Virupakshaiah, Akash
Mayo Clinic
Department of Neurology, University of California San Francisco.
Citations 5
Adenotonsillectomy is associated with increased risk and disease activity in pediatric-onset multiple sclerosis
Chang, Gina , Nasr, Z., Schoeps, Vinícius Andreoli , Virupakshaiah, Akash , Zamvil, Scott S, Moseley, Carson E. , Chong, Janet, Graves, Jennifer , Waltz, Michael , Tillema, Jan-Mendelt, Abrams, Aaron , Mar, Soe, Schreiner, Teri , Rose, John W. , Casper, T Charles, Nasr, Zahra , Graves, Jennifer , Rodriguez, Moses , Chitnis, Tanuja , Rensel, Mary R. , Abrams, Aaron , Krupp, Lauren , Schreiner, Teri , Rose, John W , Waubant, Emmanuelle L. , Virupakshaiah, Akash , Zamvil, Scott S. , Sabatino, Joseph J. , Chong, Janet, Rodriguez, Moses , Tillema, Jan‐Mendelt , Krupp, Lauren , Waldman, Amy , Mar, Soe , Casper, T. Charles
Multiple Sclerosis Journal | May 29, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background: Epstein–Barr virus (EBV) is a key environmental risk factor for multiple sclerosis (MS), and tonsils and adenoids serve as a primary viral reservoir. This study investigates the potential role of adenotonsillectomy in pediatric-onset multiple sclerosis (POMS) risk and relapse rate. Objectives: POMS participants and controls were recruited from 16 pediatric MS clinics between 1 November 2011 and 1 July 2017. Clinical and demographic information, including history of adenotonsillectomy, EBV serostatus, and HLA-DRB1*15:01:01 status, were collected. Multivariable logistic regression assessed the association between adenotonsillectomy and MS risk. In addition, negative binomial regression offset by follow-up time was used to assess the relationship between adenotonsillectomy and relapse rate in POMS participants with available follow-up data. Results: The case-control analysis included 359 POMS participants and 560 pediatric controls. Individuals with a history of adenotonsillectomy had a 63% increased odds of MS (adjusted odds ratio (OR) = 1.63, 95% confidence interval (CI) = 1.01–2.64, p = 0.046). Among the 239 POMS participants with available follow-up data, adenotonsillectomy was associated with a twofold increase in annualized relapse rate (adjusted incidence rate ratio (IRR) = 2.00, 95% CI = 1.15–3.48, p = 0.013). Conclusions: Prior adenotonsillectomy was associated with increased risk of MS and greater relapse rate in pediatric patients, suggesting a potential interplay between EBV, immune regulation, and MS pathogenesis.
Investigating the Frequency and Outcome of Central Vein Sign and Paramagnetic Rim Lesions in Children With MOGAD
Nistri, Riccardo , Cacciaguerra, Laura , Sacco, Simone , Virupakshaiah, Akash , Meo, Ermelinda De , Papinutto, Nico , Henry, Roland, Meirson, Hadas , Bensira, Liat, Pratt, Li-tal, Biswas, Asthik, Mankad, Kshitij , Chen, John J., Pittock, S J , Barkhof, Frederik , Ciccarelli, Olga, Waubant, Emmanuelle, Ciccarelli, Olga , De Meo, Ermelinda , Henry, Roland G , Hemingway, Cheryl , Rossor, Thomas , Wassmer, Evangeline , Biswas, Asthik , Sudhakar, Sniya , Mankad, Kshitij , Chen, John J , Barkhof, Frederik , Ciccarelli, Olga , Waubant, Emmanuelle L. , Flanagan, E P , Hacohen, Yael , Cacciaguerra, Laura , Virupakshaiah, Akash , Henry, Roland G. , Wassmer, Evangeline , Ben‐Sira, Liat , Pratt, Li‐tal , Flanagan, Eoin P. , Hacohen, Yael
Neurology | January 9, 2026 | Volume: 106 | Issue: 3 | Pages: No page available
Cognitive Function in People With Pediatric Multiple Sclerosis Over 2 Years
Charvet, Leigh , Waltz, Michael , George, Allan , Benson, Leslie , Gorman, Mark , Mar, Soe , Ness, Jayne , Schreiner, Teri , Waubant, Emmanuelle , Wheeler, Yolanda , Abrams, Aaron , Rose, John W. , Tillema, Jan-Mendelt , Casper, T. Charles , Charvet, Leigh E , Waltz, Michael , Benson, Leslie A , Gorman, Mark P , Mar, Soe S , Ness, Jayne M , Schreiner, Teri , Waubant, Emmanuelle L. , Weinstock‐Guttman, Bianca , Wheeler, Yolanda S , Abrams, Aaron , Chitnis, Tanuja , Rodriguez, Moses , Rose, John W , Tillema, Jan‐Mendelt , Virupakshaiah, Akash , Krupp, Lauren , O'Neill, Kimberly , Rodriguez, Moses , Virupakshaiah, Akash
Neurology | September 18, 2025 | Volume: 105 | Issue: 8 | Pages: No page available
Epidemiology and Impact of Social Hardships in Children With Multiple Sclerosis in the United States
Wilson, Elizabeth , Meeks, Huong , Barney, Bradley J. , Waltz, Michael , Casper, T. Charles , Rose, John W. , Rodriguez, Moses , Tillema, Jan-Mendelt , Chitnis, Tanuja , Gorman, Mark , Abrams, Aaron , Lotze, Timothy E. , Fisher, Kristen , Schreiner, Teri , Mar, Soe , Wheeler, Yolanda , Ness, Jayne , Meeks, Huong , Canenguez, Katia, Rose, John W , Rodriguez, Moses , Tillema, Jan‐Mendelt , Chitnis, Tanuja , Gorman, Mark P , Rensel, Mary R. , Abrams, Aaron , Krupp, Lauren , Lotze, Timothy E , Fisher, Kristen S , Shukla, Nikita Malani , Schreiner, Teri , Mar, Soe S , Waubant, Emmanuelle L. , Virupakshaiah, Akash , Wheeler, Yolanda S , Ness, Jayne M , Benson, Leslie A , Waltz, Michael , Canenguez, Katia M. , Shukla, Nikita , Virupakshaiah, Akash , Benson, Leslie
Neurology | November 12, 2024 | Volume: 103 | Issue: 11 | Pages: No page available
Association of nutritional intake with clinical and imaging activity in pediatric multiple sclerosis
Mohan, Sonam D, Peterson, Skyler, Brenton, J. Nicholas , Carmichael, Suzan L. , Virupakshaiah, Akash , Tillema, Jan‐Mendelt , Mar, Soe , Rensel, Mary , Abrams, Aaron , Gorman, Mark , Lotze, Tim, Shukla, Nikita, Graves, Jennifer, Aaen, Gregory , Casper, T. Charles , Rensel, Mary R. , Abrams, Aaron , Chitnis, Tanuja , Brenton, J Nicholas , Virupakshaiah, Akash , Rodriguez, Moses , Benson, Leslie, Waubant, Emmanuelle L.
Multiple Sclerosis Journal | July 30, 2024 | Volume: 30 | Issue: 8 | Pages: 1056-1065
Background: Understanding nutrition’s role in multiple sclerosis (MS) can guide recommendations and intervention-based studies. Objective: Evaluate the association between nutrition and pediatric-onset MS outcomes. Methods: Prospective longitudinal multicenter study conducted as part of the US Network of Pediatric MS centers. Predictors were collected using a food screener estimating intake of various dietary food groups (e.g. dairy and fruits) and additional calculated indices (e.g. Healthy Eating Index (HEI)). Outcomes included time-from-enrollment to clinical relapse, new magnetic resonance imaging (MRI) T2 lesions, and Expanded Disability Status Scale (EDSS) increase. Results: 353 children with MS were enrolled (mean ± SD age 15.4 ± 2.9, follow-up 3.9 ± 2.6 years). Multivariable analysis demonstrated that increased dairy by 50% of recommended intake was associated with increased relapse risk by 41% (adjusted hazard ratio (HR) 1.41, 95% CI 1.07–1.86), and risk of T2 progression by 40% (1.40, 1.12–1.74). Increased intake of fruit or vegetable above recommended, and every five-point HEI increase decreased relapse risk by 25% (0.75, 0.60–0.95), 45% (0.55, 0.32–0.96), and 15% (0.84, 0.74–0.96), respectively. No associations were found with EDSS. Conclusion: This work supports the influence of dietary intake on MS course, particularly with dairy intake. Future prospective study is required to establish causation.