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Article History

Received: 22 October 2025

Revised: 11 December 2025

Accepted: 25 January 2026

First Online: 2 February 2026

Declarations

:

: M. Margoni reports grants and personal fees from Sanofi Genzyme, Merck Serono, Roche, Biogen, Amgen and Novartis. M. Gueye, A. Meani, E. Pagani, P. Valsasina L. Storelli have nothing to disclose. P. Preziosa eceived speaker honoraria from Roche, Biogen, Novartis, Merck, Bristol Myers Squibb, Genzyme, Horizon and Sanofi, he has received research support from Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla. L. Moiola received compensation for speaking activities, travel grant, and participation in advisory board from Biogen, Bristol-Myers Squibb, Novartis, Roche, Sanofi-Genzyme, Merck-Serono, Biogen, and Alexion. M.A. Rocca received consulting fees from Biogen, Bristol Myers Squibb, Roche; and speaker honoraria from Alexion, Biogen, Bristol Myers Squibb, Celgene, Horizon Therapeutics Italy, Merck Serono SpA, Mitsubishi-Tanabe Pharma, Neuraxpharm, Novartis, Roche, Sandoz, and Sanofi. 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 . 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, 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, 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.

: Approval was received from the institutional ethical standards committee (Protocol 46/INT/2020) on human experimentation of IRCCS Ospedale San Raffaele for any experiments using human subjects. Written informed consent was obtained from all subjects prior to study participation according to the Declaration of Helsinki.