Multiple sclerosis in children: clinical diagnosis, therapeutic strategies, and future directions.

Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
The Lancet Neurology (Impact Factor: 21.82). 11/2007; 6(10):887-902. DOI: 10.1016/S1474-4422(07)70242-9
Source: PubMed

ABSTRACT The onset of multiple sclerosis (MS) in childhood poses diagnostic and therapeutic challenges, particularly if the symptoms of the first demyelinating event resemble acute disseminated encephalomyelitis (ADEM). MRI is an invaluable diagnostic tool but it lacks the specificity to distinguish ADEM from the first attack of MS. Advanced MRI techniques might have the required specificity to reveal whether the loss of integrity in non-lesional tissue occurs as a fundamental feature of MS. Although the onset of MS in childhood typically predicts a favourable short-term prognosis, some children are severely disabled, either physically or cognitively, and more than 50% are predicted to enter the secondary-progressive phase of the disease by the age of 30 years. Immunomodulatory therapies for MS and their safe application in children can improve long-term prognosis. Genetic and environmental factors, such as viral infection, might be uniquely amenable to study in paediatric patients with MS. Understanding the immunological consequences of these putative exposures will shed light on the early pathological changes in MS.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: For most adults with initial clinical presentation of multiple sclerosis (MS), biological disease was likely initiated many years prior. Pediatric-onset MS provides an opportunity to study early disease processes.
    Neurology 11/2014; · 8.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In order to improve the accuracy of electricity consumption forecasting in smart grid, a novel penalized weighted kernel partial least squares algorithm is presented. The original inputs are mapped into a high dimensional feature space to realize the linearization of nonlinear problems. The partial least squares algorithm is used to extract the principal component to reduce the dimensional of data. According to the local learning theory, a weighted least squares regression model is constructed based on the new data set formed by the principal component. The model sensitivity of abnormal data is reduced and the model parameters are optimized.The data from industrial electricity consumption of Jiangsu province in 2008 are used for validation and the results show that WK-PLS has higher accuracy than PLS in electricity load prediction.
    IET International Conference on Information Science and Control Engineering 2012 (ICISCE 2012); 01/2012
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In multiple sclerosis (MS), cerebellar signs and symptoms as well as cognitive dysfunction are frequent and contribute to clinical disability with only poor response to symptomatic treatment. The current consensus paper highlights the broad range of clinical signs and symptoms of MS patients, which relate to cerebellar dysfunction. There is considerable evidence of cerebellar involvement in MS based on clinical, histopathological as well as structural and functional magnetic resonance imaging (MRI) studies. The review of the recent literature, however, also demonstrates a high variability of results. These discrepancies are, at least partially, caused by the use of different techniques and substantial heterogeneity among the patient cohorts in terms of disease duration, number of patients, and progressive vs. relapsing disease courses. Moreover, the majority of studies were crosssectional, providing little insight into the dynamics of cerebellar involvement in MS. Some links between the histopathological changes, the structural and functional abnormalities as captured by MRI, cerebellar dysfunction, and the clinical consequences are starting to emerge and warrant further study. A consensus is formed that this line of research will benefit from advances in neuroimaging techniques that allow to trace cerebellar involvement at higher resolution. Using a prospective study design, multimodal high-resolution cerebellar imaging is highly promising, particularly in patients who present with radiologically or clinically isolated syndromes or newly diagnosed MS.
    The Cerebellum 01/2015; · 2.60 Impact Factor

Full-text (2 Sources)

Available from
Jan 17, 2015