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Pina Crim\u00ec has nothing to disclose. Giulio Spampinato has nothing to disclose. Erika Ferraro has nothing to disclose. Andrea Alecci has nothing to disclose. Salvatore Lo Fermo has nothing to disclose. Vincenzo Cimino has nothing to disclose. Mario Zappia has nothing to disclose. Francesco Patti is an Editorial Board member of\n                      Neurology and Therapy\n                      . Francesco Patti was not involved in the selection of peer reviewers for the manuscript nor in any of the subsequent editorial decisions. Francesco Patti has received honoraria for speaking activities from Almirall, Amgen, Bayer, Biogen, Merck Serono, Novartis, Roche, Sanofi, and Neuraxpharm; has served as an advisory board member for Amgen, Biogen, Merck Serono, Novartis, Roche, Sanofi, and Neuraxpharm; has received funding from Pfizer and FISM for epidemiological studies; and has received grants for congress participation from Almirall, Biogen, Merck Serono, Novartis, Roche, Sanofi, and TEVA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol was reviewed and approved by the Ethics Committee Catania 1, Italy (PO\/891\/2025). The study was conducted in accordance with the principles of the Declaration of Helsinki and its subsequent amendments. All participants provided written informed consent prior to any study-related procedures.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}