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小儿多发性硬化症:改变疾病进展轨迹。

Pediatric Multiple Sclerosis: Changing the Trajectory of Progression.

机构信息

Department of Pediatrics (Neurology), SickKids Research Institute, Division of Neurosciences and Mental Health, Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON, M5G1X8, Canada.

出版信息

Curr Neurol Neurosci Rep. 2023 Nov;23(11):657-669. doi: 10.1007/s11910-023-01300-3. Epub 2023 Oct 4.

Abstract

PURPOSE OF REVIEW

Multiple sclerosis is a chronic inflammatory disease of the central nervous system. When seen in children and adolescents, crucial stages of brain development and maturation may be affected. Prompt recognition of multiple sclerosis in this population is essential, as early intervention with disease-modifying therapies may change developmental trajectories associated with the disease. In this paper, we will review diagnostic criteria for pediatric multiple sclerosis, outcomes, differential diagnosis, and current therapeutic approaches.

RECENT FINDINGS

Recent studies have demonstrated the utility of newer structural and functional metrics in facilitating early recognition and diagnosis of pediatric MS. Knowledge about disease-modifying therapies in pediatric multiple sclerosis has expanded in recent years: important developmental impacts of earlier therapeutic intervention and use of highly effective therapies have been demonstrated. Pediatric MS is characterized by highly active disease and high disease burden. Advances in knowledge have led to early identification, diagnosis, and treatment. Lifestyle-related interventions and higher efficacy therapies are currently undergoing investigation.

摘要

目的综述

多发性硬化症是一种中枢神经系统的慢性炎症性疾病。当发生于儿童和青少年时,大脑发育和成熟的关键阶段可能会受到影响。因此,在这一人群中及时识别多发性硬化症至关重要,因为早期采用疾病修正疗法可能会改变与疾病相关的发育轨迹。本文将综述儿童多发性硬化症的诊断标准、结局、鉴别诊断和当前的治疗方法。

最新发现

最近的研究表明,新的结构和功能指标在促进儿童多发性硬化症的早期识别和诊断方面具有实用性。近年来,人们对儿童多发性硬化症的疾病修正疗法有了更多的了解:早期治疗干预和使用高效疗法的重要发育影响已得到证实。儿童多发性硬化症的特点是疾病高度活跃且疾病负担高。知识的进步导致了早期的识别、诊断和治疗。目前正在研究与生活方式相关的干预措施和更高疗效的治疗方法。

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