Between 2 – 5% of multiple sclerosis cases emerge before the age of 18. Research into MS in children and adolescents – referred to as pediatric-onset MS – is not only important for managing the disease in youth, but can also provide insights into some of the earliest triggers and drivers of MS, with implications for understanding and treating MS across all groups. Since MS is believed to spring from a combination of specific genetic and environmental factors, invited speakers at the pediatric-onset MS seminar session presented new data exploring these factors in children and adolescents.
The conversations taking place on the third day at AAN shifted gears from the day before, placing the focus back on multiple sclerosis and exploring existing treatment strategies for people living with MS in great depth. Specific questions that were brought up include: does stopping immune-modifying treatment in those transitioning into secondary progressive MS affect persistent relapses? How commonly do clinicians switch their patients’ first treatment regimen, and why? What are the effects of specific DMTs on pregnancy outcomes in expectant mothers? Continue reading to learn some of the answers to these questions based on the most recent research findings:
One of today’s sessions placed the focus squarely on neuromyelitis optica (more recently expanded to be called neuromyelitis optica spectrum disorder, or NMOSD), a rare autoimmune disorder of the central nervous system (CNS) in which the spinal cord and/or optic nerves are attacked and damaged by specific antibodies. While far less common than MS, NMOSD can sometimes be confused with MS due to similar clinical features, although NMOSD attacks are often more severe than MS relapses. Two of the most common symptoms experienced by people living with NMOSD are inflammation of the optic nerve (called optic neuritis) which causes blurring or loss of vision in one or both eyes, and inflammation of the spinal cord (transverse myelitis), which can lead to a host of symptoms including arm and leg weakness, muscle spasms, bladder and bowel problems, and pain.
Since NMOSD and MS are fundamentally different diseases that require their own unique set of diagnostic criteria and treatment strategies, the panel brought together researchers at the forefront of NMOSD research to present their latest findings with the view to improve our understanding and management of the disease.
This year’s AAN conference is filled to the brim with programming, with sessions starting bright and early at 6:30 am and continuing well into the evening to accommodate the staggering amount of new information pouring out of the labs and clinics of researchers around the world. Headlining the MS program for Day 1 was a series of presentations about new insights into MS gained from animal and cell studies. Although modeling disease necessarily reduces the complex mechanisms underlying MS into simplified models by design, these types of studies are crucial for uncovering important clues about the genes and molecules that can trigger and/or drive MS and for rapidly screening new therapeutics with the potential to treat MS by combating harmful inflammation, repairing damage in the brain and preventing injury from occurring in the first place. The evening poster presentations were a departure from the morning’s seminar series, shifting the focus from basic laboratory research towards observations about risk factors that both influence the likelihood of developing MS and predict how the disease changes over time in those already living with MS.
This year, more than 10,000 neurologists and basic researchers from all over the world are converging on the stunningly beautiful city of Vancouver to attend the American Academy of Neurology (AAN) 68th annual meeting. Over the next few days, they’ll be resisting the temptation to hike in the nearby mountains or stroll along the winding ocean-side paths to focus on presenting their latest cutting-edge work to peers, exchange information and ideas, and form collaborations with the goal of advancing diagnosis and treatment of neurological diseases. The conference also offers intensive education programming so that clinicians can test their knowledge and stay up to date on the best clinical practices for disease treatment and management.
Although multiple sclerosis is one of many topics that will be covered at AAN alongside dementia, epilepsy, stroke, neuromuscular disorders and other neurological diseases, there are plenty of seminars and poster sessions about MS to keep the research team and I busy over the next several days. Among the topics to be covered include: new insights from animal and cell models, treatment strategies and clinical outcomes, risk factors, advanced imaging techniques, pediatric MS, and the latest findings from clinical trials. Of course, Canadian researchers will be represented in strong numbers at the various sessions – a true testament to Canada’s reputation of punching above its weight when it comes to the breadth and depth of its MS research productivity.
Be sure to check in frequently for routine updates as I distill down the scientific details into digestible summaries and key findings. Follow me on Twitter at @Dr_KarenLee (hashtag: #AANAM) for live updates as they unfold. And of course, drop any comments or questions below.