Characterization of children with early onset pediatric multiple sclerosis

• Published in: European journal of paediatric neurology Vol. 54; pp. 113 - 120
• Main Authors: Kauth, Franziska, Bertolini, Annikki, Wendel, Eva-Maria, Koukou, Georgia, Naggar, Ines El, Chung, Jena, Baumann, Matthias, Schödl, Christopher, Lechner, Christian, Bigi, Sandra, Blaschek, Astrid, Hengstler, Jan Georg, Schimmel, Mareike, Nosadini, Margherita, Sartori, Stefano, Puthenparampil, Marco, van's Gravesande, Karin Storm, Drenckhahn, Anne, Nikolaus, Marc, Kauffmann, Birgit, Thiels, Charlotte, Häusler, Martin Georg, Eckenweiler, Matthias, Karenfort, Michael, Marina, Adela Della, Selek, Ayberk, Öncel, Ibrahim, Kornek, Barbara, Reindl, Markus, Rostásy, Kevin
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2025
• Subjects: Adolescent; Age of Onset; Child; Child, Preschool; Children; Early onset pediatric MS; Female; Humans; Magnetic Resonance Imaging; Male; Multiple sclerosis; Multiple Sclerosis - cerebrospinal fluid; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - epidemiology; Multiple Sclerosis - pathology; Multiple Sclerosis - physiopathology; Oligoclonal Bands - cerebrospinal fluid; Pediatric; Prospective Studies; Puberty; Recurrence; Puberty; Multiple sclerosis; Early onset pediatric MS; Children; Pediatric
• ISSN: 1090-3798; 1532-2130; 1532-2130
• DOI: 10.1016/j.ejpn.2025.01.006

Early onset pediatric multiple sclerosis (EOPMS) provides an early window of opportunity to understand the mechanisms leading to MS. To investigate clinical, laboratory and imaging differences between children with early onset pediatric MS (<11 years, EOPMS) and late onset pediatric MS (≥11 years, LOPMS). Mostly prospectively collected data of children with MS including clinical presentation, MRI at onset, time to second relapse, relapse rate, treatment history, and CSF markers were eligible. In total 274 children were included, n = 53 children with EOPMS and n = 221 children with LOPMS. In children with EOPMS both sexes were equally affected, while in LOPMS the female sex was more prevalent (p < 0.001). Presence of additional oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) was comparable in both age groups (92.3 % vs 89.5 %). Children with EOPMS had more relapses in the first 2 years (p = 0.004). Children with LOPMS had significantly more spinal lesions (p = 0.001). Presence of a prior EBV infection tested in a subset of children with EOPMS (n = 34) was only detected in 27/34 (79 %). Our findings suggest that both groups share important similarities but also important differences such as an increased relapse rate and a higher amount of infratentorial lesions in EOPMS. Furthermore, our results allude to a prior EBV-infection possibly not being an indispensable requirement for the development of MS in children with EOPMS. •EOPMS and LOPMS share important similarities but also important differences.•Presence of additional OCBs in the CSF was comparable in both age groups.•An EBV-infection does not seem to be mandatory for the development of MS in EOPMS.•Signs of brain tissue loss are already occurring in pre- and in post pubertal MS.