{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:02:36Z","timestamp":1793833356089,"version":"4.6.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Paul K. and Anna E. Shockey Family Foundation"},{"name":"Penn State LDN Now Fund"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Multiple sclerosis (MS) involves symptoms that may be impacted by angiogenesis. Vascular endothelial growth factor (VEGF), a potent pro-angiogenic molecule, is elevated in early MS, but its activity in later disease is understudied. [Met\n                      <jats:sup>5<\/jats:sup>\n                      ]-enkephalin (ENK) has anti-angiogenic activity and is decreased in persons with MS (PwMS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine salient symptoms of MS and evaluate relationships between common MS symptoms and angiogenesis-associated biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PwMS and non-MS control participants were identified for this cross-sectional study. Walking times and self-reported fatigue, anxiety, depression, and pain were measured. Serum VEGF and [Met\n                      <jats:sup>5<\/jats:sup>\n                      ] ENK levels were measured in a subset of PwMS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PwMS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200966) had significantly greater fatigue than controls (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200935). In PwMS, fatigue, anxiety, depression, and pain were positively intercorrelated; fatigue was positively correlated with slower walking. Serum ENK and VEGF had a trending negative relationship. Serum ENK, but not VEGF, had a trending negative relationship with the length of disease. Serum ENK and VEGF were not correlated to walking time or self-report measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fatigue is a salient MS symptom when compared to non-MS controls. Imbalanced pro- and anti-angiogenic signaling may influence fatigue in established MS, but further studies with larger sample sizes are needed to elucidate this potential relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173251329904","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T02:47:39Z","timestamp":1743562059000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring the relationships of physical, mental, and emotional symptoms and serum biomarkers of angiogenesis in multiple sclerosis"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1550-0943","authenticated-orcid":false,"given":"Laura B","family":"Odom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8390-7221","authenticated-orcid":false,"given":"Gary A","family":"Thomas","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1242-8090","authenticated-orcid":false,"given":"Jikku J","family":"Zachariah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4221-6745","authenticated-orcid":false,"given":"Ian S","family":"Zagon","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4630-8225","authenticated-orcid":false,"given":"Patricia J","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007035"},{"key":"e_1_3_4_3_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1136\/jnnp.2005.074948","article-title":"Multiple sclerosis related fatigue","volume":"77","author":"Giovannoni G","year":"2006","unstructured":"Giovannoni G. 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