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Multiple Sclerosis: Recent Advances in Clinical Diagnosis and Treatment
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Multiple Sclerosis: Recent Advances in Clinical Diagnosis and Treatment

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (31 January 2026) | Viewed by 2311

Special Issue Editors

Dr. Vasileios Giannopapas

E-Mail Website
Guest Editor
Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
Interests: neurorehabilitation; neurology; neurogenic bladder; sexual dysfunction; neuroplasticity; cardiovascular comorbidities; neuromodulation; physical therapy
Dr. John Tzartos

E-Mail Website
Guest Editor
Second Department of Neurology ‘’Attikon’’ University Hospital, School of Medicine, National & Kapodistrian University of Athens, 12462 Athens, Greece
Interests: neurology; neuro-immunology; demyelinating conditions; auto-immune conditions of the CNS; stroke
Prof. Dr. Sotirios Giannopoulos

E-Mail Website
Guest Editor
Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University Hospital, 12462 Athens, Greece
Interests: neurology; neuro-immunology; demyelinating conditions; auto-immune conditions of the CNS; stroke; cardiovascular

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the latest advancements in the diagnosis, treatment, and comprehensive management of multiple sclerosis (MS). In light of recent advances in the diagnostic criteria for both MS and Clinically Isolated Syndrome (CIS), the issue aims to feature cutting-edge clinical studies and high-quality reviews that delve into the clinical implications of these evolving definitions. Articles will highlight the role of novel clinical and biological biomarkers in facilitating early detection and more precise evaluation of disease activity and progression. A significant focus will also be placed on the expanding array of disease-modifying therapies (DMTs), exploring both their efficacy and safety across different MS phenotypes. In addition, the issue will emphasize the growing role of evidence-based complementary therapies, including cannabinoids, as adjuncts to conventional treatments. The multidisciplinary management of MS-related symptoms—such as fatigue, neurogenic bladder, sexual dysfunction, and cognitive impairment—will be addressed through advances in physical therapy and rehabilitation, cognitive rehabilitation, and other holistic interventions. By integrating research across these domains, this Special Issue aims to provide clinicians and researchers with a comprehensive understanding of the latest strategies in improving outcomes and quality of life for individuals living with MS.

Dr. Vasileios Giannopapas
Dr. John Tzartos
Prof. Dr. Sotirios Giannopoulos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multiple sclerosis
  • demyelination
  • diagnostic criteria
  • treatment
  • disease-modifying therapies
  • comorbidities
  • rehabilitation
  • management

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Published Papers (3 papers)

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Research

16 pages, 3145 KB  
Article
Benefits of a Perceived High-Intensity Exercise Program with Immersive Virtual Reality Combined with Usual Rehabilitation in Multiple Sclerosis: Exploratory Study
by Pablo Campo-Prieto, Inés González-Suárez, José Mª Cancela-Carral and Gustavo Rodríguez-Fuentes
Medicina 2026, 62(5), 968; https://doi.org/10.3390/medicina62050968 - 15 May 2026
Viewed by 461
Abstract
Background and Objectives: Multiple sclerosis (MS) is characterized by progressive disability and a spectrum of motor and cognitive impairments. Exergames and virtual reality (VR) are proposed as motivating exercise tools, potentially useful for improving adherence and expanding access to rehabilitation. The objectives [...] Read more.
Background and Objectives: Multiple sclerosis (MS) is characterized by progressive disability and a spectrum of motor and cognitive impairments. Exergames and virtual reality (VR) are proposed as motivating exercise tools, potentially useful for improving adherence and expanding access to rehabilitation. The objectives are to explore the feasibility and safety of a supervised rehabilitation program based on a high-intensity exercise program with immersive virtual reality (IVR) in people with MS and to describe its effects on physical, cognitive, and functional domains, as well as on the serum biomarker neurofilament light chain (sNfL). Materials and Methods: Pre–post exploratory study in five volunteers from a local MS Association [Vigo, Spain]. Intervention: 8 weeks, two sessions/week, 10 min/session of an IVR boxing-based exergame combined with usual rehabilitation, supervised by a physiotherapist. The variables studied were safety (Simulator Sickness Questionnaire [SSQ]), usability (System Usability Scale [SUS]), disability (Expanded Disability Status Scale [EDSS]), gait (25-Foot Walk Test [25FWT]), manual dexterity (9 Hole Peg Test [9HPT]), cognition (Symbol Digit Modalities Test [SDMT]), and axonal damage biomarker (sNfL). Results: The intervention could be feasible and safe (100% adherence, no adverse events (without SSQ symptoms), 95% usability [SUS]). There were positive changes in all variables studied (mean ± SD): EDSS −0.5 ± 0.9; 25FWT −4.9 ± 9.8 s; right 9HPT −3.3 ± 0.9 s; sNfL −4.4 ± 4.5 pg/mL, except for left 9HPT +0.5 ± 5.0 s and cognition (SDMT −2.4 ± 1.3 points). Conclusions: A brief, supervised exercise program combing an IVR exergame with standard rehabilitation was feasible and safe in people with MS. Although the results seem promising with the proposed design, the clinical and biological changes are merely exploratory, and it is not possible to infer their efficacy. Our findings open the door to future controlled studies including perceived high-intensity exercise programs and larger sample sizes to explore efficacy and estimate clinically relevant effect sizes. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Recent Advances in Clinical Diagnosis and Treatment)
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12 pages, 489 KB  
Article
Hidden Challenges: A Cross-Sectional Study on Prevalence and Determinants of Sexual Dysfunction in Men and Women with Multiple Sclerosis
by Desirèe Latella, Fabio Mauro Giambò, Gianluca La Rosa, Lilla Bonanno and Rocco Salvatore Calabrò
Medicina 2026, 62(3), 522; https://doi.org/10.3390/medicina62030522 - 11 Mar 2026
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Abstract
Background and Objectives: Sexual dysfunction (SD) is common in multiple sclerosis (MS) but remains under-recognized in routine care. This study aimed to quantify the burden of SD in men and women with relapsing–remitting MS (RRMS), describe sex-stratified patterns across primary/secondary/tertiary domains, and examine [...] Read more.
Background and Objectives: Sexual dysfunction (SD) is common in multiple sclerosis (MS) but remains under-recognized in routine care. This study aimed to quantify the burden of SD in men and women with relapsing–remitting MS (RRMS), describe sex-stratified patterns across primary/secondary/tertiary domains, and examine associations with fatigue and MS-related health-related quality of life (HRQoL). Materials and Methods: In this cross-sectional observational study, RRMS participants were voluntarily recruited online via a QR code linking to a Google Forms survey. Men completed the International Index of Erectile Function-5 (IIEF-5), and women the Female Sexual Function Index (FSFI). MS-specific SD domains were assessed using the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ), alongside the Fatigue Severity Scale (FSS) and the Multiple Sclerosis Quality of Life questionnaire (MSQOL-54). Sex differences were tested using parametric/non-parametric methods as appropriate, with false discovery rate (FDR) and Bonferroni adjustments for multiple comparisons. Results: Thirty-seven participants were included (16 men; 21 women). Mean age did not differ by sex (35.9 ± 4.0 vs. 38.9 ± 10.4 years; p = 0.23). All participants reported at least some degree of difficulty across MSISQ domains. Among men, 87.5% screened positive for erectile dysfunction within this sample (mild 37.5%, mild-to-moderate 12.5%, moderate 12.5%, severe 25.0%). When dysfunction type was defined as the highest MSISQ domain score, secondary SD was most frequent in both sexes (75.0% men; 76.2% women; p = 0.49). Women showed higher secondary domain scores at the uncorrected level (p = 0.04), but this did not survive FDR correction. In HRQoL and symptom measures, women reported markedly higher fatigue (FSS 46.1 ± 12.4 vs. 25.5 ± 12.7; p_FDR < 0.001) and poorer physical health indices, including pain-related outcomes. Conclusions: SD has represented a substantial burden within this RRMS sample, with secondary domain predominance in both sexes, highlighting the clinical relevance of symptom-related and functional interference. These findings support the value of multidimensional sexual health assessment in clinical research settings and may be relevant for clinical assessment and future research in MS. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Recent Advances in Clinical Diagnosis and Treatment)
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14 pages, 329 KB  
Article
Clinical, Cognitive and Demographic Determinants of Work Participation in Multiple Sclerosis: A Multicenter Cross-Sectional Study
by Konstantina Stavrogianni, Dimitrios K. Kitsos, Evangelia-Makrina Dimitriadou, Alexandra Akrivaki, Athanasios K. Chasiotis, Pinelopi Vlotinou, George P. Paraskevas, Georgios Tsivgoulis, Daphne Bakalidou, Konstantinos Tsamis, Dimitrios Peschos, Vasileios Giannopapas, John S. Tzartos and Sotirios Giannopoulos
Medicina 2026, 62(3), 454; https://doi.org/10.3390/medicina62030454 - 27 Feb 2026
Viewed by 637
Abstract
Background and Objectives: Employment is a major determinant of quality of life in people with multiple sclerosis (pwMS). This multicenter cross-sectional study aimed to identify which commonly studied demographic, disease-related, clinical, cognitive, and psychological variables, alongside the presence of lower urinary tract [...] Read more.
Background and Objectives: Employment is a major determinant of quality of life in people with multiple sclerosis (pwMS). This multicenter cross-sectional study aimed to identify which commonly studied demographic, disease-related, clinical, cognitive, and psychological variables, alongside the presence of lower urinary tract symptoms (LUTS), predict employment status in pwMS. Materials and Methods: Seventy-eight pwMS were classified as either full-time employed (n = 41) or non-employed (n = 37). Participants underwent clinical and neuropsychological assessment including disability status (Expanded Disability Status Scale; EDSS), fatigue (Modified Fatigue Impact Scale; MFIS), information processing speed (Symbol Digit Modalities Test; SDMT), depressive symptoms (Hospital Anxiety and Depression Scale-Depression; HADS-D), and LUTS status (presence/absence), alongside demographic and disease-related variables (sex, age, education level, relationship status, and disease duration). Results: Hierarchical binary logistic regression indicated that higher information processing speed was associated with higher odds of employment (OR = 1.11, p = 0.008), whereas the presence of LUTS was associated with lower odds of employment (OR = 0.13, p = 0.026). Disability severity, fatigue, depressive symptoms, demographic characteristics, and disease duration did not contribute in the final model (p > 0.05). Conclusions: Information processing speed and urinary dysfunction were associated with employment status in pwMS. Within the present sample, the multivariable model including these variables showed good discrimination between employed and non-employed participants. The findings should be interpreted as exploratory, and they require further confirmation in independent cohorts before any potential application is considered. Full article
(This article belongs to the Special Issue Multiple Sclerosis: Recent Advances in Clinical Diagnosis and Treatment)
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