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MS
Scientific Research Foundation Funded Study Looks at Canadian
Children to Uncover Triggers of Multiple Sclerosis
Medical Update Memo
May 7, 2004
Summary
The MS Scientific Research Foundation and the Multiple Sclerosis
Society of Canada announced funding May 4, 2004 of a $4.3
million, multi-centre study of children who have had an initial
attack (clinically isolated syndrome or CIS). The five-year
study will follow the children to find out which ones go
on to experience a second attack and be considered to have
clinically definite multiple sclerosis (MS). This study will
have clinical applicability to children and adults with the
disease. It may also identify the key triggers which cause
multiple sclerosis.
Details
The MS Scientific Research Foundation and the Multiple Sclerosis
Society of Canada announced funding May 4, 2004 of a $4.3
million, multi-centre study of children who have had an initial
attack (clinically isolated syndrome or CIS). The five-year
study will follow the children to find out which ones go
on to experience a second attack and be considered to have
clinically definite multiple sclerosis (MS).
MS is an unpredictable and often disabling
disease of the brain and spinal cord. MS can occur at any age.
While MS is usually diagnosed between the ages of 15 and 40,
when people are finishing school, building careers and establishing
families, it has been diagnosed in children as young as three.
It is likely that MS is under-diagnosed in childhood. It is
estimated that as many as 25% of adult MS patients feel that
their disease started during their childhood or teenage years.
The principal investigators of the study
are: Dr. Brenda Banwell, Hospital for Sick Children, Toronto;
Dr. Amit Bar-Or, Montreal Neurological Institute; Dr. Douglas
Arnold, Montreal Neurological Institute; and Dr. A. Dessa Sadovnick,
University of British Columbia, Vancouver. The study is taking
place at 22 Canadian hospitals in 17 cities across the country.
Paediatric CIS has never before been examined
in detail. This study is now possible by the development of
the Paediatric Demyelinating Disease Network, a Canada-wide
network of physicians and scientists located in Victoria, Vancouver,
Edmonton, Calgary, Saskatoon, Winnipeg, London, Hamilton, Windsor,
Toronto, Kingston, Ottawa, Sherbrooke, Montreal, Saint John,
Halifax and St. John's.
Researchers will follow closely children
who have had one attack suggestive of MS (CIS) to determine
features associated with risk of a second (MS-defining) attack.
Studying children from the time of the first attack allows
researchers to explore the biological factors involved in the
very beginning of the MS disease process. Researchers hope
that these studies will identify the factors involved in the
development of MS.
The three key components of the
study are:
- Clinical and genetic epidemiology
- The researchers will define the clinical
features, demographics and genetic epidemiology of children
with CIS and those children progressing to MS to identify
predictors of the disease. Currently, there are no childhood
predictors for MS.
- The results of the study will increase
awareness of childhood-onset MS and will facilitate prompt
diagnosis by identifying the features of MS in children,
and characteristics predictive of MS risk following a first
attack (CIS). This is important since it would help to
determine whether a child is at high risk of developing
MS and whether treatment with available drug therapies
should begin.
- Pathobiology
- By defining the earliest immunological
events that occur at the time of the first attack (CIS),
investigators will strive to identify both the triggers
and initial targets of the immune cell response.
- In doing so, the study will define
those immune responses associated with, or predictive of,
the risk for further attacks leading to clinically definite
MS.
- Neuroimaging
- MRI (magnetic resonance imaging) is
used to assist in MS diagnosis and in the prediction of
MS risk following CIS in adults. By studying MRI characteristics
in this paediatric study population, the researchers will:
- Create diagnostic MRI criteria for
MS in children, which will facilitate diagnosis.
- Determine if particular MRI features
are predictive of MS risk in children with CIS.
- Utilize newer MRI technologies to
explore whether there are fundamental differences in
the brain white matter (myelin) of children who develop
clinically definite MS compared to who do not go on to
develop MS.
Preliminary study enrolment is already
underway at the Hospital for Sick Children, Toronto. The surveillance
aspect (Canadian Paediatric Society Surveillance program) has
already begun. The study will be formally launched at all sites
on July 1, 2004. All Canadian health care providers will be
asked to complete surveillance information (anonymous) on all
children with CIS in order to understand the annual frequency
of CIS in Canada. Health care providers will then inform parents
and patients about the CIS study and enrolment will occur through
contact with the nearest participating paediatric demyelinating
study site.
Multiple Sclerosis Society of Canada
and MS Scientific Research Foundation
The MS Society of Canada and the MS Scientific
Research Foundation are the largest funders of MS research
in Canada. The MS Society raises funds to support research
and services almost entirely through individual and corporate
donations and fund raising events across the country. The MS
Scientific Research Foundation was established in 1973. It
supports large cooperative multi-disciplinary research projects
that are beyond the scope of the MS Society's regular granting
program. . The MS Scientific Research Foundation receives almost
all of its funding from the MS Society of Canada.
Besides funding MS research, the MS Society
also provides services for people with MS, family members and
caregivers. The MS Society also offers a unique support network
for children and teenagers with MS and their parents.
Commenting on the study Alexander Aird said:
"This is a very significant study for all those touched by
the disease. The Foundation is proud to fund this ground-breaking
research project." Mr. Aird is chair of the MS Scientific Research
Foundation and former chair of the MS Society of Canada.
ASK MS Information System Code: 3.12.u
National Research Department
National Communications & Government Relations Department
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Disclaimer
The Multiple Sclerosis Society of Canada is an independent,
voluntary health agency and does not approve, endorse or
recommend any specific product or therapy but provides information
to assist individuals in making their own decisions.
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