{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:12:03Z","timestamp":1770750723643,"version":"3.50.0"},"reference-count":81,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Government Research Training Program Scholarship from the University of Melbourne."},{"name":"Australian Government Research Training Program Scholarship from the University of Melbourne."},{"name":"Australian Government Research Training Program Scholarship from the University of Melbourne."},{"name":"Australian Research Council Industrial Transformation Training Centre in Cognitive Computing for Medical Technologies","award":["IC170100030"],"award-info":[{"award-number":["IC170100030"]}]},{"name":"Australian Research Council Industrial Transformation Training Centre in Cognitive Computing for Medical Technologies","award":["IC170100030"],"award-info":[{"award-number":["IC170100030"]}]},{"name":"Australian Research Council Industrial Transformation Training Centre in Cognitive Computing for Medical Technologies","award":["IC170100030"],"award-info":[{"award-number":["IC170100030"]}]},{"name":"Elizabeth and Vernon Puzey Scholarship"},{"DOI":"10.13039\/501100007961","name":"Melbourne School of Psychological Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007961","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Multiple Sclerosis (MS) can be a severely disabling condition that leads to various neurological symptoms. A Brain-Computer Interface (BCI) may substitute some lost function; however, there is a lack of BCI research in people with MS. Present BCI designs have also overlooked the unique pathological changes associated with MS and have not considered needs of users within their home environments. To progress this research area effectively and efficiently, we aimed to evaluate user needs and assess the feasibility and user-centric requirements of a BCI for people with MS. We hypothesised that (i) people with MS would be interested in adopting BCI technology and (ii) those with reduced independence would prefer a higher-performing invasive BCI.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted an online survey of people with MS to describe user preferences and establish the initial steps of user-centred design. The survey aimed to understand their interest in BCI applications, bionic applications, device preferences, and development considerations and related these to symptoms and assistance needs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We demonstrated widespread interest for BCI applications in all stages of MS, with a preference for a non-invasive (n = 12) or minimally invasive (n = 15) BCI over carer assistance (n = 6). Descriptive analysis indicated that level of independence did not influence preference towards the higher performing but highly invasive BCI.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The needs of end users reported in this study are crucial for efficient development of BCI systems that can be effectively translated into the home environment. Considering the potential to enhance independence and quality of life for people living with MS, the results emphasise the importance of user-centred design for future advancement of BCIs that account for the unique pathological changes associated with MS.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319811","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T17:29:58Z","timestamp":1742318998000},"page":"e0319811","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Towards developing brain-computer interfaces for people with Multiple Sclerosis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3010-8541","authenticated-orcid":true,"given":"John 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Tafti","year":"2022"},{"issue":"3","key":"pone.0319811.ref004","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S1474-4422(18)30443-5","article-title":"Global, regional, and national burden of multiple sclerosis 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"MT Wallin","year":"2019","journal-title":"Lancet Neurol"},{"issue":"12","key":"pone.0319811.ref005","doi-asserted-by":"crossref","first-page":"1380-1390.e2","DOI":"10.1016\/j.amjmed.2020.05.049","article-title":"Treatment of Multiple Sclerosis: A Review","volume":"133","author":"SL Hauser","year":"2020","journal-title":"Am J Med"},{"issue":"2","key":"pone.0319811.ref006","first-page":"39","article-title":"An overview of assistive technology for persons with multiple sclerosis","volume":"2","author":"D Blake","year":"2002","journal-title":"J Rehabil Res Dev"},{"issue":"18","key":"pone.0319811.ref007","doi-asserted-by":"crossref","first-page":"e1810","DOI":"10.1212\/WNL.0000000000200150","article-title":"The Economic Burden of Multiple Sclerosis in the United States: Estimate of Direct and Indirect Costs","volume":"98","author":"B Bebo","year":"2022","journal-title":"Neurology"},{"issue":"3","key":"pone.0319811.ref008","doi-asserted-by":"crossref","first-page":"e258","DOI":"10.1212\/WNL.0000000000005812","article-title":"Independent home use of a brain-computer interface by people with amyotrophic lateral sclerosis","volume":"91","author":"JR Wolpaw","year":"2018","journal-title":"Neurology"},{"issue":"21","key":"pone.0319811.ref009","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1056\/NEJMoa1608085","article-title":"Fully Implanted Brain-Computer Interface in a Locked-In Patient with ALS","volume":"375","author":"MJ Vansteensel","year":"2016","journal-title":"N Engl J Med"},{"issue":"3","key":"pone.0319811.ref010","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1001\/jamaneurol.2022.4847","article-title":"Assessment of Safety of a Fully Implanted Endovascular Brain-Computer Interface for Severe Paralysis in 4 Patients: The Stentrode With Thought-Controlled Digital Switch (SWITCH) Study","volume":"80","author":"P Mitchell","year":"2023","journal-title":"JAMA Neurol"},{"issue":"8","key":"pone.0319811.ref011","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1109\/TNSRE.2016.2623381","article-title":"An Asynchronous P300-Based Brain-Computer Interface Web Browser for Severely Disabled People","volume":"25","author":"V Martinez-Cagigal","year":"2017","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"pone.0319811.ref012","doi-asserted-by":"crossref","first-page":"868419","DOI":"10.3389\/fnhum.2022.868419","article-title":"Usability of a Hybrid System Combining P300-Based Brain-Computer Interface and Commercial Assistive Technologies to Enhance Communication in People With Multiple Sclerosis","volume":"16","author":"A Riccio","year":"2022","journal-title":"Front Hum Neurosci"},{"key":"pone.0319811.ref013","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/1743-0003-10-66","article-title":"MUNDUS project: MUltimodal neuroprosthesis for daily upper limb support","volume":"10","author":"A Pedrocchi","year":"2013","journal-title":"J Neuroeng Rehabil"},{"issue":"1","key":"pone.0319811.ref014","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jneumeth.2007.03.005","article-title":"An efficient P300-based brain-computer interface for disabled subjects","volume":"167","author":"U Hoffmann","year":"2008","journal-title":"J Neurosci Methods"},{"issue":"3","key":"pone.0319811.ref015","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.clinph.2005.07.024","article-title":"P300-based brain computer interface: reliability and performance in healthy and paralysed participants","volume":"117","author":"F Piccione","year":"2006","journal-title":"Clin Neurophysiol"},{"issue":"5","key":"pone.0319811.ref016","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.clinph.2017.02.010","article-title":"Simple index of functional connectivity at rest in Multiple Sclerosis fatigue","volume":"128","author":"K Buyukturkoglu","year":"2017","journal-title":"Clin Neurophysiol"},{"issue":"12","key":"pone.0319811.ref017","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1177\/1352458518799580","article-title":"Symptomatology and symptomatic treatment in multiple sclerosis: Results from a nationwide MS registry","volume":"25","author":"PS Rommer","year":"2019","journal-title":"Mult Scler"},{"issue":"3","key":"pone.0319811.ref018","doi-asserted-by":"crossref","first-page":"146","DOI":"10.7224\/1537-2073.2012-053","article-title":"Natural history of multiple sclerosis symptoms","volume":"15","author":"I Kister","year":"2013","journal-title":"Int J MS Care"},{"key":"pone.0319811.ref019","first-page":"5686","article-title":"Feasibility of using discrete Brain Computer Interface for people with Multiple Sclerosis","author":"TA Shiels","year":"2021","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"pone.0319811.ref020","first-page":"1","article-title":"Feasibility of Using Source-Level Brain Computer Interface for People with Multiple Sclerosis","author":"JS Russo","year":"2023","journal-title":"2023 45th Annu Int Conf IEEE Eng Med Biol Soc (EMBC). IEEE"},{"issue":"1\u20132","key":"pone.0319811.ref021","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/2326263X.2019.1643203","article-title":"Trends in research participant categories and descriptions in abstracts from the International BCI Meeting series, 1999 to 2016","volume":"6","author":"BS Eddy","year":"2019","journal-title":"Brain Comput Interfaces (Abingdon)"},{"issue":"5","key":"pone.0319811.ref022","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3109\/17482968.2011.572978","article-title":"What would brain-computer interface users want? 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interfaces after spinal cord injury","volume":"50","author":"JL Collinger","year":"2013","journal-title":"J Rehabil Res Dev"},{"issue":"1","key":"pone.0319811.ref026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12984-019-0624-7","article-title":"Clinician awareness of brain computer interfaces: A Canadian national survey","volume":"17","author":"S Letourneau","year":"2020","journal-title":"Journal of NeuroEngineering and Rehabilitation"},{"issue":"2","key":"pone.0319811.ref027","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1109\/TNSRE.2006.875585","article-title":"BCI Meeting 2005--workshop on clinical issues and applications","volume":"14","author":"A K\u00fcbler","year":"2006","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"pone.0319811.ref028","first-page":"445","article-title":"User-centered design","volume":"37","author":"C Abras","year":"2004","journal-title":"Encyclopedia of Human-Computer 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K\u00fcbler","year":"2019","journal-title":"Neuroethics"},{"issue":"5","key":"pone.0319811.ref032","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2501\/IJMR-2017-039","article-title":"Ideal and Maximum Length for a Web Survey","volume":"59","author":"M Revilla","year":"2017","journal-title":"International Journal of Market Research"},{"key":"pone.0319811.ref033","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1109\/TNSRE.2022.3156661","article-title":"Clinical Validation of BCI-Controlled Wheelchairs in Subjects With Severe Spinal Cord Injury","volume":"30","author":"X Chen","year":"2022","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"issue":"2","key":"pone.0319811.ref034","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1109\/THMS.2020.3047597","article-title":"A Self-Paced BCI With a Collaborative Controller for Highly Reliable Wheelchair Driving: Experimental Tests With Physically Disabled Individuals","volume":"51","author":"A Cruz","year":"2021","journal-title":"IEEE Trans Human-Mach Syst"},{"issue":"7099","key":"pone.0319811.ref035","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1038\/nature04970","article-title":"Neuronal ensemble control of prosthetic devices by a human with tetraplegia","volume":"442","author":"LR Hochberg","year":"2006","journal-title":"Nature"},{"issue":"4","key":"pone.0319811.ref036","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1152\/jn.00131.2018","article-title":"Volitional control of single-electrode high gamma local field potentials by people with paralysis","volume":"121","author":"T Milekovic","year":"2019","journal-title":"J Neurophysiol"},{"issue":"2","key":"pone.0319811.ref037","doi-asserted-by":"crossref","first-page":"10.1088\/1741-2552\/ac59a0","DOI":"10.1088\/1741-2552\/ac59a0","article-title":"An adaptive closed-loop ECoG decoder for long-term and stable bimanual control of an exoskeleton by a tetraplegic","volume":"19","author":"A Moly","year":"2022","journal-title":"J Neural Eng"},{"issue":"8","key":"pone.0319811.ref038","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1038\/sc.2012.14","article-title":"On the feasibility of using motor imagery EEG-based brain-computer interface in chronic tetraplegics for assistive robotic arm control: a clinical test and long-term post-trial follow-up","volume":"50","author":"G Onose","year":"2012","journal-title":"Spinal Cord"},{"issue":"1","key":"pone.0319811.ref039","doi-asserted-by":"crossref","first-page":"18705","DOI":"10.1038\/s41598-019-55166-y","article-title":"Optimising non-invasive brain-computer interface systems for free communication between na\u00efve human participants","volume":"9","author":"AI Renton","year":"2019","journal-title":"Sci Rep"},{"issue":"7976","key":"pone.0319811.ref040","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1038\/s41586-023-06377-x","article-title":"A high-performance speech 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Willett","year":"2021","journal-title":"Nature"},{"key":"pone.0319811.ref044","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/341208","article-title":"EEG Signal Quality of a Subcutaneous Recording System Compared to Standard Surface Electrodes","author":"J Duun-Henriksen","year":"2015","journal-title":"J Sensors"},{"key":"pone.0319811.ref045","first-page":"217","article-title":"Invasive BCI Approaches for Restoration of Upper Extremity Movements","author":"G M\u00fcller-Putz","year":"2021","journal-title":"Neuroprosthetics and Brain-Computer Interfaces in Spinal Cord Injury"},{"issue":"7976","key":"pone.0319811.ref046","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1038\/s41586-023-06443-4","article-title":"A high-performance neuroprosthesis for speech decoding and avatar control","volume":"620","author":"SL Metzger","year":"2023","journal-title":"Nature"},{"issue":"1","key":"pone.0319811.ref047","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s11948-017-0001-5","article-title":"Embodiment and Estrangement: Results from a First-in-Human \u201cIntelligent BCI\u201d Trial","volume":"25","author":"F Gilbert","year":"2019","journal-title":"Sci Eng Ethics"},{"issue":"9","key":"pone.0319811.ref048","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1111\/epi.16630","article-title":"A new era in electroencephalographic monitoring? Subscalp devices for ultra-long-term recordings","volume":"61","author":"J Duun-Henriksen","year":"2020","journal-title":"Epilepsia"},{"issue":"8","key":"pone.0319811.ref049","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.3390\/brainsci13081176","article-title":"Sub-Scalp Implantable Telemetric EEG (SITE) for the Management of Neurological and Behavioral Disorders beyond Epilepsy","volume":"13","author":"S Barua","year":"2023","journal-title":"Brain Sci"},{"key":"pone.0319811.ref050","author":"K Bruegger","year":"2019"},{"key":"pone.0319811.ref051","author":"S Payne","year":"2001"},{"issue":"1","key":"pone.0319811.ref052","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s12152-018-9364-9","article-title":"An Analysis of the Impact of Brain-Computer Interfaces on Autonomy","volume":"14","author":"O Friedrich","year":"2018","journal-title":"Neuroethics"},{"issue":"16","key":"pone.0319811.ref053","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1080\/01443610600964141","article-title":"Caregiver strain and factors associated with caregiver self-efficacy and quality of life in a community cohort with multiple sclerosis","volume":"29","author":"F Khan","year":"2007","journal-title":"Disabil Rehabil"},{"issue":"8","key":"pone.0319811.ref054","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1016\/j.clinph.2008.03.034","article-title":"A P300-based brain-computer interface for people with amyotrophic lateral sclerosis","volume":"119","author":"F Nijboer","year":"2008","journal-title":"Clin Neurophysiol"},{"key":"pone.0319811.ref055","doi-asserted-by":"crossref","first-page":"310107","DOI":"10.3389\/fnhum.2018.00165","article-title":"On the relationship between attention processing and P300-based brain computer interface control in amyotrophic lateral sclerosis","volume":"12","author":"A Riccio","year":"2018","journal-title":"Frontiers in Human Neuroscience"},{"issue":"2","key":"pone.0319811.ref056","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1177\/1550059417737443","article-title":"Evaluating Brain-Computer Interface Performance in an ALS Population: Checkerboard and Color Paradigms","volume":"49","author":"DB Ryan","year":"2018","journal-title":"Clin EEG Neurosci"},{"issue":"1\u20132","key":"pone.0319811.ref057","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/2326263X.2016.1252143","article-title":"Online BCI Typing using Language Model Classifiers by ALS Patients in their Homes","volume":"4","author":"W Speier","year":"2017","journal-title":"Brain Comput Interfaces (Abingdon)"},{"issue":"2","key":"pone.0319811.ref058","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1044\/1058-0360(2001\/013)","article-title":"Communication in Context: A Qualitative Study of the Experiences of Individuals With Multiple Sclerosis","volume":"10","author":"KM Yorkston","year":"2001","journal-title":"Am J Speech Lang Pathol"},{"key":"pone.0319811.ref059","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/B978-012057770-5\/50010-2","article-title":"Interpersonal communication problems associated with depression and loneliness","author":"C Segrin","year":"1996","journal-title":"Handbook of Communication and Emotion"},{"issue":"3","key":"pone.0319811.ref060","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1177\/0002764293036003003","article-title":"Dysfunctional Communication and Depression","volume":"36","author":"CD McCann","year":"1993","journal-title":"American Behavioral Scientist"},{"issue":"22","key":"pone.0319811.ref061","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1212\/WNL.0000000000002174","article-title":"Differences in the burden of psychiatric comorbidity in MS vs the general population","volume":"85","author":"RA Marrie","year":"2015","journal-title":"Neurology"},{"issue":"4","key":"pone.0319811.ref062","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1177\/0898264315599942","article-title":"An Exploratory Investigation of Communication Technologies to Alleviate Communicative Difficulties and Depression in Older Adults","volume":"28","author":"EK Ruppel","year":"2016","journal-title":"J Aging Health"},{"issue":"Pt 3","key":"pone.0319811.ref063","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/brain\/awv398","article-title":"The topograpy of demyelination and neurodegeneration in the multiple sclerosis brain","volume":"139","author":"L Haider","year":"2016","journal-title":"Brain"},{"key":"pone.0319811.ref064","doi-asserted-by":"crossref","first-page":"308","DOI":"10.3389\/fnhum.2015.00308","article-title":"Effects of user mental state on EEG-BCI performance","volume":"9","author":"A Myrden","year":"2015","journal-title":"Front Hum Neurosci"},{"issue":"3","key":"pone.0319811.ref065","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0301-0511(00)00085-5","article-title":"A critical review of the psychophysiology of driver fatigue","volume":"55","author":"SK Lal","year":"2001","journal-title":"Biol Psychol"},{"key":"pone.0319811.ref066","doi-asserted-by":"crossref","first-page":"3339","DOI":"10.1109\/ICSMC.2012.6378307","article-title":"Online modulation of the level of assistance in shared control systems","author":"T Carlson","year":"2012","journal-title":"2012 IEEE International Conference on Systems, Man, and Cybernetics (SMC)"},{"issue":"3","key":"pone.0319811.ref067","doi-asserted-by":"crossref","first-page":"2963","DOI":"10.3182\/20140824-6-ZA-1003.00897","article-title":"Detection of mental fatigue using an active BCI inspired signal processing chain","volume":"47","author":"RN Roy","year":"2014","journal-title":"IFAC Proceedings Volumes"},{"issue":"1","key":"pone.0319811.ref068","doi-asserted-by":"crossref","first-page":"016020","DOI":"10.1088\/1741-2552\/ab53f1","article-title":"Adaptive feature extraction in EEG-based motor imagery BCI: tracking mental fatigue","volume":"17","author":"U Talukdar","year":"2020","journal-title":"J Neural Eng"},{"key":"pone.0319811.ref069","first-page":"6599","article-title":"Regularized common spatial patterns with generic learning for EEG signal classification","author":"H Lu","year":"2009","journal-title":"Proceedings of the 31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Engineering the Future of Biomedicine, EMBC 2009"},{"key":"pone.0319811.ref070","article-title":"Plug-and-play stability for intracortical brain-computer interfaces: A one-year demonstration of seamless brain-to-text communication","author":"C Fan","year":"2023"},{"issue":"4","key":"pone.0319811.ref071","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1038\/s41551-020-00630-8","article-title":"Restoration of sensory information via bionic hands","volume":"7","author":"SJ Bensmaia","year":"2023","journal-title":"Nat Biomed Eng"},{"issue":"12","key":"pone.0319811.ref072","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1038\/sj.sc.3101797","article-title":"Implantable FES system for upright mobility and bladder and bowel function for individuals with spinal cord injury","volume":"43","author":"TE Johnston","year":"2005","journal-title":"Spinal Cord"},{"issue":"12","key":"pone.0319811.ref073","doi-asserted-by":"crossref","first-page":"987","DOI":"10.3109\/09638288.2013.825332","article-title":"Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction","volume":"36","author":"M Vitkova","year":"2014","journal-title":"Disabil 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Disord"},{"issue":"3","key":"pone.0319811.ref077","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3111\/13696998.2012.667027","article-title":"Impact of medication adherence to disease-modifying drugs on severe relapse, and direct and indirect costs among employees with multiple sclerosis in the US","volume":"15","author":"JI Ivanova","year":"2012","journal-title":"J Med Econ"},{"issue":"1","key":"pone.0319811.ref078","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/01376517-200802000-00005","article-title":"Assessment of caregiver burden in families of persons with multiple sclerosis","volume":"40","author":"M Buhse","year":"2008","journal-title":"J Neurosci Nurs"},{"issue":"5","key":"pone.0319811.ref079","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1111\/hex.13093","article-title":"\u201cIt struck at the heart of who I thought I was\u201d: A meta-synthesis of the qualitative literature examining the experiences of people with multiple 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