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Cinzia Aurilia has received travel grants from Eli-Lilly, Teva and Pfizer, honoraria from Teva. Massimo Filippi is Editor-in-Chief of the\n                      Journal of Neurology\n                      ; has received compensation for consulting services and\/or speaking activities from Bayer, Biogen Idec, Merck-Serono, Novartis, Roche, Sanofi Genzyme, Takeda, and Teva; and receives research support from Biogen Idec, Merck-Serono, Novartis, Roche, Teva, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA). Alberto Doretti has received travel grants and honoraria from Eli Lilly, Zambon, Teva, Abbvie, Neopharmed Gentili, and Lundbeck. Florindo d\u2019Onofrio has received travel grants, honoraria as a speaker or for participating in advisory boards from Novartis, Teva, Neopharmed Gentili, Qbgroup srl, K link srl and Eli-Lilly. Roberta Messina received honoraria for speaker activities and for participating in advisory boards from Abbvie, Biomedia, Eli Lilly, Lundbeck, Organon, Pfizer and Teva. Angelo Ranieri has received honoraria for speaker activities and advisory boards, consulting, editorial contributions, and travel grants from Novartis, Teva, Eli-Lilly, VyvaMed Srl, CPM Srl, CTP SrlK link srl, Lundbeck, AIM Education Srl, and Momento Medico Srl. Paola Torelli has received travel grant and honoraria as a speaker or for participating in advisory boards from Teva, Eli Lilly, Allergan, Organon, Pfizer, Lundbeck, and Abbvie. Giovanna Viticchi has received honoraria for speaker activities and for participating in advisory boards from Eli-Lilly, AbbVie, Teva, and Boehringer Ingelheim. Gabriella Egeo ha received travel grants and honoraria from Eli-Lilly, TEVA, and Lundbeck. Cinzia Finocchi has received grants and honoraria from Abbvie, Eli Lilly, Orion, Organon, Lundbeck, Pfizer, and TEVA. Marco Bartolini has received honoraria for speaker activities from Lusofarmaco and Neopharmed. Paola Scatena, Rosario Vecchio, Luisa Vinciguerra, Francesco Baldisseri, Marco Russo, Carolina Cutrona, Massimo Autunno, Francesca Pistoia, Cecilia Camarda, Stefano Messina, Steno Rinalduzzi, Valeria Drago, Luigi Caputi, Monica Laura Bandettini di Poggio, Simone Quintana, Antonio Salerno, Giulia Fiorentini, Jesuely Spieckert de Souza, Fabrizio Di Stani, Stefano Bonassi, and Annamaria Porreca have no disclosures to declare.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with principles outlined in the Declaration of Helsinki. The study protocol received approval by Lazio Area 5 Review Board (No. 177\/SR\/24) and mutually recognized by other local Institutional Review Boards. All copyrighted scales used in this study (HIT-6, MIDAS, MIBS-4, ASC-12) were administered with appropriate permission from the respective copyright holders. Eligible participants provided informed consent to participate in the study and were subsequently enrolled.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}