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Article History

Received: 9 April 2026

Accepted: 6 May 2026

First Online: 19 May 2026

Declarations

:

: This study was performed in line with the principles of the Declaration of Helsinki. The Ethics Committee of IRCCS San Raffaele Scientific Institute waived the need for ethics approval for publication of case reports.

: The patient provided written informed consent for the inclusion in the study.

: The patient provided informed consent for publication of the images in Fig.  , anonymized data, and clinical history.

: M. Filippi is Editor-in-Chief of the Journal of Neurology , Associate Editor of Human Brain Mapping , Neurological Sciences , and Radiology , received compensation for consulting services from Almirall, Biogen, Bristol-Myers Squibb, Eli Lilly, Merck, Novartis, Roche, Sanofi, speaking activities from Amgen, Bayer, Biogen, Bristol-Myers Squibb, Celgene, Chiesi Italia SpA, Eisai, Eli Lilly, Fujirebio, Genzyme, Janssen, Merck, Neopharmed Gentili, Neuraxpharm, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, participation in Advisory Boards for Alexion, Biogen, Bristol-Myers Squibb, Eli Lilly, GE Healthcare Ltd, Merck, Neuraxpharm, Novartis, Roche, Sandoz, Sanofi, Takeda, scientific direction of educational events for Biogen, Merck, Roche, Celgene, Bristol-Myers Squibb, Lilly, Novartis, Sanofi-Genzyme, he receives research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla; A. Ghirelli received speaker honoraria from Eli Lilly; G. Cecchetti has received speaker honoraria from Neopharmed Gentili and Eli Lilly; A.M. Samanes Gajate has nothing to disclose; G. Rugarli has nothing to disclose; E.G. Spinelli has nothing to disclose; S. Pisano has nothing to disclose; A. Panzacchi has nothing to disclose; G. Pepe has nothing to disclose; A. Chiti reports consulting or advisory role for Blue Earth Diagnostics, Telix Pharmaceuticals, InnovaRadi Therapeutic, and General Electric Healthcare; and Speaker’s Bureaus for Bracco Diagnostics, General Electric Healthcare, Novartis, Telix Pharmaceuticals, and United Imaging, he is Editor in Chief of The EANM Journal; F. Agosta is Associate Editor of NeuroImage: Clinical and the European Journal of Neurology , has received speaker honoraria from Biogen Idec, Bristol Myers Squibb, Eisai, Eli Lilly, GE Healthcare, Neuraxpharm, and Roche, and receives or has received research supports from the Italian Ministry of Health, the Italian Ministry of University and Research, AriSLA (Fondazione Italiana di Ricerca per la SLA), the European Research Council (ERC), the EU Joint Programme – Neurodegenerative Disease Research (JPND), and Foundation Research on Alzheimer Disease (France).