Italian studies on early-onset multiple sclerosis: the present and the future

Over the last years some studies have been published in Italy evaluating the features at presentation, the natural history and outcome of multiple sclerosis (MS) with onset during childhood [1] or adolescence [2-4], and the characteristics of MRI [5]. The results of these studies are reported in other sections of this volume. These studies have contributed to better understanding of the peculiar findings of early-onset MS. Cases with onset in infancy raise the question about the criteria for differentiating MS from ADEM [1, 6, 7]; cases with onset during adolescence raise the possibility of understanding the prognosis of the disease better, and thus ameliorating it by means of disease modifying drugs (DMDs). There is increasing evidence that immunomodulatory drugs are effective in reducing the relapse rate and disease progression in adult cases with relapsing-remitting (RR) MS [8], however there are no sufficient data in cases in a younger age group or on the long-term tolerability [9]. In order to obtain data from a large number of cases observed over a long follow-up, four studies have been promoted in Italy: the objectives and preliminary results, when available, will be presented in the following sections.