According to researchers, magnetic resonance images (MRI) of patients diagnosed with multiple sclerosis in childhood show that pediatric onset multiple sclerosis is more aggressive and causes more brain lesions than multiple sclerosis diagnosed in adulthood.
The study also showed that patients with pediatric-onset multiple sclerosis (comprising up to 5 percent of total multiple sclerosis cases) develop disabilities at a slower pace than patients with adult-onset multiple sclerosis.
“Patients with pediatric-onset multiple sclerosis have three times as many relapses annually than patients with adult-onset disease, which suggests there is greater disease activity in this population,” said corresponding author Bianca Weinstock-Guttman.
“But surprisingly, the average time to reach the secondary progressive phase of the disease is longer in patients who develop multiple sclerosis in childhood than in adult onset multiple sclerosis,” she said. “Reaching the next stage of disability is almost 10 years longer in pediatric-onset patients.”
The National Multiple Sclerosis Society estimates that 8,000 to 10,000 children (defined as up to 18 years old) in the U.S. have multiple sclerosis, and another 10,000 to 15,000 have experienced at least one symptom suggestive of multiple sclerosis. Multiple sclerosis causes demyelination, destruction of the sheath that protects and insulates nerve fibers. Breaks in the myelin sheath disrupt the flow of electrical impulses, causing loss of sensation and coordination.
Image: Bundles of neurons, each neuron with a myelin sheath coating.
The study involved four sets of patients:
- 17 children with an average age of 13.7 who were diagnosed with multiple sclerosis 2.7 years earlier
- 33 adults with an average age of 36.5 years who were diagnosed with pediatric multiple sclerosis 20 years earlier
- 81 adults with an average age of 40 who have had multiple sclerosis for an average of 2.6 years
- 300 adults with an average age of 50.5 who’ve had multiple sclerosis for 20 years
“This corresponds with recent data that suggest a higher lesion burden in pediatric multiple sclerosis than adult-onset multiple sclerosis. These findings are somewhat surprising, considering we have assumed that children generally have a greater capacity for central nervous tissue repair.”
“Our findings, which are limited to a cross-sectional study design, suggest that children have a somewhat better reserve and functional adaptability than adults, but less support for a better remyelination process,” added Weinstock-Guttman. “However, the remyelination process may require a more in-depth prospective analysis” She said the data support the need for early diagnosis and therapeutic intervention in pediatric multiple sclerosis patients.
References:
1. Eluen A. Yeh, et al. Magnetic resonance imaging characteristics of children and adults with paediatric-onset multiple sclerosis. Brain, November 5, 2009. doi:10.1093/brain/awp278.
