Improved relapse recovery in paediatric compared to adult multiple sclerosis

Tanuja Chitnis^{1

2}, Greg Aaen³, Anita Belman⁴, Leslie Benson⁵, Mark Gorman⁵, Manu S Goyal⁶, Jennifer S Graves⁷, Yolanda Harris⁸, Lauren Krupp⁴, Timothy Lotze⁹, Soe Mar⁶, Jayne Ness⁸, Mary Rensel¹⁰, Teri Schreiner¹¹, Jan-Mendelt Tillema¹², Emmanuelle Waubant¹³, Bianca Weinstock-Guttman¹⁴, Shelly Roalstad¹⁵, John Rose¹⁵, Howard L Weiner^{2

16}, T Charles Casper¹⁵, Moses Rodriguez¹²; US Network of Paediatric Multiple Sclerosis Centers

Affiliations

¹ Partners Paediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA, USA.
² Harvard Medical School, Boston, MA, USA.
³ Paediatric Multiple Sclerosis Center, Loma Linda University Children's Hospital, Loma Linda, CA, USA.
⁴ Paediatric MS Center at NYU Langone Health, New York, NY, USA.
⁵ Paediatric Multiple Sclerosis and Related Disorders Program at Boston Children's Hospital, MA, USA.
⁶ Washington University, St. Louis, MO, USA.
⁷ Paediatric Multiple Sclerosis Center, University of California San Diego, San Diego, CA, USA.
⁸ UAB Center for Paediatric-Onset Demyelinating Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
⁹ The Blue Bird Circle Clinic for Multiple Sclerosis, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
¹⁰ Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA.
¹¹ Rocky Mountain Multiple Sclerosis Center, Children's Hospital Colorado, University of Colorado at Denver, Aurora, CO, USA.
¹² Mayo Clinic Paediatric Multiple Sclerosis Center, Mayo Clinic, Rochester, MN, USA.
¹³ Paediatric Multiple Sclerosis Center, University of California San Francisco, San Francisco, CA, USA.
¹⁴ Jacobs Paediatric Multiple Sclerosis Center, State University of New York at Buffalo, Buffalo, NY, USA.
¹⁵ Data Coordinating and Analysis Center, University of Utah, Salt Lake City, UT, USA.
¹⁶ Partners MS Center, Brigham and Women's Hospital, Boston, MA, USA.

PMID: 32810215
DOI: 10.1093/brain/awaa199

Comparative Study

Improved relapse recovery in paediatric compared to adult multiple sclerosis

Tanuja Chitnis et al. Brain. 2020.

. 2020 Sep 1;143(9):2733-2741.

doi: 10.1093/brain/awaa199.

Authors

Affiliations

¹ Partners Paediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA, USA.
² Harvard Medical School, Boston, MA, USA.
³ Paediatric Multiple Sclerosis Center, Loma Linda University Children's Hospital, Loma Linda, CA, USA.
⁴ Paediatric MS Center at NYU Langone Health, New York, NY, USA.
⁵ Paediatric Multiple Sclerosis and Related Disorders Program at Boston Children's Hospital, MA, USA.
⁶ Washington University, St. Louis, MO, USA.
⁷ Paediatric Multiple Sclerosis Center, University of California San Diego, San Diego, CA, USA.
⁸ UAB Center for Paediatric-Onset Demyelinating Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
⁹ The Blue Bird Circle Clinic for Multiple Sclerosis, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
¹⁰ Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA.
¹¹ Rocky Mountain Multiple Sclerosis Center, Children's Hospital Colorado, University of Colorado at Denver, Aurora, CO, USA.
¹² Mayo Clinic Paediatric Multiple Sclerosis Center, Mayo Clinic, Rochester, MN, USA.
¹³ Paediatric Multiple Sclerosis Center, University of California San Francisco, San Francisco, CA, USA.
¹⁴ Jacobs Paediatric Multiple Sclerosis Center, State University of New York at Buffalo, Buffalo, NY, USA.
¹⁵ Data Coordinating and Analysis Center, University of Utah, Salt Lake City, UT, USA.
¹⁶ Partners MS Center, Brigham and Women's Hospital, Boston, MA, USA.

PMID: 32810215
DOI: 10.1093/brain/awaa199

Abstract

Incomplete relapse recovery contributes to disability accrual and earlier onset of secondary progressive multiple sclerosis. We sought to investigate the effect of age on relapse recovery. We identified patients with multiple sclerosis from two longitudinal prospective studies, with an Expanded Disability Status Scale (EDSS) score within 30 days after onset of an attack, and follow-up EDSS 6 months after attack. Adult patients with multiple sclerosis (n = 632) were identified from the Comprehensive Longitudinal Investigations in Multiple Sclerosis at Brigham study (CLIMB), and paediatric patients (n = 132) from the US Network of Paediatric Multiple Sclerosis Centers (NPMSC) registry. Change in EDSS was defined as the difference in EDSS between attack and follow-up. Change in EDSS at follow-up compared to baseline was significantly lower in children compared to adults (P = 0.001), as were several functional system scores. Stratification by decade at onset for change in EDSS versus age found for every 10 years of age, EDSS recovery is reduced by 0.15 points (P < 0.0001). A larger proportion of children versus adults demonstrated improvement in EDSS following an attack (P = 0.006). For every 10 years of age, odds of EDSS not improving increase by 1.33 times (P < 0.0001). Younger age is associated with improved recovery from relapses. Age-related mechanisms may provide novel therapeutic targets for disability accrual in multiple sclerosis.

Keywords: clinical practice; epidemiology; multiple sclerosis; vision; white matter lesion.

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Improved relapse recovery in paediatric compared to adult multiple sclerosis

Affiliations

Improved relapse recovery in paediatric compared to adult multiple sclerosis

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical