{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:38:01Z","timestamp":1782139081811,"version":"3.54.5"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2025,6]]},"DOI":"10.1007\/s00415-025-13134-9","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T14:08:25Z","timestamp":1746886105000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Safety and efficacy of teriflunomide on clinical course, and laboratory findings in patients with HTLV-1-associated myelopathy\/tropical spastic paraparesis: a triple-blind study"],"prefix":"10.1007","volume":"272","author":[{"given":"Neda Ghadiri","family":"Jozan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohreh","family":"Vahidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houshang","family":"Rafatpanah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Boostani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fariba","family":"Zemorshidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadali","family":"Sahraian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamshid","family":"Tabeshpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdieh","family":"Baghaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8373-6053","authenticated-orcid":false,"given":"Mohammadali","family":"Nahayati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"issue":"12","key":"13134_CR1","doi-asserted-by":"publisher","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","volume":"77","author":"BJ Poiesz","year":"1980","unstructured":"Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC (1980) Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Natl Acad Sci 77(12):7415\u20137419","journal-title":"Proc Natl Acad Sci"},{"issue":"1","key":"13134_CR2","doi-asserted-by":"publisher","first-page":"7659","DOI":"10.1038\/s41598-023-34757-w","volume":"13","author":"D Schor","year":"2023","unstructured":"Schor D, Porto LC, Roma EH, Castro-Alves J, Villela AP, Ara\u00fajo AQC et al (2023) Putative role of HLA polymorphism among a Brazilian HTLV-1-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) population. Sci Rep 13(1):7659","journal-title":"Sci Rep"},{"key":"13134_CR3","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2012.00388","author":"A Gessain","year":"2012","unstructured":"Gessain A, Cassar O (2012) Epidemiological aspects and world distribution of HTLV-1 infection. Front Microbiol. https:\/\/doi.org\/10.3389\/fmicb.2012.00388","journal-title":"Front Microbiol"},{"key":"13134_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2016.10.015","author":"L Willems","year":"2017","unstructured":"Willems L, Hasegawa H, Accolla R, Bangham C, Bazarbachi A, Bertazzoni U et al (2017) Reducing the global burden of HTLV-1 infection: An agenda for research and action. Antiviral Res. https:\/\/doi.org\/10.1016\/j.antiviral.2016.10.015","journal-title":"Antiviral Res"},{"issue":"2","key":"13134_CR5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/s11908-014-0459-0","volume":"17","author":"AQC Araujo","year":"2015","unstructured":"Araujo AQC (2015) Update on neurological manifestations of HTLV-1 infection. Curr Infect Dis Rep 17(2):6","journal-title":"Curr Infect Dis Rep"},{"issue":"1","key":"13134_CR6","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/S0736-4679(99)00173-0","volume":"18","author":"RF Edlich","year":"2000","unstructured":"Edlich RF, Arnette JA, Williams FM (2000) Global epidemic of human T-cell lymphotropic virus type-I (HTLV-I). J Emerg Med 18(1):109\u2013119","journal-title":"J Emerg Med"},{"issue":"1","key":"13134_CR7","first-page":"1","volume":"1","author":"CRM Bangham","year":"2015","unstructured":"Bangham CRM, Araujo A, Yamano Y, Taylor GP (2015) HTLV-1-associated myelopathy\/tropical spastic paraparesis. Nat Rev Dis Primers 1(1):1\u201316","journal-title":"Nat Rev Dis Primers"},{"issue":"3","key":"13134_CR8","doi-asserted-by":"publisher","first-page":"e820","DOI":"10.1093\/cid\/ciac614","volume":"76","author":"MR Talukder","year":"2023","unstructured":"Talukder MR, Woodman R, Pham H, Wilson K, Gessain A, Kaldor J et al (2023) High human T-Cell leukemia virus type 1c proviral loads are associated with diabetes and chronic kidney disease: results of a cross-sectional community survey in central australia. Clin Infect Dis 76(3):e820\u2013e826","journal-title":"Clin Infect Dis"},{"issue":"5","key":"13134_CR9","doi-asserted-by":"publisher","first-page":"565","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_388_22","volume":"65","author":"M Kamrani","year":"2023","unstructured":"Kamrani M, Rad NN, Zemorshidi F, Khadem-Rezaiyan M (2023) Prevalence of sexual dysfunction in HTLV-1 patients without spastic paraparesis and the association with psychiatric symptoms. Indian J Psychiatry 65(5):565\u2013571","journal-title":"Indian J Psychiatry"},{"key":"13134_CR10","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2012.00389","author":"Y Yamano","year":"2012","unstructured":"Yamano Y, Sato T (2012) Clinical pathophysiology of human T-lymphotropic virus-type 1-associated myelopathy\/tropical spastic paraparesis. Front Microbiol. https:\/\/doi.org\/10.3389\/fmicb.2012.00389","journal-title":"Front Microbiol"},{"issue":"5","key":"13134_CR11","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1016\/j.urology.2007.01.052","volume":"69","author":"NM Castro","year":"2007","unstructured":"Castro NM, Rodrigues W Jr, Freitas DM, Muniz A, Oliveira P, Carvalho EM (2007) Urinary symptoms associated with human T-cell lymphotropic virus type I infection: evidence of urinary manifestations in large group of HTLV-I carriers. Urology 69(5):813\u2013818","journal-title":"Urology"},{"issue":"3","key":"13134_CR12","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.neurol.2011.12.006","volume":"168","author":"A Gessain","year":"2012","unstructured":"Gessain A, Mahieux R (2012) Tropical spastic paraparesis and HTLV-1 associated myelopathy: clinical, epidemiological, virological and therapeutic aspects. Rev Neurol (Paris) 168(3):257\u2013269","journal-title":"Rev Neurol (Paris)"},{"issue":"490","key":"13134_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1126\/scitranslmed.aao5563","volume":"11","author":"L Klotz","year":"2019","unstructured":"Klotz L, Eschborn M, Lindner M, Liebmann M, Herold M, Janoschka C et al (2019) Teriflunomide treatment for multiple sclerosis modulates T cell mitochondrial respiration with affinity-dependent effects. Sci Transl Med 11(490):1\u201317","journal-title":"Sci Transl Med"},{"key":"13134_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2014.06.00","author":"A Bar-Or","year":"2014","unstructured":"Bar-Or A (2014) Teriflunomide (Aubagio\u00ae) for the treatment of multiple sclerosis. Exp Neurol. https:\/\/doi.org\/10.1016\/j.expneurol.2014.06.00","journal-title":"Exp Neurol"},{"issue":"5","key":"13134_CR15","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1177\/1756285614546855","volume":"7","author":"J Oh","year":"2014","unstructured":"Oh J, O\u2019Connor PW (2014) Teriflunomide in the treatment of multiple sclerosis: current evidence and future prospects. Ther Adv Neurol Disord 7(5):239\u2013252","journal-title":"Ther Adv Neurol Disord"},{"issue":"5","key":"13134_CR16","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1189\/jlb.0504308","volume":"76","author":"T Korn","year":"2004","unstructured":"Korn T, Magnus T, Toyka K, Jung S (2004) Modulation of effector cell functions in experimental autoimmune encephalomyelitis by leflunomide\u2013mechanisms independent of pyrimidine depletion. J Leukoc Biol 76(5):950\u2013960","journal-title":"J Leukoc Biol"},{"issue":"27","key":"13134_CR17","doi-asserted-by":"publisher","first-page":"44266","DOI":"10.18632\/oncotarget.17863","volume":"8","author":"A Bilger","year":"2017","unstructured":"Bilger A, Plowshay J, Ma S, Nawandar D, Barlow EA, Romero-Masters JC et al (2017) Leflunomide\/teriflunomide inhibit Epstein-Barr virus (EBV)- induced lymphoproliferative disease and lytic viral replication. Oncotarget 8(27):44266\u201344280","journal-title":"Oncotarget"},{"key":"13134_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.crphar.2021.100055","author":"AM Rabie","year":"2021","unstructured":"Rabie AM (2021) Teriflunomide: A possible effective drug for the comprehensive treatment of COVID-19. Curr Res Pharmacol Drug Discov. https:\/\/doi.org\/10.1016\/j.crphar.2021.100055","journal-title":"Curr Res Pharmacol Drug Discov."},{"key":"13134_CR19","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000986","author":"Y Enose-Akahata","year":"2021","unstructured":"Enose-Akahata Y, Ngouth N, Ohayon J, Mandel M, Chavin J, Turner TJ et al (2021) Effect of teriflunomide on cells from patients with human T-cell lymphotropic virus type 1-associated neurologic disease. Neurol Neuroimmunol Neuroinflamm. https:\/\/doi.org\/10.1212\/NXI.0000000000000986","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"issue":"8","key":"13134_CR20","doi-asserted-by":"publisher","first-page":"3114","DOI":"10.1093\/brain\/awad229","volume":"146","author":"NWS Davies","year":"2023","unstructured":"Davies NWS, Taylor GP (2023) Targeted immunotherapy for HTLV-1-associated myelopathy: a step in the right direction. Brain 146(8):3114\u20133116","journal-title":"Brain"},{"issue":"5","key":"13134_CR21","doi-asserted-by":"publisher","DOI":"10.1002\/cti2.1451","volume":"12","author":"OG Thomas","year":"2023","unstructured":"Thomas OG, Rickinson A, Palendira U (2023) Epstein-Barr virus and multiple sclerosis: moving from questions of association to questions of mechanism. Clin Transl Immunology 12(5):e1451","journal-title":"Clin Transl Immunology"},{"key":"13134_CR22","unstructured":"Organization WH. 1989 Virus diseases: Human T lymphotropic virus type I, HTLV-I. Weekly Epidemiological Record= Relev\u00e9 \u00e9pid\u00e9miologique hebdomadaire.. 64(49):382\u20133"},{"issue":"16","key":"13134_CR23","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1212\/WNL.0b013e31828cf7f3","volume":"80","author":"J Hobart","year":"2013","unstructured":"Hobart J, Blight AR, Goodman A, Lynn F, Putzki N (2013) Timed 25-foot walk. Neurology 80(16):1509\u20131517","journal-title":"Neurology"},{"issue":"1","key":"13134_CR24","first-page":"271","volume":"3","author":"M Osame","year":"1990","unstructured":"Osame M (1990) HTLV-I-associated myelopathy (HAM), treatment trials, retrospective survey and clinical laboratory findings. Hematol Rev 3(1):271\u2013284","journal-title":"Hematol Rev"},{"issue":"4","key":"13134_CR25","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1212\/WNL.46.4.1016","volume":"46","author":"S Izumo","year":"1996","unstructured":"Izumo S, Goto I, Itoyama Y, Okajima T, Watanabe S, Kuroda Y et al (1996) Interferon-alpha is effective in HTLV-I-associated myelopathy: a multicenter, randomized, double-blind, controlled trial. Neurology 46(4):1016\u20131021","journal-title":"Neurology"},{"issue":"8","key":"13134_CR26","doi-asserted-by":"publisher","first-page":"665","DOI":"10.2340\/16501977-0235","volume":"40","author":"T Paternostro-Sluga","year":"2008","unstructured":"Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuhfried O, Vacariu G, Mittermaier C et al (2008) Reliability and validity of the medical research council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med 40(8):665\u2013671","journal-title":"J Rehabil Med"},{"issue":"2","key":"13134_CR27","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","volume":"67","author":"RW Bohannon","year":"1987","unstructured":"Bohannon RW, Smith MB (1987) Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther 67(2):206\u2013207","journal-title":"Phys Ther"},{"issue":"23","key":"13134_CR28","first-page":"2776","volume":"131","author":"W Qiu","year":"2018","unstructured":"Qiu W, Huang DH, Hou SF, Zhang MN, Jin T, Dong HQ et al (2018) Efficacy and Safety of teriflunomide in chinese patients with relapsing forms of multiple sclerosis: a subgroup analysis of the phase 3 tower study. Chin Med J (Engl) 131(23):2776\u20132784","journal-title":"Chin Med J (Engl)"},{"issue":"6","key":"13134_CR29","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1056\/NEJMoa1704827","volume":"378","author":"T Sato","year":"2018","unstructured":"Sato T, Coler-Reilly ALG, Yagishita N, Araya N, Inoue E, Furuta R et al (2018) Mogamulizumab (Anti-CCR4) in HTLV-1-associated myelopathy. N Engl J Med 378(6):529\u2013538","journal-title":"N Engl J Med"},{"issue":"3","key":"13134_CR30","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jcv.2011.07.004","volume":"52","author":"H Rafatpanah","year":"2011","unstructured":"Rafatpanah H, Hedayati-Moghaddam MR, Fathimoghadam F, Bidkhori HR, Shamsian SK, Ahmadi S et al (2011) High prevalence of HTLV-I infection in Mashhad, Northeast Iran: a population-based seroepidemiology survey. J Clin Virol 52(3):172\u2013176","journal-title":"J Clin Virol"},{"issue":"17","key":"13134_CR31","doi-asserted-by":"publisher","first-page":"9716","DOI":"10.1128\/JVI.77.17.9716-9722.2003","volume":"77","author":"PK Goon","year":"2003","unstructured":"Goon PK, Igakura T, Hanon E, Mosley AJ, Asquith B, Gould KG et al (2003) High circulating frequencies of tumor necrosis factor alpha- and interleukin-2-secreting human T-lymphotropic virus type 1 (HTLV-1)-specific CD4+ T cells in patients with HTLV-1-associated neurological disease. J Virol 77(17):9716\u20139722","journal-title":"J Virol"},{"key":"13134_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2018.09.009","author":"M Guerra","year":"2018","unstructured":"Guerra M, Luna T, Souza A, Amorim C, Carvalho NB, Carvalho L et al (2018) Local and systemic production of proinflammatory chemokines in the pathogenesis of HAM\/TSP. Cell Immunol. https:\/\/doi.org\/10.1016\/j.cellimm.2018.09.009","journal-title":"Cell Immunol"},{"key":"13134_CR33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.09.012","author":"AE Miller","year":"2019","unstructured":"Miller AE, Xu X, Macdonell R, Vucic S, Truffinet P, Benamor M et al (2019) Efficacy and safety of teriflunomide in Asian patients with relapsing forms of multiple sclerosis: a subgroup analysis of the phase 3 TOWER study. J Clin Neurosci. https:\/\/doi.org\/10.1016\/j.jocn.2018.09.012","journal-title":"J Clin Neurosci"},{"key":"13134_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2020.107669","author":"J Yamauchi","year":"2021","unstructured":"Yamauchi J, Araya N, Yagishita N, Sato T, Yamano Y (2021) An update on human T-cell leukemia virus type I (HTLV-1)-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) focusing on clinical and laboratory biomarkers. Pharmacol Ther. https:\/\/doi.org\/10.1016\/j.pharmthera.2020.107669","journal-title":"Pharmacol Ther"},{"issue":"5","key":"13134_CR35","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1158\/1078-0432.CCR-09-2697","volume":"16","author":"T Ishii","year":"2010","unstructured":"Ishii T, Ishida T, Utsunomiya A, Inagaki A, Yano H, Komatsu H et al (2010) Defucosylated humanized anti-CCR4 monoclonal antibody KW-0761 as a novel immunotherapeutic agent for adult T-cell leukemia\/lymphoma. Clin Cancer Res 16(5):1520\u20131531","journal-title":"Clin Cancer Res"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-13134-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-025-13134-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-025-13134-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T14:50:18Z","timestamp":1751554218000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-025-13134-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,10]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["13134"],"URL":"https:\/\/doi.org\/10.1007\/s00415-025-13134-9","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,10]]},"assertion":[{"value":"11 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2025","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"ORCiD number for Mohammadali Nahayati was incorrect and should be 0000-0001-8373-6053","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Conflicts of interestMohammadali Nahayati: has received educational and research grants, lecture honoraria, and travel supports to attend scientific meetings from Cinnagen, Zistdaru, Abidi, Merck-Sereno, Novartis, Nano alvand and Biogen-Idec. Mohammadali Sahraian: has received educational and research grants, lecture honoraria, and travel supports to attend scientific meetings from Abidi, Biogen-Idec, Merck-Serono, Bayer-Schering- Novartis, Cinnagen, Osveh, Zistdaru, Zahravi and Genzyme.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approval for the study protocol was obtained from the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.MEDICAL.REC.1399.441). Written informed consent was obtained and recorded in their medical records.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"386"}}