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Record W4414153439 · doi:10.1016/j.ebiom.2025.105921

Smouldering disease in paediatric-onset multiple sclerosis

2025· review· en· W4414153439 on OpenAlexafffund
Massimo Filippi, Monica Margoni, Brenda Banwell, Tanuja Chitnis, Russell C. Dale, Giulia Fadda, Yael Hacohen, Lauren Krupp, Paolo Preziosa, E. Ann Yeh, Emmanuelle Waubant, Maria A. Rocca

Bibliographic record

VenueEBioMedicine · 2025
Typereview
Languageen
FieldMedicine
TopicSystemic Sclerosis and Related Diseases
Canadian institutionsSickKids FoundationUniversity of TorontoOttawa HospitalHospital for Sick ChildrenUniversity of Ottawa
FundersCanadian Institutes of Health ResearchAmgen CanadaEMD SeronoNational Institutes of HealthUniversidad de ChileStem Cell NetworkNational Multiple Sclerosis SocietyHorizon TherapeuticsMultiple Sclerosis Society of CanadaRace to Erase MSHospital for Sick ChildrenMinistero della SaluteMultiple Sclerosis Scientific Research FoundationFondation Brain CanadaMultiple Sclerosis SocietyEuropean Committee for Treatment and Research in Multiple SclerosisBristol-Myers SquibbCelgeneFondazione Italiana Sclerosi MultiplaBiogenAlexion PharmaceuticalsPatient-Centered Outcomes Research InstituteNeuraxpharmJohns Hopkins UniversityAmgenUniversity of OttawaSanofi
KeywordsMultiple sclerosisSubclinical infectionDiseaseCentral nervous systemMagnetic resonance imagingCentral nervous system disease

Abstract

fetched live from OpenAlex

Smouldering disease in multiple sclerosis (MS) refers to chronic central nervous system processes that occur beyond acute inflammation, driving long-term disability. Although current therapies effectively reduce relapse rates and MRI lesions, many individuals experience progression independent of relapse activity. While clinical progression is uncommon during childhood or adolescence, growing evidence suggests that subclinical progressive disease biology is already active even in this young age group, warranting early intervention to preserve function. Conventional MRI, while critical for diagnosis, lacks sensitivity for subtle damage. Advanced MRI techniques, including detection of chronic active lesions, global and focal brain damage, hold promise for early identification. Fluid biomarkers, such as neurofilament light chain and glial fibrillary acidic protein, provide non-invasive measures of neuroaxonal injury and ongoing chronic inflammation. This review summarises the role of MRI and fluid biomarkers in detecting smouldering disease in paediatric-onset MS and their application in supporting therapeutic decision-making.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.897
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0030.001
Bibliometrics0.0020.002
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.071
GPT teacher head0.326
Teacher spread0.254 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designOther design
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2025
Admission routes2
Has abstractyes

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