At the Center for NeuroEpidemiological and Clinical Neurological Research Chalk Talk on Thursday, August 9, Naila Makhani, MD, MPH, assistant professor of pediatrics (neurology) and of neurology, and director of the pediatric MS program, discussed her research on pediatric multiple sclerosis (MS) with her colleagues during the Center for Neuroepidemiology and Clinical Neurological Research (CNE2) Chalk Talk on Thursday, August 9. The CNE2 is a virtual center comprising researchers in various departments of the School of Medicine and the School of Public Health.
A diagnosis of MS is usually given when someone develops symptoms like vision changes, muscle weakness, numbness or tingling in parts of the body, or trouble walking in conjunction with characteristic findings on MRI scans of the brain. But some people may have changes in the brain that are visible on an MRI and suggest MS before symptoms develop. In these cases, the patient has received an MRI for an unrelated reason—a headache for instance—and the neurologist recognizes brain lesions characteristic of MS. This condition is called the radiologically isolated syndrome (RIS). RIS appears to increase the risk of MS, but not all patients with RIS go on to develop the condition.
Most RIS research comes from adult neurology. Before Makhani began her research, “there was no data for children,” she says. About three years ago, Makhani and a team of neurologists from over ten different countries decided to correct this oversight. They started a database to document MRI scans and laboratory tests from children with RIS. The researchers found that children with RIS had a 42% risk of developing MS symptoms over a median time period of 2 years. They also noted that certain biomarkers in the cerebrospinal fluid and changes in MRI scans of the spinal cord helped predict a diagnosis of MS.
But these procedures were not standardized, limiting the conclusions that the researchers could draw. Makhani and her colleagues are now using a five-year grant from the National Institutes of Health to launch a prospective study of children with RIS. The research team hopes that its standardized procedures will identify which children have a higher risk of developing MS and the biomarkers that can aid in early diagnosis.