Evidence map›Paper›PMID 42525242›Full record

ReviewJournal of neurology2026

Prognostic factors in paediatric-onset multiple sclerosis: a narrative review.

Mariaclara Achille, Massimiliano Copetti, Tommaso Guerra, Caterina Ferri, Pietro Iaffaldano, Sandra D'Alfonso, Maura Pugliatti, Roberto Palumbi, Marta Simone

Abstract readReview
In one paragraph

Review in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mariaclara AchilleDepartment of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro", Bari, Italy.
Massimiliano CopettiUnit of Biostatistics, Fondazione IRCCS "Casa Sollievo Della Sofferenza", San Giovanni Rotondo, Italy.
Tommaso GuerraDepartment of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro", Bari, Italy.
Caterina FerriDepartment of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
Pietro IaffaldanoDepartment of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro", Bari, Italy.
Sandra D'AlfonsoUniversity of Piemonte Orientale "Amedeo Avogadro", Novara, Italy.
Maura PugliattiDepartment of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
Roberto PalumbiDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Marta SimoneChild Neuropsychiatry Unit, Department of Precision and Regenerative Medicine, Jonic Area, University of Bari "Aldo Moro", Bari, Italy. marta.simone@uniba.it.ORCID http://orcid.org/0000-0003-4381-4613

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPaediatric-onset multiple sclerosis (POMS) accounts for 3-10% of multiple sclerosis (MS) cases and differs from adult-onset disease in course, treatment response and long-term outcomes. Risk stratification is essential, yet the literature frequently conflates three distinct questions: which children develop MS (susceptibility), which convert from a first demyelinating event (conversion) and which, once diagnosed, will accrue disability (prognosis).

objectiveThis study aimed to provide a narrative overview of candidate prognostic factors in POMS, separated from susceptibility and conversion factors and organised by the outcome each predicts.

methodsPubMed and Google Scholar were searched (2002-2025, with hand searching of pivotal 2026 cohorts) using a predefined string and full eligibility criteria. Factors were classified along three axes of inference and graded into four evidence tiers (replicated; preliminary; susceptibility rather than prognosis; inconsistent). No formal risk-of-bias assessment was undertaken, consistent with the narrative design.

resultsThe most reproducible post-diagnosis predictors were early inflammatory activity (relapse number and inter-attack interval in the first two years, annualised relapse rate, early EDSS change), lesion topography (brainstem, spinal cord), T2 lesion accrual, serum neurofilament light chain and treatment-related variables (delayed disease-modifying therapy, early high-efficacy treatment). Advanced MRI metrics, serum glial fibrillary acidic protein and other fluid biomarkers remain preliminary; baseline EDSS was inconsistent. Most dietary, environmental and perinatal exposures relate to susceptibility, not course.

conclusionsCurrent evidence supports candidate predictors, not a validated instrument, and inference is further complicated by confounding by indication. A multidimensional, externally validated POMS-specific prognostic score remains to be developed-the aim of the ongoing PROMISING study.

Indexed as

Disease ProgressionMultiple SclerosisAge of OnsetChildHumansPrognosisDisability progressionDisease-modifying therapyPaediatric-onset multiple sclerosisPrediction modelsPrognostic factorsSerum neurofilament light chain

Identifiers

PMID42525242
PMCPMC13421221

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.