Multiple Sclerosis in Children: Current and Emerging Concepts

Brenton, J. Nicholas; Kammeyer, Ryan; Gluck, Louis; Schreiner, Teri; Makhani, Naila

doi:10.1055/s-0040-1703000

Cited by 22 publications

(18 citation statements)

References 91 publications

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“…Existing literature underscores that multiple sclerosis primarily affects young adults, making it a rare occurrence in children. Although a small percentage of patients may experience symptoms before the age of 20, diagnosis typically occurs at a later stage (Alroughani & Boyko, 2018 ; Brenton et al., 2020 ). Another point to note is that registry data might incorporate diagnostic inaccuracies arising from the coding of pTBI diagnoses by healthcare practitioners.…”

Section: Discussionmentioning

confidence: 99%

“…The primary study cohort included individuals with pTBI under 18, transitioning to legal adulthood (at 18 according to Finnish law) during the study period. According to existing literature, multiple sclerosis primarily affects young adults and childhood multiple sclerosis is a rare occurrence and, therefore, only patients who reached adulthood during the study period were selected (Alroughani & Boyko, 2018 ; Brenton et al., 2020 ). This group had a higher prognosis for having a diagnosis of multiple sclerosis.…”

Section: Methodsmentioning

confidence: 99%

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Pediatric traumatic brain injury and early age multiple sclerosis in Finland: A nationwide register‐based cohort study

Laaksonen,

Ponkilainen,

Kuitunen

et al. 2024

Brain and Behavior

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ObjectiveExamine the link between pediatric traumatic brain injury (pTBI) and early‐onset multiple sclerosis in Finland.MethodsConducted nationwide register study (1998−2018) with 28,750 pTBI patients (< 18) and 38,399 pediatric references with extremity fractures. Multiple sclerosis diagnoses from Finnish Social Insurance Institution. Employed Kaplan−Meier and multivariable Cox regression for probability assessment, results presented with 95% CI.ResultsOf 66 post‐traumatic multiple sclerosis cases, 30 (0.10%) had pTBI, and 36 (0.09%) were in the reference group. Cumulative incidence rates (CIR) in the first 10 years were 46.5 per 100,000 (pTBI) and 33.1 per 100,000 (reference). Hazard ratio (HR) for pTBI was 1.10 (95% CI: 0.56−1.48).Stratified by gender, women's CIR was 197.9 per 100,000 (pTBI) and 167.0 per 100,000 (reference) after 15 years. For men, CIR was 44.6 per 100,000 (pTBI) and 34.7 per 100,000 (reference). In the initial 3 years, HR for female pTBI was 1.75 (95% CI: 0.05−6.32), and between years 3 and 20, it was 1.08 (95% CI: 0.51−1.67). For male patients, HR was 1.74 (95% CI: 0.69−4.39).SignificanceWe did not find evidence of an association between pTBI and early‐onset multiple sclerosis 20 years post‐initial trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pediatric traumatic brain injury and early age multiple sclerosis in Finland: A nationwide register‐based cohort study

Laaksonen,

Ponkilainen,

Kuitunen

et al. 2024

Brain and Behavior

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“…In children under 10, the prevalence is similar between girls and boys, while in older children and adults a female predominance is usually observed. Hormonal interference during puberty may explain this difference ( Langille et al, 2019 ; Brenton et al, 2020 ; Deiva, 2020 ). All the children we have just described are of Caucasian race, but this situation may result from the racial distribution of Portuguese population.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease that affects the central nervous system (CNS) ( Brola and Steinborn, 2020 ; Jakimovski et al, 2022 ). When the first demyelinating event occurs before the age of 18, it is called paediatric-onset MS and this can actually occur in 3–5% of cases ( Brola and Steinborn, 2020 ; Ramphul et al, 2020 ; Luca et al, 2021 ), according to the literature, with some studies reporting a rising incidence of MS in children ( Brenton et al, 2020 ; Margoni et al, 2021 ). Seventeen percent of patients diagnosed at paediatric age had their first relapse before the age of 10 ( Deiva, 2020 ), corresponding to 0.2 to 0.7% of all MS patients ( Ruggieri et al, 2004 ).…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis under the age of ten: the challenge of a rare diagnosis in a special population – a case series

Carvalho,

dos Santos,

Amaral

et al. 2023

Front. Neurosci.

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IntroductionMultiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease of the central nervous system which, when it begins before the age of 18, is defined as paediatric MS. Most common clinical presentations include long tract involvement, brainstem/cerebellum syndromes, optic neuritis and acute disseminated encephalomyelitis. Paediatric-onset MS typically has a more inflammatory-active course and a higher lesion burden in imaging studies, but an extensive post-relapse recovery, with a slower long-term disability progression. The first demyelinating clinical attack occurs before 10 years old in less than 1% of patients, and, in this special population, the condition has particularities in clinical presentation, differential diagnosis, diagnostic assessment, current treatment options and outcome.Clinical casesWe present the cases of four Caucasian children (2 girls) diagnosed with relapsing–remitting MS before the age of ten, with a mean age at the time of the first relapse of 7.4 ± 2.4 years. Clinical presentation included optic neuritis, myelitis, brainstem syndrome, and acute disseminated encephalomyelitis. Baseline MRI identified several lesions, frequently large and ill-defined. Two patients were included in clinical trials and two patients remain in clinical and imaging surveillance.ConclusionDiagnosis of MS before the age of 10 years is rare, but it has significant long-term physical and cognitive consequences, as well as a substantial impact on the current and future quality of life of the child and family. Early and correct diagnosis is essential. Prospective, randomized, large cohort studies are needed to assess the efficacy and safety of disease-modifying treatments in children under the age of ten.

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“…Multiple sclerosis (MS) is a demyelinating disease in which the sheaths of nerve cells in the brain and spinal cord are damaged. The disease typically manifests between the ages of 20 and 40, although it can occur in childhood in less than 1% of cases and approximately 2%−10% of cases after the age of 50 1–3 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Self‐management interventions for people with multiple sclerosis: A systematic review and meta‐analysis protocol

Heidari‐Soureshjani,

Nasrabadi,

Zakerimoghadam

et al. 2023

Health Science Reports

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Background and AimsEducational self‐management interventions (SMI) have an important role in improving symptom management, preventing relapse of multiple sclerosis (MS) and promoting quality of life (QoL) of these patients; since there is little knowledge about overall effectiveness of MS self‐management programs and which types of SMI improves the outcomes, this research aims to assess the efficacy of structured SMI in improving health outcomes in people with MS (PwMS) by synthesizing and compare outcomes from related randomized controlled trials.MethodsIn the present systematic review protocol, the keywords related to self‐management and MS will be searched in electronic databases including (PubMed, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials [CENTRAL]), gray literature resources and key journals from 2000 to July 2023. Research‐related articles will be collected and after removing duplicate articles, will be included in the study. In the screening step, titles and abstracts of articles will be reviewed and after deleting irrelevant articles, the full text of related articles will be evaluated independently by two researchers and data will be extracted from final articles and the findings will be categorized in an extraction table. Risk of bias will be assessed by using the Cochrane collaboration's tool. If possible, the data will be analyzed using random effect models and the statistical analysis will be performed using STATA software (version 14.2) developed by StataCorp.DiscussionComparative effectiveness of SMI is currently unknown. We will analyze outcome measures used to assess effectiveness of self‐management education in improving QoL, depression, self‐efficacy, pain, and fatigue. These findings will help identify the most promising components of SMIs, guiding targeted interventions for specific subpopulations, and facilitating the design of better interventions.

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Multiple Sclerosis in Children: Current and Emerging Concepts

Cited by 22 publications

References 91 publications

Pediatric traumatic brain injury and early age multiple sclerosis in Finland: A nationwide register‐based cohort study

Pediatric traumatic brain injury and early age multiple sclerosis in Finland: A nationwide register‐based cohort study

Multiple sclerosis under the age of ten: the challenge of a rare diagnosis in a special population – a case series

Self‐management interventions for people with multiple sclerosis: A systematic review and meta‐analysis protocol

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