Early Adversity and Socioeconomic Factors in Pediatric Multiple Sclerosis: A Case-Control Study.

IF 7.8 1区 医学 Q1 CLINICAL NEUROLOGY Neurology® Neuroimmunology & Neuroinflammation Pub Date : 2024-09-01 Epub Date: 2024-08-15 DOI:10.1212/NXI.0000000000200282
Sarah K G Jensen, Susana Camposano, Anne Berens, Michael Waltz, Lauren B Krupp, Leigh Charvet, Anita L Belman, Gregory S Aaen, Leslie A Benson, Meghan Candee, Theron C Casper, Tanuja Chitnis, Jennifer Graves, Yolanda S Wheeler, Ilana Kahn, Timothy E Lotze, Soe S Mar, Mary Rensel, Moses Rodriguez, John W Rose, Jennifer P Rubin, Jan-Mendelt Tillema, Amy T Waldman, Bianca Weinstock-Guttman, Lisa F Barcellos, Emmanuelle Waubant, Mark P Gorman
{"title":"Early Adversity and Socioeconomic Factors in Pediatric Multiple Sclerosis: A Case-Control Study.","authors":"Sarah K G Jensen, Susana Camposano, Anne Berens, Michael Waltz, Lauren B Krupp, Leigh Charvet, Anita L Belman, Gregory S Aaen, Leslie A Benson, Meghan Candee, Theron C Casper, Tanuja Chitnis, Jennifer Graves, Yolanda S Wheeler, Ilana Kahn, Timothy E Lotze, Soe S Mar, Mary Rensel, Moses Rodriguez, John W Rose, Jennifer P Rubin, Jan-Mendelt Tillema, Amy T Waldman, Bianca Weinstock-Guttman, Lisa F Barcellos, Emmanuelle Waubant, Mark P Gorman","doi":"10.1212/NXI.0000000000200282","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Psychosocial adversity and stress, known to predispose adults to neurodegenerative and inflammatory immune disorders, are widespread among children who experience socioeconomic disadvantage, and the associated neurotoxicity and proinflammatory profile may predispose these children to multiple sclerosis (MS). We sought to determine associations of socioeconomic disadvantage and psychosocial adversity with odds of pediatric-onset MS (POMS), age at POMS onset, and POMS disease activity.</p><p><strong>Methods: </strong>This case-control study used data collected across 17 sites in the United States by the Environmental and Genetic Risk Factors for Pediatric Multiple Sclerosis Study. Cases (n = 381) were youth aged 3-21 years diagnosed with POMS or a clinically isolated demyelinating syndrome indicating high risk of MS. Frequency-matched controls (n = 611) aged 3-21 years were recruited from the same institutions. Prenatal and postnatal adversity and postnatal socioeconomic factors were assessed using retrospective questionnaires and zip code data. The primary outcome was MS diagnosis. Secondary outcomes were age at onset, relapse rate, and Expanded Disability Status Scale (EDSS). Predictors were maternal education, maternal prenatal stress events, child separation from caregivers during infancy and childhood, parental death during childhood, and childhood neighborhood disadvantage.</p><p><strong>Results: </strong>MS cases (64% female, mean age 15.4 years, SD 2.8) were demographically similar to controls (60% female, mean age 14.9 years, SD 3.9). Cases were less likely to have a mother with a bachelor's degree or higher (OR 0.42, 95% CI 0.22-0.80, <i>p</i> = 0.009) and were more likely to experience childhood neighborhood disadvantage (OR 1.04 for each additional point on the neighborhood socioeconomic disadvantage score, 95% CI 1.00-1.07; <i>p</i> = 0.025). There were no associations of the socioeconomic variables with age at onset, relapse rate, or EDSS, or of prenatal or postnatal adverse events with risk of POMS, age at onset, relapse rate, or EDSS.</p><p><strong>Discussion: </strong>Low socioeconomic status at the neighborhood level may increase the risk of POMS while high parental education may be protective against POMS. Although we did not find associations of other evaluated prenatal or postnatal adversities with POMS, future research should explore such associations further by assessing a broader range of stressful childhood experiences.</p>","PeriodicalId":19472,"journal":{"name":"Neurology® Neuroimmunology & Neuroinflammation","volume":"11 5","pages":"e200282"},"PeriodicalIF":7.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379435/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology® Neuroimmunology & Neuroinflammation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1212/NXI.0000000000200282","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background and objectives: Psychosocial adversity and stress, known to predispose adults to neurodegenerative and inflammatory immune disorders, are widespread among children who experience socioeconomic disadvantage, and the associated neurotoxicity and proinflammatory profile may predispose these children to multiple sclerosis (MS). We sought to determine associations of socioeconomic disadvantage and psychosocial adversity with odds of pediatric-onset MS (POMS), age at POMS onset, and POMS disease activity.

Methods: This case-control study used data collected across 17 sites in the United States by the Environmental and Genetic Risk Factors for Pediatric Multiple Sclerosis Study. Cases (n = 381) were youth aged 3-21 years diagnosed with POMS or a clinically isolated demyelinating syndrome indicating high risk of MS. Frequency-matched controls (n = 611) aged 3-21 years were recruited from the same institutions. Prenatal and postnatal adversity and postnatal socioeconomic factors were assessed using retrospective questionnaires and zip code data. The primary outcome was MS diagnosis. Secondary outcomes were age at onset, relapse rate, and Expanded Disability Status Scale (EDSS). Predictors were maternal education, maternal prenatal stress events, child separation from caregivers during infancy and childhood, parental death during childhood, and childhood neighborhood disadvantage.

Results: MS cases (64% female, mean age 15.4 years, SD 2.8) were demographically similar to controls (60% female, mean age 14.9 years, SD 3.9). Cases were less likely to have a mother with a bachelor's degree or higher (OR 0.42, 95% CI 0.22-0.80, p = 0.009) and were more likely to experience childhood neighborhood disadvantage (OR 1.04 for each additional point on the neighborhood socioeconomic disadvantage score, 95% CI 1.00-1.07; p = 0.025). There were no associations of the socioeconomic variables with age at onset, relapse rate, or EDSS, or of prenatal or postnatal adverse events with risk of POMS, age at onset, relapse rate, or EDSS.

Discussion: Low socioeconomic status at the neighborhood level may increase the risk of POMS while high parental education may be protective against POMS. Although we did not find associations of other evaluated prenatal or postnatal adversities with POMS, future research should explore such associations further by assessing a broader range of stressful childhood experiences.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
小儿多发性硬化症的早期逆境和社会经济因素:病例对照研究
背景和目的:众所周知,社会心理逆境和压力会使成年人易患神经退行性疾病和炎症性免疫疾病,而在处于社会经济不利地位的儿童中,社会心理逆境和压力也很普遍,相关的神经毒性和促炎症特征可能会使这些儿童易患多发性硬化症(MS)。我们试图确定社会经济劣势和社会心理逆境与小儿多发性硬化症(POMS)发病几率、POMS发病年龄和POMS疾病活动性之间的关系:这项病例对照研究使用了 "小儿多发性硬化症环境和遗传风险因素研究"(Environmental and Genetic Risk Factors for Pediatric Multiple Sclerosis Study)在美国 17 个地点收集的数据。病例(n = 381)为被诊断患有多发性硬化症或临床孤立性脱髓鞘综合征(表明多发性硬化症风险较高)的 3-21 岁青少年。年龄在3-21岁的频率匹配对照组(n = 611)从同一机构招募。采用回顾性问卷和邮政编码数据对产前和产后逆境以及产后社会经济因素进行了评估。主要结果是多发性硬化症的诊断。次要结果为发病年龄、复发率和扩展残疾状况量表(EDSS)。预测因素包括母亲教育程度、母亲产前压力事件、婴儿期和儿童期与照顾者分离、儿童期父母死亡以及儿童期邻里关系不利:多发性硬化症病例(64%为女性,平均年龄为15.4岁,SD为2.8)与对照组(60%为女性,平均年龄为14.9岁,SD为3.9)的人口统计学特征相似。病例的母亲拥有学士学位或更高学历的可能性较低(OR 0.42,95% CI 0.22-0.80,p = 0.009),并且更有可能在童年时期处于邻里不利地位(邻里社会经济不利地位得分每增加一分,OR 1.04,95% CI 1.00-1.07;p = 0.025)。社会经济变量与发病年龄、复发率或EDSS没有关联,产前或产后不良事件与POMS风险、发病年龄、复发率或EDSS也没有关联:讨论:邻里层面的低社会经济地位可能会增加罹患POMS的风险,而父母的高教育程度可能会对POMS起到保护作用。虽然我们没有发现其他已评估过的产前或产后逆境与POMS有关联,但未来的研究应通过评估更广泛的童年压力经历来进一步探讨这种关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
15.60
自引率
2.30%
发文量
219
审稿时长
8 weeks
期刊介绍: Neurology Neuroimmunology & Neuroinflammation is an official journal of the American Academy of Neurology. Neurology: Neuroimmunology & Neuroinflammation will be the premier peer-reviewed journal in neuroimmunology and neuroinflammation. This journal publishes rigorously peer-reviewed open-access reports of original research and in-depth reviews of topics in neuroimmunology & neuroinflammation, affecting the full range of neurologic diseases including (but not limited to) Alzheimer's disease, Parkinson's disease, ALS, tauopathy, and stroke; multiple sclerosis and NMO; inflammatory peripheral nerve and muscle disease, Guillain-Barré and myasthenia gravis; nervous system infection; paraneoplastic syndromes, noninfectious encephalitides and other antibody-mediated disorders; and psychiatric and neurodevelopmental disorders. Clinical trials, instructive case reports, and small case series will also be featured.
期刊最新文献
"Lupus Myelitis" Revisited: A Retrospective Single-Center Study of Myelitis Associated With Rheumatologic Disease. Missing Full Disclosures. Obesity Affects Disease Activity and Progression, Cognitive Functioning, and Quality of Life in People With Multiple Sclerosis. Proteomic Profiling and Pathophysiological Implications in Multiple Sclerosis. Proteomics Reveals Age as Major Modifier of Inflammatory CSF Signatures in Multiple Sclerosis.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1