Progressive degeneration from onset in pediatric multiple sclerosis: Evaluation of clinical and health-related quality of life, early loss of brain integrity and accelerated immunological senescence

Investigators:

  • Dr. Brenda Banwell, Children’s Hospital of Philadelphia
  • Dr. Ruth Ann Marrie, Health Science Centre Winnipeg
  • Dr. Amit Bar-Or, McGill University
  • Dr. Douglas Arnold, McGill University
  • Dr. Ann Yeh, Hospital for Sick Children

Term: July 1, 2015- June 30, 2020

Funding: $3,200,000.00

Keywords: pediatric MS, quality of life, imaging, immune response

Project Summary:

  • Most people think of multiple sclerosis (MS) as a disease of young adults. In 2004, when the Canadian Pediatric Demyelinating Disease study was launched, most Canadians did not know that MS can affect children.
  • The Canadian Demyelinating Disease study has enrolled 585 children across 23 sites at the time of acute illness. Some of these children have progressed to an MS diagnosis.
  • The research team will:
    • Evaluate the health services utilization among people with pediatric onset and their parents.
    • Analyze changes in the brain of children diagnosed with MS using magnetic resonance imaging.
    • Characterize the immune response in children diagnosed with MS.

Project Description:

Until the launch of the Canadian Pediatric Demyelinating Disease Network in 2004, the prevalence and impact of MS in children and adolescents was unknown, and how their MS differs from MS in adults was poorly understood. In collaboration with a team consisting of immunologists, epidemiologists, and imaging specialists, Dr. Brenda Banwell leads the pediatric MS research efforts that focus on the impact of MS on quality of life, health care service utilization, brain development, cognitive performance, and the immune system. The collaborative research team has discovered that approximately 1 in every 100,000 Canadian children experiences the first MS-like attack each year. Over 90% of children recover well from this first attack, but approximately 20% will be diagnosed with MS. Why some children develop MS, while others have only one demyelinating attack is still unclear. Understanding why some children have only a single attack, without developing the lifelong disease, MS, may shed light on valuable strategies for MS treatment. Infection with Epstein Barr virus, low vitamin D levels and an imbalance between the “good” immune cells (those that control immune reactions) and the “aggressive” immune cells that attack the brain are all prevalent in children that become diagnosed with MS. In characterizing the children diagnosed with the MS, the research team noted that at least 30% of children living with MS have trouble with learning and memory, and have smaller brains that do not grow as much as expected. These critical findings emphasize the need to find ways to protect the brain and to improve repair. Dr. Banwell notes, “We are proud to say that Canada is a world leader in pediatric MS care and research.”

Potential Impact: Understanding the earliest aspects of MS, by studying them in children, may lead to novel strategies for disease prevention and treatment.

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