{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:52:51Z","timestamp":1791301971109,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to investigate the ability of patient\u2010reported\/administered outcomes to capture disability worsening and progression independent of relapse activity (PIRA) in multiple sclerosis (MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included patients from the longitudinal multicenter MS PATHS cohort with \u22653 assessments and &gt;6\u2009months follow\u2010up. PIRA was defined on the patient\u2010determined disease steps (PDDS) and self\u2010administered tests assessing walking speed, manual dexterity, and processing speed, in the absence of self\u2010reported relapses. We assessed (i) prevalence of PDDS\/self\u2010administered test\u2010based disability worsening and PIRA definitions; (ii) their concurrent validity, through the association with worsening and PIRA definitions based on the expanded disability status scale (EDSS; Barcelona subcohort); and (iii) their clinical meaningfulness, through the correlation with brain magnetic resonance imaging (MRI) and quality\u2010of\u2010life (QoL) data trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 9,088 patients (73% female patients; age\u2009=\u200946.8\u2009years; disease duration\u2009=\u200914.2\u2009years). Over a 3\u2010year follow\u2010up, 4,066 (45%) patients worsened on \u22651 patient\u2010reported\/administered outcome, of which 2,357 (58%) developed PIRA. In the Barcelona subcohort (N\u2009=\u2009279), 68 (24%) patients developed EDSS\u2010based worsening, of which 30 (44%) developed EDSS\u2010based PIRA; 99 of 279 (35%) worsened on \u22651 patient\u2010reported\/administered test, of which 78 of 99 (79%) had PIRA. Worsening (but not PIRA) on PDDS was associated with EDSS\u2010based worsening (odds ratio\u2009=\u20093.03 [1.42; 6.43],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). PDDS\/self\u2010administered\u2010test\u2010based worsening or PIRA strongly correlated with accelerated brain atrophy and T2 lesion volume increase compared to non\u2010worseners (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and showed worse QoL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Despite only partial agreement with EDSS\u2010based definitions, PDDS\/self\u2010administered test\u2010based worsening and PIRA definitions were clinically meaningful, by identifying patients with greater brain damage and poorer QoL, supporting their use in clinical practice. ANN NEUROL 2026;100:525\u2013546<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78275","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:26:09Z","timestamp":1783333569000},"page":"525-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing Progression Independent of Relapse Activity in Multiple Sclerosis Using a Patient\u2010Reported Disability Measure and Self\u2010Administered Neuroperformance Outcomes"],"prefix":"10.1002","volume":"100","author":[{"given":"Evy M.","family":"Reinders","sequence":"first","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Masot\u2010Llima","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Otero\u2010Romero","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Department of Preventive Medicine and Epidemiology Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-8412","authenticated-orcid":false,"given":"Ren\u00e9","family":"Carvajal","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2574-0721","authenticated-orcid":false,"given":"\u00c1lvaro","family":"Cobo\u2010Calvo","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Carbonell\u2010Mirabent","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordina","family":"Beltran","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jes\u00fas","family":"Ar\u00e9valo","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Ari\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Arrambide","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Auger","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Department of Radiology (IDI) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3673-2030","authenticated-orcid":false,"given":"Luca","family":"Bollo","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Castill\u00f3","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2373-6657","authenticated-orcid":false,"given":"Manuel","family":"Comabella","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Gal\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Garc\u00eda\u2010Sarre\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Goodman","sequence":"additional","affiliation":[{"name":"Neuroimmunology Unit, and Director of the Multiple Sclerosis Center at the University of Rochester  Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie M.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lou Ruvo Center for Brain Health  Las Vegas NV USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delon","family":"La Puma","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le H.","family":"Hua","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lou Ruvo Center for Brain Health  Las Vegas NV USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Midaglia","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0338-4797","authenticated-orcid":false,"given":"Neus","family":"Mongay\u2010Ochoa","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen M.","family":"Mowry","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Pappolla","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breog\u00e1n","family":"Rodr\u00edguez\u2010Acevedo","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"R\u00edo","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Tagliani","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Vidal\u2010Jordana","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-8505","authenticated-orcid":false,"given":"Andreu","family":"Vilaseca","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3860-5251","authenticated-orcid":false,"given":"Ana","family":"Zabalza","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7356-3769","authenticated-orcid":false,"given":"Deborah","family":"Pareto","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Department of Radiology (IDI) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Nos","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2504-6959","authenticated-orcid":false,"given":"Menno","family":"Schoonheim","sequence":"additional","affiliation":[{"name":"MS Center Amsterdam, Department of Anatomy and Neurosciences Vrije Universiteit Amsterdam, Amsterdam Neuroscience  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Strijbis","sequence":"additional","affiliation":[{"name":"MS Center Amsterdam, Department of Neurology Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1589-2254","authenticated-orcid":false,"given":"Jaume","family":"Sastre\u2010Garriga","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Tivarus","sequence":"additional","affiliation":[{"name":"Department of Imaging Sciences and Neuroscience University of Rochester Medical Center  Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8799-8202","authenticated-orcid":false,"given":"Tjalf","family":"Ziemssen","sequence":"additional","affiliation":[{"name":"Center of Clinical Neuroscience, Neurological Clinic University Hospital Carl Gustav Carus  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2132-6750","authenticated-orcid":false,"given":"\u00c0lex","family":"Rovira","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Department of Radiology (IDI) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Montalban","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Universitat de Vic\u2010Universitat Central de Catalunya (UVic\u2010UCC)  Vic Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Tintor\u00e9","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Universitat de Vic\u2010Universitat Central de Catalunya (UVic\u2010UCC)  Vic Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Tur","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2010 Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac016"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25463"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1568"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.4655"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac111"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.1025"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00289-7"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.3331"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.2565"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012690"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-37"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/135245859900500508"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16046"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-024-03871-1"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3791\/51318"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585251318516"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00632"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318258f744"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000062554.74615.4C"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1191\/1352458502ms845oa"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/122.5.871"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518808204"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517690821"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14162"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585211017013"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.01.043"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207664"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517709619"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.94.15"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585241273037"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585241264476"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585241256540"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213558"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14432"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.209890"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.5250"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207768"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-0108-0"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.27096"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae260"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12389-y"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16529"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.0495"}],"container-title":["Annals of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.78275","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ana.78275","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.78275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:00:12Z","timestamp":1791298812000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ana.78275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":44,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ana.78275"],"URL":"https:\/\/doi.org\/10.1002\/ana.78275","archive":["Portico"],"relation":{},"ISSN":["0364-5134","1531-8249"],"issn-type":[{"value":"0364-5134","type":"print"},{"value":"1531-8249","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"2025-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}