Uncovering the facts: MS and children
Dr. Banwell’s research is uncovering critical information about pediatric MS and moving us closer to understanding MS genetics
When Dr. Brenda Banwell and her team launched the Canadian Pediatric Demyelinating Disease study in 2004, most Canadians didn’t even know that multiple sclerosis (MS) could affect children. But through our research, the MS Society of Canada was able to determine that many Canadian children are diagnosed with MS every year.
Over the last 15 years, the researchers have enrolled and monitored children across 23 sites, including every Children’s Hospital in Canada. The children were first seen at the time of their initial neurological attack, with additional follow-ups annually and at the time of any further demyelinating attacks (which damage the myelin sheath protecting nerve fibers of the brain, optic nerves and the spinal cord). Detailed information about their symptoms, family history, and physical and cognitive health are collected at every visit. Blood samples and brain imaging (MRI) studies are also obtained.
Of the 585 children participating to date, there are 133 healthy controls and 96 children who have been diagnosed with MS. The study has demonstrated that around 1 in every 100,000 Canadian children experiences a first attack of what might be MS each year. Over 90% of children recover well from this first attack, but approximately 20% of those 90% will ultimately be diagnosed with MS.
One of the study’s primary goals is to understand why some children develop MS, while others have only one demyelinating attack. Understanding why some children have only a single attack — and not the lifelong disease, MS — may teach us valuable strategies for MS treatment and help to inform similar research with adults.
To date, researchers have shown that children who were ultimately diagnosed with MS are more likely to have been infected with Epstein Barr virus, and have lower vitamin D levels than children who experience only a single demyelinating attack. The immune cells of children with MS also show an imbalance between the “good” immune cells (those that effectively control immune reactions) and “aggressive” immune cells that attack the brain.
At least 30% of children living with MS have trouble with learning and memory, and MRI studies have shown that children with MS have smaller brains that do not grow as expected. These critical findings emphasize the urgent need to find ways to protect the brain and to improve its ability to repair.
Building on this study, we have expanded our work to include The Children’s Hospital of Philadelphia, one of the top-ranked pediatric hospitals in the U.S. We are partnering with the Network of Pediatric MS Centers in a study of the bacteria that live in human intestines, commonly referred to as the gut microbiome. And in an effort to better understand MS genetics, we are working with other international sites as well.
To learn more about what we’ve been up to this year, read the full Fall Progress Report.