Friday, 14 December 2012

Research: fatigue, emotional problems in young MSers

#MSBlog: Childhood MS causes similar problem to adult-onset disease!

EpubHolland AA, Graves D, Greenberg BM, Harder LL. Fatigue, emotional functioning, and executive dysfunction in pediatric multiple sclerosis. Child Neuropsychol. 2012 Dec.

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with MS in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MSers or CISers, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. MSers and parents completed questionnaires related to the MSers' quality of life and fatigue. Pearson's correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices-but not age of onset or disease duration-significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.

"These results are not surprising. MS is a disease of the brain, whether or not you are an adult or a child. Time to get on top of the issue?"


  1. "Time to get on top of the issue?"

    Strange question. Just found out that my friend's 14 year old daughter has been diagnosed with MS. I'm waiting for the call to ask me what they should do. Handing them the guide will scare them to death - endless list of dreadful things that may affect her life. I'd like to give them so hope for the future e.g. The possibility of Alemtuzumab in a couple of years or B cell depleting treatment a few years after this. What struck me, is there are no stats in the same way as cancer e.g. XX per cent alive after XX years. We're nearly in 2013, but I couldn't hand on heart tel them the future is much better and MS won't impact on her life as it did for those before.

    1. Do not get her checked for CCSVI, it is unproven and will be a waste of her parent's money.
      MS is not a death sentence, everybody's experience is different it may even go away of it's own accord.
      The reason the stats aren't there is that drugs like Alemtuzumab are new treatments and have only been used for a few years but the initial data is encouraging as is the prospect of better and more effective treatments in the future.
      The future is much brighter than some would suggest.

    2. MD2,

      Thanks for the response - don't worry about the scam which is CCSVI. The parents know I've done extremely well (Campath patient). I think there is quite a bit of MS in their family e.g. Aunts. I want to be positive for them and will tell them that the future looks much brighter.

    3. Glad that Campath has done so well for you. Hope many more get the chance to get treated in the future.
      I would stress that the future IS much brighter than it was 10 years ago and certainly since I started in the MS field. If her parents have any questions, direct them to the blog and we'll answer asap.

    4. I've done pretty well on CCSVI too. Still lasting. Why take one case as true and the other as a placebo?

    5. Because a large-group trial showed campath patients did better than placebo? Which may just be true of ccsvi too, but we don't know

    6. Campath patients did better than INFb, not placebo. On the other hand INFb trials were essentially unblinded on patient side, due to side effects, which means that their "efficacy" was largely a placebo effect.

      Still, taking two real MS cases that do well, one on Alem, the other on CCSVI treatment, makes you wonder what do we really know about MS.

  2. She can always get checked for CCSVI, but NOT proceed into any intervention. Knowing everything that might be wrong in the body is a first sensible step.

  3. Scans are not free & it puts you in the land of the scammers, who are out to make a buck or too.

    If you believe the recent Italian study, CCSVI only exists in about 2-3% of cases, so why would you want an intervention for something that may not exist and an intervention with no proven lasting benefit.

    Why not have your genome sequenced? Whilst your at it, this costs about as much as an intervention, maybe much more informative in the long run.

    Oh the microbiome is the next hot topic, so maybe check out your gut flora too....

    Where do you stop.....At the start.

    1. This comment has been removed by the author.

    2. Is that what you would do MD? Stop at the start?

  4. Anon this is a facebook group for parents of kid and teens with MS. In my experience a group like this is a lifesaver when a child is diagnosed

  5. According to the latest cochrane review, there is no evidence to support or refute the efficacy of CCSVI treatment.

    There is a lot of refuting going on here, isn't there? "Unproven" is accurate but "scam" comes across harshly. Over in the CCSVI community the talk about neuros can be harsh also. Deep division when as far as I can tell there is agreement that research is needed.

    Fatigue, emotional difficulties, and executive dysfunction in pediatric's awful enough as an adult, it is painful to imagine in a child. 'Time to get on top of the issue' is completely accurate, and there clearly is much research and effort being put into ameliorating or solving MS.


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