Abstract Details

Title Childhood Adversity is Associated With Greater MS Symptoms, Disability Scores, and Epigenetic Changes in Pediatric and Adult-onset Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 18-003

Objective To describe associations between childhood adversity and multiple sclerosis (MS) symptoms and disability in early adulthood among pediatric-onset MS and adult-onset MS. Epigenetic changes are also assessed.

Background

Childhood adversity is increasingly recognized as a critical modifier of neurologic disease, including in MS. While the underlying biological mechanisms remain poorly understood, epigenetic modifications may be a potential pathogenic mechanism.

Design/Methods We evaluated 60 consecutively enrolled young adults with MS; 30 with pediatric-onset MS (POMS) and 30 with adult-onset MS (AOMS). Childhood adversity was defined using a composite index of the Adverse Childhood Experiences (ACEs) questionnaire, parental education level, and estimated household income during childhood. Clinical outcomes included patient-reported SymptoMScreen questionnaire regarding MS symptom burden and MS neurologist-assessed disability using the Expanded Disability Status Scale (EDSS) of the participant’s neurologic exam at the time of enrollment. Genome-wide epigenetic profiles (DNA methylation via RRBS; reduced representation bisulfite sequencing) were also assessed.

Results At time of enrollment in this cross-sectional study, participants had MS disease duration of 6 years on average. POMS participants were mean 22.09 (2.66) years and AOMS participants were mean 32.41 (2.19) years old. 62% of participants were female. 26 participants met criteria for high childhood adversity and 34 participants did not. Individuals with high childhood adversity reported greater SymptoMScreen composite scores compared to individuals with low childhood adversity (15.12 vs 7.54, p=0.001). Among individuals with EDSS scores above 0, 6/24 (10%) had a history of low childhood adversity compared to 18/24 (30%) with a history of high childhood adversity, p=0.027. Furthermore, POMS participants with high childhood adversity had increased DNA methylation.

Conclusions

Our findings suggest that childhood adversity is associated with increased MS symptom burden and neurologic disability in young adults with MS. Epigenetic changes associated with childhood adversity were especially notable among the POMS population.

Authors/Disclosures
Kimberly O'Neill, MD PRESENTER	Dr. O'Neill has nothing to disclose.
Bernard K. van der Veer, PhD	Dr. van der Veer has nothing to disclose.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.
Nadine Azmy	No disclosure on file
Steven Friedman	Steven Friedman has nothing to disclose.
Jiyuan Hu (NYU Grossman School of Medicine)	Jiyuan Hu has nothing to disclose.
Kevin Lei, BS	Mr. Lei has nothing to disclose.
Robin Ortiz, MD	Dr. Ortiz has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCAAN (UCLA-UCSF ACEs Aware Family Resilience Network) and related Adverser Childhood Experiences (ACEs) work. Dr. Ortiz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for New York State Trauma-Informed Resource Network Adivosry Board.
Shayna Pehel	Ms. Pehel has nothing to disclose.
Ruyu Shi, PhD	Ms. Shi has nothing to disclose.
Anna Sosa	Anna Sosa has nothing to disclose.
Kian Koh, PhD	Prof. Koh has nothing to disclose.
Mirjana Maletic-Savatic, MD, PhD (Baylor College of Medicine)	Dr. Maletic-Savatic has nothing to disclose.
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.

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