Document is current

Article History

Received: 11 August 2025

Revised: 8 October 2025

Accepted: 10 November 2025

First Online: 19 November 2025

Declarations

:

: The authors do not have any conflicts of interest in relation to this work. Potential conflicts of interest outside the submitted work are the following: N. Tedone, M. Grosselle, and D. Mistri have nothing to disclose. E. Portaccio reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, and educational events, participation on a data safety monitoring board or advisory board, and support for attending meetings or travel from Biogen, Merck Serono, Sanofi, Teva, Roche, BMS Celgene, Janssen, and Novartis. M.P. Amato reports grants from Roche, Merck, and Novartis and advisory board and speaker fees from Roche, Sanofi, Celgene, Bristol Myers Squibb, Merck, Novartis, Biogen, Sandoz, and Amgen, and serves on the editorial board of Multiple Sclerosis Journal and BMC Neurology . 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 Alexion, Almirall, Biogen, Merck, Novartis, Roche, and Sanofi, speaking activities from Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA, participation in advisory boards for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, and Takeda, scientific direction of educational events for Biogen, Merck, Roche, Celgene, Bristol-Myers Squibb, Lilly, Novartis, and Sanofi-Genzyme, 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. M.A. Rocca received consulting fees from Biogen, Bristol Myers Squibb, Eli Lilly, and Janssen, Roche and speaker honoraria from AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi,and Teva. She receives research support from the MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla. She is Associate Editor for Multiple Sclerosis and Related Disorders ; and Associate Co-Editor for Europe and Africa for Multiple Sclerosis Journal .

: Approval was obtained from the local ethical standards committee on human experimentation. Written informed consent was obtained from all subjects before participation in the study in accordance with the Declaration of Helsinki.