{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:59:35Z","timestamp":1778857175111,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Progressive multifocal leukoencephalopathy (PML), an opportunistic infection of the central nervous system from the John Cunningham virus (JCV), is a side effect of natalizumab (NTZ) treatment for relapsing\u2013remitting multiple sclerosis (RRMS), potentially leading to a substantial increase of physical and mental disability. Nevertheless, data of neuropsychological impairment during the NTZ\u2010PML disease course are missing. Our objective was to evaluate the neuropsychological disease course of NTZ\u2010PML patients and to compare neuropsychological deficits of NTZ\u2010PML patients with two different non\u2010PML multiple sclerosis (MS) cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Neuropsychological examinations of 28 NTZ\u2010PML patients performed during different phases of the disease ([i] at PML diagnosis, [ii] during immune reconstitution inflammatory syndrome [IRIS], and [iii] post\u2010IRIS\/PML) were retrospectively analyzed and compared to those of NTZ\u2010treated RRMS or secondary progressive MS patients with and without immunotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to controls, NTZ\u2010PML patients performed worse in neuropsychological examinations during all stages of disease, mainly affecting visuospatial ability and working memory. Furthermore, failure to eliminate the JCV from the central nervous system was associated with a progredient decline of cognition, especially working memory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Working memory and visuospatial abilities are the core neuropsychological deficits of NTZ\u2010PML patients in long\u2010term follow\u2010up. Our findings should be implemented in neurorehabilitation strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14604","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T17:51:47Z","timestamp":1603302707000},"page":"921-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Course of neuropsychological impairment during natalizumab\u2010associated progressive multifocal leukoencephalopathy"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-4164","authenticated-orcid":false,"given":"Markus","family":"Kinner","sequence":"first","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Prehn","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Kolb","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Hoepner","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"},{"name":"Department of Neurology Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andew","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Josef Hospital Ruhr University Bochum Bochum Germany"},{"name":"Department of Neurology Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/81.1.93"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051847"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044397"},{"key":"e_1_2_8_5_1","unstructured":"Biogen.Medical Information: TYSABRI\u00ae (natalizumab): PML in Patients Receiving TYSABRI (USA TYSABRI PML Update).https:\/\/www.tysabri.de\/de_de\/home\/dcsecure\/welcome.html(accessed 06\/03\/2019)."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-014-0289-8"},{"key":"e_1_2_8_7_1","first-page":"224","article-title":"Neuropsychological impairment in natalizumab\u2010associated progressive multifocal leukoencephalopathy: implications for early diagnosis","volume":"87","author":"Hoepner R","year":"2016","journal-title":"J Neurol Neurosurg 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