Sal Napoli MD

One potential drawback of using kappa free light chain index rather than oligoclonal bands for the diagnosis of multiple sclerosis: It declines with age (r=-0.334, p < 0.001) and could be less accurate in older people, though it's highly accurate overall link.springer.com/article/10.100…

2024 updated multiple sclerosis diagnostic criteria in visual form. pubmed.ncbi.nlm.nih.gov/41520421/

Wang/Martin: EBV infection of B cells modifies the peptidome, resulting in presentation of myelin basic protein (MBP) peptides to CD4+ T cells. CD4+ T cells reactive to the B cell-derived MBP peptides were much higher in MS patients cell.com/cell/fulltext/…

Nearly all Alzheimer’s, and half of dementia, is driven by APOE. A new, large-scale analysis reports that up to 93% of Alzheimer’s cases and 85% of brain amyloid burden are attributable to having an APOE ε3/ε4 genotype, and the combined contribution of ε3 and ε4 to all-cause dementia is roughly 46%. The authors estimate that without the strong underlying risks conferred by APOE ε3 and ε4, almost all Alzheimer’s disease and about half of all dementia cases would not occur. APOE is a risk factor, not an absolute determinant—many people with ε4 never develop Alzheimer’s and many without it do. Still, the scale of these estimates makes it clear that APOE biology is a dominant driver of Alzheimer’s risk at the population level.

Our ancestors didn’t wait for opportunity — they created it. With no shortcuts, no guarantees, and no safety nets. Their bakeries, delis, butcher shops, and family businesses weren’t just places to make a living… they were places that gave neighborhoods a heartbeat. Every storefront told a story of sacrifice, grit, and pride in putting your name on something you believed in. That’s the Italian American spirit. Day 10 🇮🇹🇺🇸

Management of Monoclonal Gammopathy of Undetermined Significance. In low-risk patients who are younger than 50 years of age, bone marrow biopsy and imaging may be considered a baseline evaluation, given the anticipated life expectancy. Learn more: nej.md/473uOsj

Disease reactivation occurred after 40.5 months from only two ocrelizumab courses in 6/19 (32%) participants with #MultipleSclerosis vs 0/52 propensity-score-matched participants with continued treatment. Results of two open-label trials @JohnsHopkins ▶️ journals.sagepub.com/doi/abs/10.117…

St. Francis of Assisi says: “We must be simple, charitable, humble, and pure.” When we live in such a way, we are instruments of the Lord’s peace and reflect his image to others. With God’s grace, may we walk in the footsteps of Francis today and always.

"Start by doing what's necessary; then do what's possible; and suddenly you are doing the impossible." -St. Francis of Assisi on his feast day

Paramagnetic rim lesions (PRLs) [dark lesions on SWI sequences in multiple sclerosis] appear to be a phenomenon associated with relatively newer lesions. In this study, PRLs were only present in lesions formed within the last 5 years. pubmed.ncbi.nlm.nih.gov/41019415/

However great the work that God may achieve by an individual, he must not indulge in self-satisfaction. He ought rather to be all the more humbled, seeing himself merely as a tool which God has made use of. - Saint Vincent de Paul ⚜️

Late Breaking #ECTRIMS2025. Prof Giovannoni presents the first study demonstrating the benefit of a DMT (ocrelizumab) in pwMS who are EDSS > 6.5

Dalla Costa: #MS patients with highest ultra-processed food #UPF intake quartile experienced about 30% more relapses over five years compared to those with the lowest intake. High #UPF intake? More active MRI lesions. #DietMatters #ECTRIMS2025

Trial assessing A2AR antagonist treatment on glial activation using PET imaging #ectrims2025

Effects of glial activation in MS #ectrims2025

Higher density of activated microglia have greater TSPO presence . PET ligand binds to TSPO #ectrims2025

PET imaging can detect hidden pathology within and at edge of white matter lesions and NAWM #ectrims2025

SEL’s slowly expanding lesions can predict progression over time and can be detected on conventional MRI #ectrims2025

PRL’s rarely seen in non MS conditions

SWI can detect paramagnetic rim lesions #ectrims2025