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ShareWASHINGTON: Multiple sclerosis (MS) diagnosed in childhood is more aggressive and causes more brain lesions than that detected in adulthood, according to magnetic resonance images (MRI) performed by University at Buffalo researchers.
However, patients with pediatric-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 pediatric-onset MS have three times as many relapses annually than patients with adult-onset disease, which suggests there is greater disease activity in this population," said Bianca Weinstock-Guttman.
"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. Reaching the next stage of disability is almost 10 years longer in pediatric-onset patients," she continued.
MS 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.
The UB study involved four 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 years who were diagnosed with pediatric 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've had MS for 20 years.
All participants underwent a brain MRI scan and specific MRI metric analysis.
The MRI measured two 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 researchers.
"This corresponds with recent data that suggest a higher lesion burden in pediatric 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," they added.
"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. However, the remyelination process may require a more in-depth prospective analysis," said Weinstock-Guttman.
She said that the data support the need for early diagnosis and therapeutic intervention in paediatric MS patients. The study was published online on November 5.
