Magnetic resonance images (MRI) of patients diagnosed with multiple sclerosis in childhood show that paediatric onset multiple sclerosis is more aggressive, and causes more brain lesions, than MS diagnosed in adulthood.
Interestingly, however, patients with paediatric-onset MS – which comprise up to five percent 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 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, corresponding author.
"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 ten years longer in paediatric-onset patients."
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.
"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," says Weinstock-Guttman. "However, the remyelination process may require a more in-depth prospective analysis." Weinstock-Guttman also said the data support the need for early diagnosis and therapeutic intervention in paediatric MS patients.
MEDICA.de; Source: University at Buffalo