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Researchers Compare MS in Hispanic Latinos Who Get the Disease Before or After Age 18

May 9, 2016

Summary
  • Researchers show that Hispanic/Latinos diagnosed with MS after age 18 were more likely to have severe disability, and also had spinal cord involvement more often as an initial symptom. Those diagnosed before age 18 were more likely to have initial symptoms of seizures and cognitive changes.
  • The team compared these groups for clues to differences that might highlight environmental or genetic factors important to MS development or course in Hispanic/Latinos.
  • Researchers are continuing this work and are seeking to recruit Hispanic/Latinos with MS in Florida and California for these studies.
  • Lead author Dr. Megan Langille was supported by a Clinical Care Physician Fellowship from the National MS Society.
  • The team (Dr. Megan Langille and colleagues, Keck School of Medicine of University of Southern California, Los Angeles) has published results in the Journal of Child Neurology (published early online, March 28, 2016).
 
Details
Background: For decades, many healthcare professionals assumed that MS was uncommon in the Hispanic/Latino population. But recent studies are suggesting an increase in the number of people throughout Latin America diagnosed with MS. Previous findings supported by the National MS Society have called attention to the need to better understand any unique characteristics of MS in this population and the need for more accessible and culturally relevant healthcare and social services. Improving access to quality MS care across the cultural and socioeconomic spectrum means understanding how each group experiences and perceives the disease and identifying the factors that limit access to care. Also, understanding genetic and clinical differences between ethnic groups may yield important clues to the causes of MS.
 
Last year, researchers at the University of Miami reported that Hispanic/Latinos (primarily of Caribbean ancestry) were younger at the time of diagnosis and had more mobility impairment than non-Hispanic white people with MS. The current University of Southern California (USC) study compared characteristics of MS between Hispanic/Latinos diagnosed before age 18 and those diagnosed as adults, for clues to differences that might highlight environmental or genetic factors important to development or course of MS in this population.
 
The Study: Dr. Langille and colleagues compiled information on 110 Hispanic Latinos diagnosed with MS before age 18 and 253 people diagnosed as adults, who were enrolled in the USC Hispanic MS Registry and Children’s Hospital Los Angeles MS Registry. They looked at clinical characteristics including age of first symptom, age of diagnosis, disease activity, current disease-modifying treatment, disability (as measured by the EDSS scale), cognitive difficulties, and place of birth.
 
Their results suggest that those diagnosed as adults had more severe disability than those diagnosed before age 18, despite similar disease duration and time to diagnosis. However, those experiencing first symptom at a younger age and born in the United States were less likely to have ambulatory disability. The most common initial symptom of MS in both groups was optic neuritis (inflammation of the optic, or eye nerve), and those with adult onset were more likely to have spinal cord involvement. Cognitive changes and seizures at MS onset were more common in the pediatric-onset group. A majority of those diagnosed before 18 were taking glatiramer acetate, which was used significantly less frequently in those with adult onset. Treatment rates of other medications were similar.
 
Dr. Megan Langille was supported by a Clinical Care Physician Fellowship from the National MS Society. The team at Keck School of Medicine of USC recently published results in the Journal of Child Neurology (published early online, March 28, 2016).
 
Comment: Studies such as this one can improve our understanding of how MS impacts specific populations, which could improve healthcare and may also provide important clues to the development of MS in this population and in others.  These researchers and others are continuing this work and are seeking to recruit Hispanic/Latinos with MS in Florida and California for these studies.
 
Read more: The National MS Society’s Hispanic/Latino Advisory Council advises the Society on strategies and programs to overcome cultural barriers and make resources more available to this community.
Read more about this council and about resources for Hispanics/Latinos with MS.
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About Multiple Sclerosis

Multiple sclerosis is an unpredictable disease of the central nervous system. Currently there is no cure. Symptoms vary from person to person and may include disabling fatigue, mobility challenges, cognitive changes, and vision issues. An estimated 1 million people live with MS in the United States. Early diagnosis and treatment are critical to minimize disability. Significant progress is being made to achieve a world free of MS.

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