Mellen Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Mellen Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, USA

Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA

OhioHealth Multiple Sclerosis Center, Riverside Methodist Hospital, Columbus, OH, USA

Centre d’Esclerosi Múltiple de Catalunya, Department of Neurology and Neuroimmunology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Centre d’Esclerosi Múltiple de Catalunya, Department of Neurology and Neuroimmunology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Multiple Sclerosis Center Dresden, Center of Clinical Neuroscience, Department of Neurology, University Clinic Carl-Gustav Carus, Dresden, Germany

Centre d’Esclerosi Múltiple de Catalunya, Department of Neurology and Neuroimmunology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

*M.L.N. and R.R. were employees of Biogen at the time the analysis was conducted.

JA Cohen Mellen Center, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. [email protected]