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MS More Aggressive in Children but Slower to Cause Disability Than in Adults BUFFALO, NY -- November 16, 2009 -- Magnetic resonance images (MRI) of patients diagnosed with multiple sclerosis (MS) in childhood show that paediatric-onset MS is more aggressive, and causes more brain lesions, than MS diagnosed in adulthood, researchers have reported in the November 5 online edition of Brain. Interestingly, however, patients with paediatric-onset MS -- which comprise up to 5% of total MS cases -- develop disabilities at a slower pace than patients with adult-onset MS, the data showed. “Patients with paediatric-onset MS have 3 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, MD, Pediatric Multiple Sclerosis Center of Excellence, Women and Children’s Hospital, and the William C. Baird MS Center in Buffalo General Hospital (BGH), and University at Buffalo (UB) School of Medicine and Biomedical Sciences, Buffalo, New York. “But surprisingly, the average time to reach the secondary progressive phase of the disease is longer in patients who develop MS in childhood than in adult-onset MS,” she continued. “Reaching the next stage of disability is almost 10 years longer in paediatric-onset patients.” The UB study involved 4 sets of patients: · 17 children with an average age of 13.7 who were diagnosed with MS 2.7 years earlier · 33 adults with an average age of 36.5 who were diagnosed with paediatric MS 20 years earlier · 81 adults with an average age of 40 who have had MS for an average of 2.6 years · 300 adults with an average age of 50.5 who have had MS for 20 years All participants underwent a brain MRI scan at facilities at BGH and at Women and Children’s Hospital, while the specific MRI metric analysis was performed at the Buffalo Neuroimaging Analysis Center, part of the UB Department of Neurology/Jacobs Neurological Institute, located in BGH. The MRI measured 2 types of brain tissue damage: T1-lesion volume, which shows “black holes,” or hypointense lesions, which are areas of permanent axonal damage; and T2-lesion volume, which shows the total number of lesions (lesion load) and overall disease burden. Both of these measures indicated that MS is more aggressive in children in the early stages, said the study’s first author, Eluen A. Yeh, MD, Pediatric Multiple Sclerosis Center of Excellence, Women and Children’s Hospital. “This corresponds with recent data that suggest a higher lesion burden in paediatric MS than adult-onset MS. These findings are somewhat surprising, considering we have assumed that children generally have a greater capacity for central nervous tissue repair,” noted Dr. Yeh. “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 Dr. Weinstock-Guttman. “However, the remyelination process may require a more in-depth prospective analysis” Dr. Weinstock-Guttman said the data support the need for early diagnosis and therapeutic intervention in paediatric MS patients. SOURCE: The University at Buffalo E-mail this page to a friend or colleague! To print, use this version