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Neurology International
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Advances in Multiple Sclerosis, Third Edition
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Advances in Multiple Sclerosis, Third Edition

A special issue of Neurology International (ISSN 2035-8377).

Deadline for manuscript submissions: 30 June 2026 | Viewed by 3266

Special Issue Editor

Dr. Marcello Moccia

E-Mail Website
Guest Editor
Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
Interests: multiple sclerosis; biomarkers; neurorehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, the management of multiple sclerosis (MS) and related disorders, including neuromyelitis optica spectrum disorder (NMOSD) and MOG-antibody-associated disease (MOGAD), has undergone a profound transformation, driven by advances in clinical research, neuroimaging, and biomarker discovery.

The updated 2024 McDonald diagnostic criteria now allow for earlier and more accurate diagnosis, integrating novel elements such as optic nerve involvement, CSF kappa free light chains (kFLCs), and advanced MRI markers, including the central vein sign and paramagnetic rim lesions. In particular, the possibility of diagnosing MS in patients with radiologically isolated syndrome (RIS) (when combined with biomarker evidence) has implications for treatment and, more generally, for preventative neurology.

At the same time, our understanding of disease progression is evolving. Traditional subtypes (RRMS, SPMS, PPMS) are increasingly viewed as points along a continuum of disease activity, rather than distinct entities. Recent AI-driven analyses suggest that MS should be described using dynamic features reflecting the biology of MS and its clinical expression, rather than fixed categories. This paradigm shift supports the use of a personalized, biology-based approach to treatment. Moreover, new biomarkers of progression are emerging as predictors of aggressive disease, enabling earlier identification of patients who may benefit from high-efficacy therapies. Integrating clinical assessment, biofluid biomarkers, and advanced MRI is now central to MS care.

We welcome reviews, original research, short communications, and case reports that provide new insights into the evolving landscape of MS and related disorders.

Dr. Marcello Moccia
Guest Editor

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. Neurology International 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 1800 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
  • clinical
  • treatment
  • cognition
  • biomarkers
  • neuroimmunology
  • neuroimaging

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Related Special Issues

Published Papers (3 papers)

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9 pages, 1635 KB  
Article
Central Vein Sign and Paramagnetic Rim Lesions in Patients with Relapsing–Remitting Multiple Sclerosis: An Assessment of Prevalence and Anatomical Location
by Marija Nikola Jansone, Nauris Zdanovskis, Elina Polunosika, Daina Pastare and Guntis Karelis
Neurol. Int. 2026, 18(5), 95; https://doi.org/10.3390/neurolint18050095 - 20 May 2026
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Abstract
Background/Objectives: Multiple sclerosis (MS) remains challenging to diagnose due to clinical and radiological overlap with mimicking conditions. The 2024 revisions of the McDonald criteria have incorporated the central vein sign (CVS) and paramagnetic rim lesions (PRLs) as magnetic resonance imaging (MRI) biomarkers to [...] Read more.
Background/Objectives: Multiple sclerosis (MS) remains challenging to diagnose due to clinical and radiological overlap with mimicking conditions. The 2024 revisions of the McDonald criteria have incorporated the central vein sign (CVS) and paramagnetic rim lesions (PRLs) as magnetic resonance imaging (MRI) biomarkers to improve diagnostic specificity. This study assessed the prevalence and anatomical distribution of CVS and PRLs in patients with relapsing–remitting MS (RRMS). Methods: This cross-sectional study included 91 patients with RRMS diagnosed according to the 2017 McDonald criteria. MRI scans were obtained using 3T scanners, and T2-FLAIR and susceptibility-weighted angiography (SWAN) sequences were analyzed. CVS and PRLs were identified using established criteria. Patients were stratified by lesion count (<5, 5–9, ≥10), and lesions were categorized by anatomical location. Descriptive statistics, chi-square tests, and multivariable logistic regression adjusted for covariates were performed. Results: CVS was present in 69.2% of patients, while PRLs were identified in 29.7%. Both markers were more frequent in patients with higher lesion burden in univariate analysis. CVS prevalence increased significantly with lesion count (p < 0.001) and remained an independent predictor in multivariable logistic regression. PRL presence was associated with lesion count in univariate analysis but not after adjustment. Most CVS- and PRL-positive lesions were supratentorial and predominantly periventricular. No significant association was observed between CVS and PRL presence. Conclusions: CVS is a highly prevalent MRI feature in RRMS and independently associated with lesion burden, supporting its role as a diagnostically relevant imaging marker. PRLs were less prevalent and showed weaker independent associations. Full article
(This article belongs to the Special Issue Advances in Multiple Sclerosis, Third Edition)
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17 pages, 8025 KB  
Article
Quantitative Analysis of Smooth Pursuit and Saccadic Eye Movements in Multiple Sclerosis
by Pavol Skacik, Lucia Kotulova, Ema Kantorova, Egon Kurca and Stefan Sivak
Neurol. Int. 2026, 18(2), 22; https://doi.org/10.3390/neurolint18020022 - 26 Jan 2026
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Abstract
Introduction: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system, frequently associated with visual and oculomotor disturbances. Quantitative analysis of eye movements represents a non-invasive method for assessing central nervous system dysfunction beyond conventional imaging; however, [...] Read more.
Introduction: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system, frequently associated with visual and oculomotor disturbances. Quantitative analysis of eye movements represents a non-invasive method for assessing central nervous system dysfunction beyond conventional imaging; however, the diagnostic and predictive value of oculomotor metrics remains insufficiently defined. Objectives: The aims of this study were to compare smooth pursuit gain and reflexive saccade parameters (latency, velocity, and precision) between individuals with MS and healthy controls, and to evaluate their ability to discriminate disease status. Methods: This cross-sectional study included 46 clinically stable patients with MS (EDSS ≤ 6.5) and 46 age- and sex-matched healthy controls. Oculomotor function was assessed using videonystagmography under standardized conditions. Group differences across horizontal and vertical gaze directions were analyzed using linear mixed-effects models. Random forest models were applied to assess the discriminative performance of oculomotor parameters, with permutation-based feature importance and receiver operating characteristic (ROC) curve analysis. Results: Patients with MS showed significantly reduced smooth pursuit gain across most horizontal and vertical directions compared with controls. Saccadic latency was significantly prolonged in all tested movement directions. Saccadic velocity exhibited selective directional impairment consistent with subtle medial longitudinal fasciculus involvement, whereas saccadic precision did not differ significantly between groups. A random forest model combining pursuit and saccadic parameters demonstrated only moderate discriminative performance between MS patients and controls (AUC = 0.694), with saccadic latency contributing most strongly to classification. Conclusions: Quantitative eye-movement assessment revealed widespread oculomotor abnormalities in MS, particularly reduced smooth pursuit gain and prolonged saccadic latency. Although the overall discriminative accuracy of oculomotor parameters was limited, these findings support their potential role as complementary markers of central nervous system dysfunction. Further longitudinal and multimodal studies are required to clarify their clinical relevance and prognostic value. Full article
(This article belongs to the Special Issue Advances in Multiple Sclerosis, Third Edition)
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Other

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18 pages, 713 KB  
Opinion
Multiple Sclerosis: An Ethnically Diverse Disease with Worldwide Equity Challenges Accessing Care
by Victor M. Rivera
Neurol. Int. 2026, 18(1), 2; https://doi.org/10.3390/neurolint18010002 - 22 Dec 2025
Cited by 4 | Viewed by 2005
Abstract
Multiple sclerosis (MS) affects approximately 2.9 million people in the world, exerting a significant economic and societal burden. The disease is increasingly identified among populations considered as uncommonly affected. MS is reported in all regions of the World Health Organization (WHO) member states [...] Read more.
Multiple sclerosis (MS) affects approximately 2.9 million people in the world, exerting a significant economic and societal burden. The disease is increasingly identified among populations considered as uncommonly affected. MS is reported in all regions of the World Health Organization (WHO) member states in Africa, the Americas, South-East Asia, Europe, the Eastern Mediterranean and the Western Pacific, affecting all ethnicities while exhibiting substantially variable prevalences. Countries with high MS prevalence and some with moderate frequencies generally have economically better structured healthcare systems. Nevertheless, health disparities in these countries are accentuated by suboptimal accessibility of care for their minorities, immigrants and other underserved populations. Social Determinants of Health (SDOH) might have an impact on morbidity and higher rates of disability. Large segments of the world population (i.e., African, Latin American, people from the Middle East and Southeast Asia) do not have access to adequate MS diagnostic procedures, compounded by reduced availability of neurologists. Healthcare disparities exist practically in every country of the world. Active wars and a large number of refugees resulting from conflict augments the challenges to healthcare systems. These global factors constitute obstacles to the adequate management of MS. A collective international path is required to facilitate access to highly effective, albeit onerous treatments, some already approved and being utilized, i.e., monoclonal antibodies and B-lymphocyte depletory agents, and others foreseen in the future as advanced therapeutic molecules continue to develop. Full article
(This article belongs to the Special Issue Advances in Multiple Sclerosis, Third Edition)
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