Contributions
Abstract: P857
Type: Poster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Background: Depression occurs with greater frequency in healthy girls than boys, and is influenced by physical activity level (PAL) in youth. In youth with Multiple Sclerosis (MS), cross-sectional studies have shown PAL to correlate with fatigue and depressive symptoms. It is unknown whether fatigue and depression change over time in youth with demyelinating disease, and whether these changes are affected by sex or PAL.
Objectives: To determine if sex and PAL are predictive of symptoms of fatigue and depression in youth with MS or monophasic acquired demyelinating syndrome (mono-ADS) over time.
We hypothesize that girls will report greater symptoms of depression and fatigue than boys, and that greater physical activity participation is associated with reduced symptoms in both sexes but will have a larger effect in girls.
Methods: Standardized fatigue, depression, and PAL questionnaires were collected at each visit in youth attending a Neuroinflammatory Clinic (2013-2017). Joint mixed linear models examined the associations of sex and PAL with fatigue and depression over time controlling for age and time from disease onset, sex, relapse rate, depression, and disability.
Results: In 183 patients (49=MS, 35F) (134=mono-ADS, 67 F) representing 525 patient visits (average followup 10 years), a trajectory of increased fatigue over-time was found in both MS (1.4 points/year, p < 0.01) and mono-ADS (0.75 points/year, p< 0.04). Females in the MS group demonstrated (2.2 point/year, p< 0.009) increase in total fatigue, and a trend was present in males with a mono-ADS (1.1 point/year, p< 0.058). Youth with MS demonstrated higher depressive symptoms (estimate=7.3, p< 0.0002) than mono-ADS. However, depressive symptoms did not increase significantly over time in either group. Females with MS demonstrated a trend for increased depressive symptoms over time (1.2 points/year, p = 0.07). Every unit increase in PAL was associated with a decrease in depression score (-0.08, p= 0.0004) in MS youth, a similar effect was exhibited in both males and females. Further, every unit increase in PAL was also associated with a decrease in general fatigue (-0.04, p< 0.01) in females with MS and (-0.04, p< 0.02) in males with mono-ADS.
Conclusions: In youth with demyelinating conditions, PAL and sex differentially influenced symptoms of depression and fatigue over time. Our results may inform planning of future interventions to improve mood in youth with demyelinating disease.
Disclosure:
S. Stephens nothing to disclosure
S.Shams nothing to disclosure
J. Lee nothing to disclosure
S.A. Grover nothing to disclosure
G. Longoni nothing to disclosure
M. Finlayson nothing to disclosure
R.W. Motl nothing to disclosure
EAY has received funds from NMSS, CIHI, CIHR, OIRM, MS Society of Canada, Mario Batali Foundation, SickKids Foundation, CBMH Innovation Fund, CMSC, Rare Diseases Foundation and Guthy Jackson Foundation. She serves as a relapse adjudicator for ACI. She has served on a scientific advisory panel for Juno Therapeutics and has received a speaker's honorarium from Novartis.
Abstract: P857
Type: Poster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Background: Depression occurs with greater frequency in healthy girls than boys, and is influenced by physical activity level (PAL) in youth. In youth with Multiple Sclerosis (MS), cross-sectional studies have shown PAL to correlate with fatigue and depressive symptoms. It is unknown whether fatigue and depression change over time in youth with demyelinating disease, and whether these changes are affected by sex or PAL.
Objectives: To determine if sex and PAL are predictive of symptoms of fatigue and depression in youth with MS or monophasic acquired demyelinating syndrome (mono-ADS) over time.
We hypothesize that girls will report greater symptoms of depression and fatigue than boys, and that greater physical activity participation is associated with reduced symptoms in both sexes but will have a larger effect in girls.
Methods: Standardized fatigue, depression, and PAL questionnaires were collected at each visit in youth attending a Neuroinflammatory Clinic (2013-2017). Joint mixed linear models examined the associations of sex and PAL with fatigue and depression over time controlling for age and time from disease onset, sex, relapse rate, depression, and disability.
Results: In 183 patients (49=MS, 35F) (134=mono-ADS, 67 F) representing 525 patient visits (average followup 10 years), a trajectory of increased fatigue over-time was found in both MS (1.4 points/year, p < 0.01) and mono-ADS (0.75 points/year, p< 0.04). Females in the MS group demonstrated (2.2 point/year, p< 0.009) increase in total fatigue, and a trend was present in males with a mono-ADS (1.1 point/year, p< 0.058). Youth with MS demonstrated higher depressive symptoms (estimate=7.3, p< 0.0002) than mono-ADS. However, depressive symptoms did not increase significantly over time in either group. Females with MS demonstrated a trend for increased depressive symptoms over time (1.2 points/year, p = 0.07). Every unit increase in PAL was associated with a decrease in depression score (-0.08, p= 0.0004) in MS youth, a similar effect was exhibited in both males and females. Further, every unit increase in PAL was also associated with a decrease in general fatigue (-0.04, p< 0.01) in females with MS and (-0.04, p< 0.02) in males with mono-ADS.
Conclusions: In youth with demyelinating conditions, PAL and sex differentially influenced symptoms of depression and fatigue over time. Our results may inform planning of future interventions to improve mood in youth with demyelinating disease.
Disclosure:
S. Stephens nothing to disclosure
S.Shams nothing to disclosure
J. Lee nothing to disclosure
S.A. Grover nothing to disclosure
G. Longoni nothing to disclosure
M. Finlayson nothing to disclosure
R.W. Motl nothing to disclosure
EAY has received funds from NMSS, CIHI, CIHR, OIRM, MS Society of Canada, Mario Batali Foundation, SickKids Foundation, CBMH Innovation Fund, CMSC, Rare Diseases Foundation and Guthy Jackson Foundation. She serves as a relapse adjudicator for ACI. She has served on a scientific advisory panel for Juno Therapeutics and has received a speaker's honorarium from Novartis.