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Article History

Received: 26 January 2026

Accepted: 6 August 2026

First Online: 19 August 2026

Declarations

Ethics approval and consent to participate: The study protocol was approved by the Ethics Committee of the Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar (Approval number: 2022-317-S-SR) and the Ethics Committee of North-western and Central Switzerland (EKNZ 2017 − 01451). All participants provided written informed consent prior to participation. The study was registered at ClinicalTrials.gov (NCT05635552).

Consent for publication: Not applicable.

Competing interests: TW, RG, IL, AR, ML, LR, BH, LS, HH, MW, and CS declare that they have no competing interests. FCO reports current research funding from the German Research Foundation (DFG; TRR418), the Hertie Foundation, the German ME/CFS Foundation, Novartis, and UCB, all unrelated to this project. She reports past fellowship support from the American Academy of Neurology and the National Multiple Sclerosis Society (until 2023), and past research funding from the German Neurological Society (DGN) and the DFG-TWAS program. FCO reports speaker honoraria from UCB and Novartis, and travel support from the Guthy-Jackson Charitable Foundation, the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), and the American Academy of Neurology. She serves as academic editor at DGNeurologie and Neurological Research & Practice, is a board member of the IMSVISUAL consortium, and co-chairs the Committee for Neuro-ophthalmology and Neuro-otology of the German Neurology Association. None of the authors is a member of the BMC Medicine Editorial Board.