Incomplete relapse recovery contributes to disability accrual and earlier onset of secondary progressive multiple sclerosis. We sought to investigate the effect of age on relapse recovery. We identified patients with multiple sclerosis from two longitudinal prospective studies, with an Expanded Disability Status Scale (EDSS) score within 30 days after onset of an attack, and follow-up EDSS 6 months after attack. Adult patients with multiple sclerosis (n = 632) were identified from the Comprehensive Longitudinal Investigations in Multiple Sclerosis at Brigham study (CLIMB), and paediatric patients (n = 132) from the US Network of Paediatric Multiple Sclerosis Centers (NPMSC) registry. Change in EDSS was defined as the difference in EDSS between attack and follow-up. Change in EDSS at follow-up compared to baseline was significantly lower in children compared to adults (P = 0.001), as were several functional system scores. Stratification by decade at onset for change in EDSS versus age found for every 10 years of age, EDSS recovery is reduced by 0.15 points (P < 0.0001). A larger proportion of children versus adults demonstrated improvement in EDSS following an attack (P = 0.006). For every 10 years of age, odds of EDSS not improving increase by 1.33 times (P < 0.0001). Younger age is associated with improved recovery from relapses. Age-related mechanisms may provide novel therapeutic targets for disability accrual in multiple sclerosis.

中文翻译：

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与成人多发性硬化症相比，儿科的复发恢复得到改善。

不完全的复发恢复有助于残障的累积和继发性进行性多发性硬化的较早发作。我们试图调查年龄对复发恢复的影响。我们从两项纵向前瞻性研究中确定了多发性硬化症患者，发作后30天内具有扩展的残疾状态量表（EDSS）评分，发作后6个月进行了随访EDSS。从在Brigham研究中进行的多发性硬化症纵向综合调查（CLIMB）中确定了成年多发性硬化症患者（n  =  632），而儿科患者（n  = 132）来自美国小儿多发性硬化症中心网络（NPMSC）注册表。EDSS的变化定义为发作和随访之间EDSS的差异。与成人相比，儿童的随访中EDSS的变化与基线相比显着更低（P  =  0.001），几个功能系统评分也是如此。EDSS相对于每10岁的年龄发生变化时按十年分层，EDSS恢复降低0.15点（P  <  0.0001）。发作后，较大的儿童对成年人表现出EDSS改善（P  =  0.006）。每10岁，EDSS改善的几率增加1.33倍（P  < 0.0001）。年龄越小，复发的恢复就越好。与年龄有关的机制可能为多发性硬化症中应计残疾提供新的治疗靶标。