Clinical Characteristics of Pediatric-Onset and Adult-Onset Multiple Sclerosis in Hispanic Americans

Area of Science:

• Neurology
• Pediatric Neurology
• Epidemiology

Background:

• Multiple sclerosis (MS) affects both children and adults.
• Understanding demographic and clinical differences in MS presentation is crucial for targeted treatment and prognosis.
• Hispanic Americans represent a unique population for studying MS characteristics.

Purpose of the Study:

• To compare the demographic and clinical characteristics of pediatric-onset multiple sclerosis (POMS) versus adult-onset multiple sclerosis (AOMS) in Hispanic Americans.
• To identify differences in presenting symptoms and long-term outcomes between POMS and AOMS.
• To explore factors associated with severe ambulatory disability in Hispanic Americans with MS.

Main Methods:

• Cross-sectional analysis of 363 Hispanic American MS cases.
• Comparison of demographic and clinical data between patients with POMS (onset <18 years) and AOMS (onset ≥18 years).
• Multivariable analysis to identify predictors of severe ambulatory disability.

Main Results:

• Optic neuritis was the most common presenting symptom in both POMS and AOMS.
• POMS showed higher prevalence of polyfocal symptoms, seizures, and cognitive symptoms at presentation compared to AOMS (P ≤ .001).
• Transverse myelitis was more frequent in AOMS (P ≤ .001). POMS and being US-born were associated with reduced odds of severe ambulatory disability (P = .004 and P = .006, respectively).

Conclusions:

• Pediatric-onset and adult-onset MS in Hispanic Americans exhibit distinct clinical presentations.
• Differences in symptoms and outcomes suggest potential variations in disease mechanisms or response to treatment.
• Identifying early indicators like POMS and birth origin may help predict ambulatory disability, informing prognosis and management strategies.