Impact of endocrine dysregulation on disability and non-motor symptoms in pediatric onset multiple sclerosis

Area of Science:

• Pediatric Endocrinology
• Neuroimmunology
• Pediatric Neurology

Background:

• Pediatric onset multiple sclerosis (POMS) often coincides with significant endocrine shifts.
• The relationship between endocrine status and POMS disease severity remains under-explored.

Purpose of the Study:

• To investigate the impact of sex and stress hormones on motor and non-motor disease severity in pediatric patients with multiple sclerosis.
• To compare endocrine profiles of children with POMS to healthy controls.

Main Methods:

• A single-center case-control study involving 40 children with POMS and 40 controls.
• Three morning blood draws per participant to assess hormone levels (testosterone, cortisol, ACTH, progesterone).
• Standardized questionnaires evaluated fatigue (Epworth Sleepiness Scale), depression (PHQ-9), and quality of life (PedsQL).

Main Results:

• Children with POMS exhibited lower free testosterone, cortisol, and ACTH, alongside higher progesterone levels compared to controls.
• No significant association was found between endocrine variables and relapse rates or Expanded Disability Status Scale (EDSS) scores.
• The POMS group reported significantly higher fatigue and depression scores and lower quality of life.

Conclusions:

• Children with POMS display distinct alterations in key sex and stress hormones.
• Despite hormonal differences, endocrine status did not appear to influence motor disease markers or non-motor symptoms in this cohort.