Evidence map›Paper›PMID 42533190›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026

Comorbidities in multiple sclerosis: acquired hepatocerebral degeneration mimicking disease progression.

Maximilian Einsiedler, Alexandros Polymeris, Nikolaos Raptis, Anika Beyer, Denise Becker, Lisette Krassenburg, Isabelle Panne, Mustafa Ahmed Mahmutoglu, Johanna Maria Lieb, Stephan Rüegg and 2 more

Abstract readCase Reports
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In one paragraph

Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Maximilian EinsiedlerMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland. maximilian.einsiedler@usb.ch.ORCID http://orcid.org/0000-0002-0786-2872
Alexandros PolymerisMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
Nikolaos RaptisMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
Anika BeyerMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
Denise BeckerMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
Lisette KrassenburgDepartment of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland.
Isabelle PanneDepartment of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland.
Mustafa Ahmed MahmutogluDivision of Diagnostic and Interventional Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Johanna Maria LiebDivision of Diagnostic and Interventional Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Stephan RüeggMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
Tobias DerfussMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
Jens KuhleMultiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Petersgraben 4, Basel, CH-4031, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 63-year-old patient with relapsing-remitting multiple sclerosis (MS) and comorbid liver cirrhosis presented with progressive cognitive decline, gait disturbance and elevated serum neurofilament light chain (NfL), suggesting disease progression independent of relapse activity (PIRA). Development of acute hepatic encephalopathy led to reconsideration of the cause of previous clinical worsening and MRI revealed progressive basal ganglia manganese accumulation, establishing the diagnosis of acquired hepatocerebral degeneration, retrospectively challenging the PIRA diagnosis. Careful evaluation of comorbidities is warranted in older MS patients, as progressive worsening and high NfL may indicate alternative etiologies, particularly if GFAP (glial fibrillary acidic protein) stays within normal range.

Indexed as

Hepatolenticular DegenerationMultiple Sclerosis, Relapsing-RemittingComorbidityDiagnosis, DifferentialDisease ProgressionHumansMagnetic Resonance ImagingMiddle AgedGlial fibrillary acidic proteinHepatic encephalopathyHepatocerebral degenerationNeurofilament light chainProgression independent of relapse activity

Identifiers

PMID42533190
PMCPMC13423982

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.