Multiple Sclerosis and Demyelinating Disorders in Children

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child Neurology".

Deadline for manuscript submissions: closed (31 January 2019) | Viewed by 35234

Special Issue Editors

Department of Paediatrics, The Hospital for Sick Children Division of Neurology, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8
Interests: paediatric multiple sclerosis; pediatric demyelinating disorders; Inflammatory disorders of the central nervous system
Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA
Interests: pediatric multiple sclerosis; NMOSD; MOGAD; cognitive outcomes

Special Issue Information

Dear Colleagues,

Pediatric Multiple Sclerosis (MS) occurs in 3–5% of individuals with MS. Youth with MS experience a higher disease burden than their adult onset counterparts, as well as early cognitive decline and altered trajectories of brain development. The last decade has seen marked advances in knowledge about the risk factors for and treatment and recognition of this condition. In this Special Issue, we will provide a comprehensive overview of pediatric MS, highlighting recent research findings of relevance to this population. Topics to be covered will include, among others: (1) Diagnosis of MS in children and distinction from monophasic demyelinating entities; (2) long term treatment strategies including use of disease modifying therapies; (3) cognitive and psychosocial outcomes; (4) MRI outcomes; (5) visual outcomes; (6) risk factors, wellness and lifestyle factors; and (7) pediatric Neuromyelitis Optica Spectrum Disorders (NMOSD) and Myelin Oligodendrocyte Glycoprotein (MOG) related disease.

Dr. E. Ann Yeh
Dr. Bianca Weinstock-Guttman
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Pediatric
  • Inflammation
  • Optic Neuritis
  • Multiple Sclerosis
  • Outcomes
  • NMOSD
  • MOG
  • Diagnosis
  • Treatment

Published Papers (5 papers)

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Research

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17 pages, 299 KiB  
Article
Cognitive Functioning in Patients with Pediatric-Onset Multiple Sclerosis, an Updated Review and Future Focus
by Joy B. Parrish and Emily Fields
Children 2019, 6(2), 21; https://0-doi-org.brum.beds.ac.uk/10.3390/children6020021 - 04 Feb 2019
Cited by 10 | Viewed by 5636
Abstract
Pediatric-onset multiple sclerosis (POMS) is relatively rare, but as technology and neuroimaging advance, an increasing number of cases are identified, and our understanding of how multiple sclerosis (MS) impacts the developing brain improves. There are consistent findings in the literature highlighting the impact [...] Read more.
Pediatric-onset multiple sclerosis (POMS) is relatively rare, but as technology and neuroimaging advance, an increasing number of cases are identified, and our understanding of how multiple sclerosis (MS) impacts the developing brain improves. There are consistent findings in the literature highlighting the impact of MS and other demyelinating diseases on cognitive functioning and cognitive development. We also have a better understanding of how POMS impacts psychosocial functioning and functional outcomes in daily living. This paper hopes to review findings associated with cognitive and psychosocial functioning in patients with POMS, as well as explore more recent advances in the field and how they relate to cognitive and psychosocial outcomes. We also discuss the ongoing need for future studies with a focus on better understanding deficits and disease correlates, but also preventative measures and potential rehabilitation. Full article
(This article belongs to the Special Issue Multiple Sclerosis and Demyelinating Disorders in Children)

Review

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24 pages, 2378 KiB  
Review
Differential Diagnosis of Pediatric Multiple Sclerosis
by Maria Milagros Galardi, Cristina Gaudioso, Saumel Ahmadi, Emily Evans, Laura Gilbert and Soe Mar
Children 2019, 6(6), 75; https://0-doi-org.brum.beds.ac.uk/10.3390/children6060075 - 03 Jun 2019
Cited by 11 | Viewed by 8578
Abstract
The differential diagnosis of pediatric multiple sclerosis (MS) can be broad and pose diagnostic challenges, particularly at initial presentation. Among demyelinating entities, neuromyelitis optica spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein antibodies (MOG-ab) associated disorders, and acute disseminated encephalomyelitis (ADEM) are now well-known as [...] Read more.
The differential diagnosis of pediatric multiple sclerosis (MS) can be broad and pose diagnostic challenges, particularly at initial presentation. Among demyelinating entities, neuromyelitis optica spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein antibodies (MOG-ab) associated disorders, and acute disseminated encephalomyelitis (ADEM) are now well-known as unique disease processes and yet continue to overlap with MS in regards to clinical presentation and imaging. In non-inflammatory entities, such as metabolic disorders and leukodystrophies, an erroneous diagnosis of MS can be made even while applying appropriate diagnostic criteria. Knowing the epidemiology, typical clinical presentation, diagnostic criteria, and ancillary test results in each disease, can aid in making the correct diagnosis by contrasting these features with those of pediatric MS. Determining the correct diagnosis early, allows for efficient and effective treatment as well as appropriate prognostication. Full article
(This article belongs to the Special Issue Multiple Sclerosis and Demyelinating Disorders in Children)
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16 pages, 296 KiB  
Review
Long-Term Treatment Strategies of Pediatric Multiple Sclerosis, Including the use of Disease Modifying Therapies
by Mary Rensel
Children 2019, 6(6), 73; https://0-doi-org.brum.beds.ac.uk/10.3390/children6060073 - 31 May 2019
Cited by 10 | Viewed by 5085
Abstract
Multiple sclerosis (MS) presenting in the pediatric years can lead to landmark disability levels younger in life than adult onset MS and so therefore early and effective treatment remains paramount for long-term outcomes. The goals of MS therapeutics in adults have widened to [...] Read more.
Multiple sclerosis (MS) presenting in the pediatric years can lead to landmark disability levels younger in life than adult onset MS and so therefore early and effective treatment remains paramount for long-term outcomes. The goals of MS therapeutics in adults have widened to address multiple mechanisms: anti-inflammatory, neuroprotective, and myelin repair, yet the optimal paradigm for MS therapies in the pediatric population is not known. Pediatric onset MS add complexities due to the ongoing development of the central nervous system and the immune system. Clinical trials have led to an increasing number of pharmaceutical therapies for adult onset MS (AOMS), one POMS randomized controlled trial is completed and other trials are ongoing, yet due to the low prevalence of POMS, the dynamic landscape and risk management of the MS disease modifying therapies (DMT) it remains more difficult to complete trials in POMS. There is consensus that controlled clinical trials leading to appropriate and safe therapies for POMS are important for a multitude of reasons that include unique pediatric pharmacokinetics, short and long-term safety, developmental issues, clinical benefits, and regulatory approval. This review will focus on new treatment goals, paradigm, strategies, monitoring, compliance, and products in the long-term treatment of POMS. The discussion will focus on these new concepts and the published data related to DMT use in POMS. This review provides significant insight into new concepts of treatment goals and current approaches to enhance the lives of the POMS patients now and in the future. Full article
(This article belongs to the Special Issue Multiple Sclerosis and Demyelinating Disorders in Children)
6 pages, 200 KiB  
Review
Clinical Approach to Pediatric Transverse Myelitis, Neuromyelitis Optica Spectrum Disorder and Acute Flaccid Myelitis
by Cynthia Wang and Benjamin Greenberg
Children 2019, 6(5), 70; https://0-doi-org.brum.beds.ac.uk/10.3390/children6050070 - 17 May 2019
Cited by 17 | Viewed by 10539
Abstract
Pediatric transverse myelitis (TM) is an acquired, immune-mediated disorder that leads to injury of the spinal cord and often manifests as weakness, numbness, bowel dysfunction, and/or bladder dysfunction. Multiple etiologies for myelitis can result in a similar clinical presentation, including idiopathic transverse myelitis [...] Read more.
Pediatric transverse myelitis (TM) is an acquired, immune-mediated disorder that leads to injury of the spinal cord and often manifests as weakness, numbness, bowel dysfunction, and/or bladder dysfunction. Multiple etiologies for myelitis can result in a similar clinical presentation, including idiopathic transverse myelitis (TM), multiple sclerosis (MS), neuromyeltis optica spectrum disorder (NMOSD) associated with anti-aquaporin 4 antibodies, MOG antibody-associated disease, and acute flaccid myelitis (AFM). Diagnosis relies on clinical recognition of the syndrome and confirming inflammation through imaging and/or laboratory studies. Acute treatment is targeted at decreasing immune-mediated injury, and chronic preventative therapy may be indicated if TM is determined to be a manifestation of a relapsing disorder (i.e., NMOSD). Timely recognition and treatment of acute transverse myelitis is essential, as it can be associated with significant morbidity and long-term disability. Full article
(This article belongs to the Special Issue Multiple Sclerosis and Demyelinating Disorders in Children)
11 pages, 546 KiB  
Review
A Scoping Review of Modifiable Risk Factors in Pediatric Onset Multiple Sclerosis: Building for the Future
by Julie Pétrin, Maximillian D.J. Fiander, Prenitha Mercy Ignatius Arokia Doss and E. Ann Yeh
Children 2018, 5(11), 146; https://0-doi-org.brum.beds.ac.uk/10.3390/children5110146 - 26 Oct 2018
Cited by 6 | Viewed by 4815
Abstract
Knowledge of the effect of modifiable lifestyle factors in the pediatric multiple sclerosis (MS) population is limited. We therefore conducted a scoping review, following the framework provided by Arksey and O’Malley. Four databases were searched for pediatric MS and modifiable lifestyle factors using [...] Read more.
Knowledge of the effect of modifiable lifestyle factors in the pediatric multiple sclerosis (MS) population is limited. We therefore conducted a scoping review, following the framework provided by Arksey and O’Malley. Four databases were searched for pediatric MS and modifiable lifestyle factors using index terms and keywords, from inception to May 2018. All quantitative and qualitative primary articles were included and limited to English and full text. Of the 7202 articles identified and screened, 25 full-text articles were relevant to our objective and were included. These articles focused on diet obesity, physical activity, and sleep. In cross-sectional analyses, these lifestyle factors were associated with increased risk of pediatric onset MS (POMS), and increased disease activity. Diet, particularly vitamin D and vegetable intake, was associated with reduced relapse rate. Obesity was linked to increased risk of POMS, and physical activity was associated with reduced relapse rate and sleep/rest fatigue. Thus, available studies of lifestyle related outcomes in pediatric MS suggest specific lifestyle related factors, including obesity, higher vitamin D levels, and higher physical activity may associate with lower disease burden in POMS. Studies reviewed are limited by their observational designs. Future studies with longitudinal and experimental designs may further clarify the role of modifiable lifestyle factors in this population. Full article
(This article belongs to the Special Issue Multiple Sclerosis and Demyelinating Disorders in Children)
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