Hossein NAJAFPOUR, Azam RIAZAT, Sahar NAJAFPOUR
Journal of Multiple Sclerosis Research - 2026;6(1):57-61
We report two patients with secondary progressive multiple sclerosis who demonstrated substantial multidomain functional improvement following the Self-organizing Neuro-adaptive Personalized Physiological System, a non-invasive, non-contact, passive-state, hypothesis-generating rehabilitation framework, and subsequently experienced complete functional regression at follow-up. Both patients shared a defining clinical feature: severe, chronic psychosocial stressors that were clinician-observed as persistent and apparently unresolvable throughout and beyond the intervention period. Case 1 (SH, 36F) received 20 sessions, with the Comprehensive Disability and Functional Status Scale (CDFSS) score improving from 26 to 9 before regressing to 18 at the 24-month follow-up. Case 2 (MH, 34M) received 19 sessions, with the CDFSS score improving from 32 to 11 before regressing to 24 at follow-up. In both cases, psychological-behavioral-cognitive domain scores regressed before or concurrently with the decline in physical domain scores. In contrast, four non-relapsing cases from the same observational series did not exhibit similar regression, suggesting that clinician-observed chronic psychosocial burden may be associated with reduced functional durability in progressive multiple sclerosis. This observation is strictly hypothesis-generating.
