{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:15:22Z","timestamp":1780557322910,"version":"3.54.1"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Multiple sclerosis (MS) is a complex and heterogeneous disease characterized by variable clinical outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>We aimed to develop a predictive model combining principal component analysis (PCA) and clustering techniques to identify biomarker sets associated with MS and characterize distinct phenotypes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>A monocentric, cross-sectional study on treatment na\u00efve patients at the time of MS diagnosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Clinical, laboratory, and neuroimaging data were collected, including retinal layer measurements via optical coherence tomography and neurofilament light (NFL) chains levels.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The cohort included 71 MS patients with mean age 35.7\u2009years (SD\u2009=\u20099.8). PCA yielded five components with eigenvalues &gt;1.0, explaining 68.1% of total variance. Component 1 showed strong negative coefficients for retinal thickness (ganglion cell-inner plexiform layer: \u22120.82, peripapillary retinal nerve fiber layer (RNFL): \u22120.79, macular RNFL: \u22120.75) and moderate positive coefficient for serum NFL (0.45). Component 2 featured high positive coefficients for NFL in cerebrospinal fluid (0.88) and serum (0.56).\n              <jats:italic>K<\/jats:italic>\n              -means clustering identified two distinct groups: one (\n              <jats:italic>n<\/jats:italic>\n              \u2009=\u200933) with thicker retinal layers, better cognitive performance, and unexpectedly higher serum NFL levels compared to the other group (\n              <jats:italic>n<\/jats:italic>\n              \u2009=\u200938).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>These findings suggest that MS may present with distinct phenotypic profiles even at diagnosis. Future longitudinal studies are needed to validate these early biomarkers and refine personalized treatment approaches.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/17562864251369747","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:21:21Z","timestamp":1759562481000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A multimodal approach to distinguish multiple sclerosis phenotypes at diagnosis using biomarker profiles"],"prefix":"10.1177","volume":"18","author":[{"given":"Aurora","family":"Zangh\u00ec","sequence":"first","affiliation":[{"name":"Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Sofia","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Greco","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rutigliano","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermete","family":"Giancipoli","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Iaculli","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Avolio","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7494-9057","authenticated-orcid":false,"given":"Emanuele","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Scientific Director, BRAND (Breakthrough Research in Autoimmune and Neurodegenerative Diseases) Center, Department of Medical and Surgical Sciences, Viale L. 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