here for coverage of 2025 ACTRIMS Forum.

REFERENCES
1. La Rosa F, Dereskewicz EM, Silva JD, et al. Characterizing Longitudinal Brain Age in Multiple Sclerosis. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. Session PS1. 016. 

The assistant professor in the department of neurology at Mount Sinai discussed distinguishing cognitive impairment in MS from AD emphasizing orientation as a key differentiator. [WATCH TIME: 5 minutes]

SAP Partners

The professor of neurology at University of Colorado School of Medicine talked about the challenges of telehealth and device-based data collection in clinical practice. 

Challenges and Trust in Telehealth Integration for Multiple Sclerosis Care: Enrique Alvarez, MD, PhD

"As technology gets better, I think we’ll also have more stability in the measures. The challenge we really have in that regard is just knowing what the best measures are to look at. Technology can measure a lot of things, but what do we need to focus on?"

Telehealth has emerged as a vital tool in the management of multiple sclerosis (MS), offering patients enhanced access to care, especially during periods when in-person visits are challenging. However, its implementation presents several obstacles. Studies have identified that older age, lower socioeconomic status, and certain disease-related impairments may be associated with reduced access to and utilization of telehealth services among individuals with MS. These disparities can exacerbate existing healthcare inequities if not proactively addressed.

 Additionally, healthcare providers have reported difficulties in interpreting remote examinations, communicating effectively with patients, and managing technical issues during telehealth sessions, highlighting the need for improved training and support for both patients and providers.

As telehealth continues to play a larger role, the integration of device-based data collection into clinical practice presents its own set of challenges. Mobile and wearable technologies offer the potential for continuous monitoring of MS symptoms and progression, but several issues persist. Concerns around data quality, consistency, and patient privacy are prevalent, with the need for secure and accurate data collection being paramount for its acceptance and utility in clinical settings. Furthermore, the reporting burden on patients, particularly those with progressive forms of MS, is a significant factor. Careful consideration of study designs and data collection frequencies could be required to avoid participant fatigue and disengagement. Addressing these challenges may be essential for successfully integrating digital tools into MS care, ensuring enhanced patient outcomes without creating new barriers.

, held February 27 to March 1, in West Palm Beach, Florida, 

, spoke in a symposium titled “Using Modern Tools and Frameworks to Reengineer Multiple Sclerosis Management.” During the event, Alvarez, a professor of neurology at the University of Colorado School of Medicine, discussed these ongoing challenges in telehealth, particularly with technology issues such as internet connectivity and device malfunctions. He also addressed the growing concerns about privacy and trust, especially as wearable devices and other technologies are increasingly used to monitor patient data. Alvarez emphasized the importance of transparent communication and establishing trust with patients to overcome these obstacles. He also underscored the need for careful consideration of which aspects of patient health to measure and how to analyze that data effectively.

REFERENCES
1. Marrie RA, Kosowan L, Cutter G, Fox R, Salter A. Disparities in Telehealth Care in Multiple Sclerosis. Neurol Clin Pract. 2022;12(3):223-233. doi:10.1212/CPJ.0000000000001167
2. Keszler P, Maloni H, Miles Z, Jin S, Wallin M. Telemedicine and Multiple Sclerosis: A Survey of Health Care Providers Before and During the COVID-19 Pandemic. Int J MS Care. 2022;24(6):266-270. doi:10.7224/1537-2073.2021-103
3. Krieger K, Nicholas J, Alvarez E. Time for a Reset: Using Modern Tools and Frameworks to Reengineer Multiple Sclerosis Management. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. SS3.



The professor of neurology at University of Colorado School of Medicine talked about the challenges of telehealth and device-based data collection in clinical practice. [WATCH TIME: 4 minutes]

The professor of neurological sciences at the University of Vermont discussed the work of the MS Differential Diagnosis Consortium, highlighting efforts to refine MS differential diagnosis and improve clinical accuracy. 

Updates on Guidance for Diagnosing Pediatric and Late-Onset Multiple Sclerosis: Andrew Solomon, MD

“The diagnostic process [for multiple sclerosis] should be thinking about our diagnostic criteria and making sure that patients fulfill that criteria but also considering other diagnoses that can mimic [the disease] along the way.”

The MS Differential Diagnosis Consortium (MSDDC), sponsored by the 

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS)

, as co-chair. The consortium includes representatives from key multiple sclerosis (MS) organizations, such as the MS International Federation, the Consortium of MS Centers, and the European Committee for Treatment and Research in MS (ECTRIMS). In addition to developing updated general guidelines for MS differential diagnosis, the MSDDC is also working on forthcoming recommendations tailored to different geographic regions and underrepresented populations, aiming to refine diagnostic accuracy worldwide.

As part of these ongoing efforts, a recent review led by ACTRIMS provides specific guidance on diagnosing MS in individuals under 18 and adults over 50. Developed by an international team of 19 MS experts from North America, Europe, and Latin America, the comprehensive review—published in 

—addresses the unique challenges of diagnosing MS in these age groups, where presentations can be atypical. The article includes detailed figures and tables highlighting frequently encountered MS mimics, as well as clinical and imaging red flags that may suggest an alternative diagnosis.

ACTRIMS noted that these new guidelines serve as a key supplement to the 2024 revision of the McDonald criteria, which was presented at the 

, held February 27 to March 1 in West Palm Beach, Florida, MS expert Solomon, a neurologist at the University of Vermont (UVM) Medical Center, spoke with 

 about the significant work of the MS Differential Diagnosis Consortium. In the interview, Solomon, who also serves as a professor of neurological sciences at the Larner College of Medicine at UVM, discussed the persistent challenges of MS misdiagnosis, the limitations of current biomarkers, and the necessity of a structured diagnostic approach that carefully evaluates alternative conditions.

REFERENCES
1. Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Outlines Guidance for Diagnosing Pediatric and Late-Onset Multiple Sclerosis. News Release. ACTRIMS. Published September 26, 2024. Accessed March 20, 2025. https://actrims.memberclicks.net/assets/2024/JAMA%20Neuro_Differential%20Diagnosis_Final_Sept%2016%2C%202024.pdf
2. Solomon AJ, Arrambide G, Brownlee WJ, et al. Differential diagnosis of suspected multiple sclerosis: an updated consensus approach. Lancet Neurol. 2023;22(8):750-768. doi:10.1016/S1474-4422(23)00148-5
3. Hua LH, Solomon AJ, Tenembaum S, et al. Differential Diagnosis of Suspected Multiple Sclerosis in Pediatric and Late-Onset Populations: A Review. JAMA Neurol. Published online September 16, 2024. doi:10.1001/jamaneurol.2024.3062
4. Amezcua L, Rotstein D, Shirani A, et al. Differential diagnosis of suspected multiple sclerosis: considerations in people from minority ethnic and racial backgrounds in North America, northern Europe, and Australasia. Lancet Neurol. 2024;23(10):1050-1062. doi:10.1016/S1474-4422(24)00288-6
5. Correale J, Solomon AJ, Cohen JA, et al. Differential diagnosis of suspected multiple sclerosis: global health considerations. Lancet Neurol. 2024;23(10):1035-1049. doi:10.1016/S1474-4422(24)00256-4

The professor of neurological sciences at the University of Vermont discussed the work of the MS Differential Diagnosis Consortium, highlighting efforts to refine MS differential diagnosis and improve clinical accuracy. [WATCH TIME: 8 minutes]

The medical director of the Barlo Multiple Sclerosis Program at St Michaels Hospital discussed findings from phase 3 trials suggesting that baseline PRLs can predict disability accumulation and may serve as biomarkers for treatment response to tolebrutinib. 

Using Baseline Paramagnetic Rim Lesion Count as Prognostic and Treatment Biomarkers in Multiple Sclerosis: Jiwon Oh, MD, PhD

“This finding has several clinical and clinical trial implications, particularly for trial design in the future. If we want to enrich clinical trial populations for people more likely to accumulate disability, ‘pearls’ could be considered as a measure to help with this—though, of course, these findings need to be validated.”

Tolebrutinib (Sanofi) is a highly selective, oral Bruton tyrosine kinase (BTK) inhibitor designed to target the BTK enzyme in immune cells, particularly B cells. Unlike other BTK inhibitors, it exhibits strong selectivity, minimizing off-target effects and reducing central nervous system-related adverse events. Its irreversible binding mechanism allows it to permanently attach to the BTK enzyme, potentially offering sustained therapeutic benefits and a lower risk of relapse in multiple sclerosis (MS). Recent research has further highlighted tolebrutinib's potential, particularly in patients with MS who have a higher burden of paramagnetic rim lesions (PRLs).

, including the HERCULES study (NCT04411641) and GEMINI 1 and 2 trials (NCT04410978; NCT04410991), suggested that the therapy is more effective in patients with higher PRL counts, demonstrating a significant reduction in disability progression.

 In HERCULES, tolebrutinib reduced the risk of 6-month confirmed disability worsening by 54% in those with at least 4 PRLs, whereas GEMINI participants experienced a 46%-49% risk reduction. These findings, presented by lead author 

, held February 27 to March 1, in West Palm Beach, Florida, underscored PRLs as potential biomarkers for treatment response.

, Oh, medical director at the Barlo Multiple Sclerosis Program, St. Michael’s Hospital, University of Toronto, further elaborated on the prognostic value of baseline PRLs in predicting disability accumulation. She talked about how the study demonstrated that a higher baseline PRL count was associated with increased disability risk and how that tolebrutinib’s effect was more pronounced in patients with greater PRL burdens. Furthermore, Oh emphasized that these findings suggest that PRLs may serve as both prognostic and predictive biomarkers, which could inform clinical trial design and personalized treatment approaches. However, she noted that further validation in additional trials may be needed before PRLs can be integrated into routine clinical decision-making.

REFERENCES
1. Oh J, Fox RJ, Arnold DL, et al. Paramagnetic Rim Lesions as a Prognostic and Predictive Biomarker in the Tolebrutinib Phase 3 Trials for Disability Outcomes. Presented at: 2025 ACTRIMS Forum; February 27-March 1; West Palm Beach, FL. ABSTRACT LB1.1.

The medical director of the Barlo Multiple Sclerosis Program at St Michaels Hospital discussed findings from phase 3 trials suggesting that baseline PRLs can predict disability accumulation and may serve as biomarkers for treatment response to tolebrutinib. [WATCH TIME: 6 minutes]

CMSC interim CEO Costello supported by Wilken and Trott

Replacing June Halper: What's Next for CMSC

The death of June Halper, long-time chief executive officer of the Consortium of Multiple Sclerosis Centers (CMSC), signified the beginning of a new era for the organization. Its board of governors and staff faced a momentous task: Who could replace the woman who had led the organization for over 30 years? In January 2025, they named Kathleen Costello to the role of interim CEO. She will be the first to tell you that she is not replacing Halper, “No one can fill those shoes. June was unique…. I have my own way of doing things…[including] a deep desire to continue her legacy, but also to continue to evolve the CMSC.” Costello began her career as a staff nurse at a community hospital then moved to an academic acute neurology unit and then to a specialized MS clinic. Through the clinic, she was introduced to and became involved with the CMSC and was a founding member of the International Organization of Multiple Sclerosis Nurses (IOMSN). She eventually took on leadership roles with both groups, serving on the CMSC board of governors and as president of the IOMSN. Her strong clinical background was an asset when she shifted into the realm of advocacy with a position at the National Multiple Sclerosis Society and then Can Do MS, where she was named chief operating officer in late 2022. It was this strong resume covering clinical care, advocacy, and leadership as well as familiarity with IOMSN and CMSC that made Costello the CMSC’s choice as it moved into its future. Costello was a thrilling choice for CMSC director Tina Trott. Jeff Wilken, CMSC president, says Costello is a “nice bridge between what was there before…and where we need to go in the future.” In this video, Costello comments on Halper's legacy, the transition, and her plans for the CMSC with commentary about her selection from Wilken and Trott.

Kathleen Costello discusses her new role as interim CEO of the CMSC. She has the support of Jeff Wilken, CMSC president, and Tina Trott, CMSC director.

Continuing the Vision of June Halper: What's Next for CMSC

The interim chief executive officer at the Consortium of Multiple Sclerosis Centers invites healthcare professionals to the Consortium’s annual meeting from May 28–31 in Phoenix, Arizona. 

What to Expect From the 2025 CMSC Annual Meeting: Kathleen Costello, CRNP, MSCN

The interim chief executive officer at the Consortium of Multiple Sclerosis Centers invites healthcare professionals to the Consortium’s annual meeting from May 28–31 in Phoenix, Arizona. [WATCH TIME: 2 minutes]

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