Age at disease onset has a significant effect on pathophysiology of multiple sclerosis (MS); younger patients initially present with limited MS-related damage that progresses with loss of white matter (WM) integrity, followed by gray matter (GM) atrophy, then disability.
Why this matters
While several studies have evaluated pathophysiological processes involved in MS, interpretation of their results has been limited by confounding effects of age or disease duration (DD).
The present study used a large cohort of healthy controls (HC) to remove MS-independent effects of age and sex from magnetic resonance imaging (MRI) variables to evaluate MS pathophysiology.
This study supports application of disease modifying treatments (DMT) early in the disease process for pediatric-onset MS (POMS) patients, to mitigate neuroaxonal damage.