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Abstract Details

Association of Social Determinants of Health with Brain MRI Outcomes in Individuals with Pediatric Onset Multiple Sclerosis
Multiple Sclerosis
S3 - Multiple Sclerosis: Clinical Trials (1:24 PM-1:36 PM)
003

Accumulating evidence points to worse clinical outcomes among adults with MS belonging to minority or poverty-impacted groups. In contrast, little is known about the outcomes of these populations with POMS. Individuals with POMS represent 5% of the MS population and are more racially diverse, yet have been understudied with respect to socioeconomic environment or characteristics.

To investigate the association between childhood social determinants of health (SDOH) and brain MRI outcomes in individuals with pediatric onset multiple sclerosis (POMS).

This is a retrospective study of POMS patients evaluated at the NYU Langone MS Comprehensive Care Center who underwent quantitative volumetric neuroimaging of the brain using icobrain software. Associations between volumetric MRI results (white matter lesion volume, black hole volume) and proxies of SDOH (including insurance type, childhood neighborhood social vulnerability index (SVI), and self-reported race and ethnicity) were assessed. Comprehensive linear regression models using LASSO (Least Absolute Shrinkage and Selection Operator) methods were utilized.

138 POMS patients (70% female) were included with a median disease duration of 4 years at time of scan. Public health insurance, Black race, Hispanic ethnicity, low parental education, and high SVI (greater neighborhood disadvantage) were each associated with white matter lesion and black hole volume. SVI was the strongest individual predictor of total white matter lesion (β=4.63, p=0.002) and black hole volume (β=2.91, p=0.003). In models incorporating all SDOH variables, public health insurance was the strongest predictor of total lesion (β=2.48, p=0.01) and black hole volume (β=1.50, p=0.02), attenuating the effect of SVI. There were no differences in disease modifying therapy (DMT) timing or efficacy between categories of social disadvantage.

Individual and neighborhood-level indicators of social disadvantage are associated with worse brain MRI outcomes in POMS. Further investigation of social risk factors for MS susceptibility and severity is needed to reduce MS health disparities.

Authors/Disclosures
Kimberly O'Neill, MD
PRESENTER
Dr. O'Neill has nothing to disclose.
Ruby Ross (NYU Grossman School of Medicine) Ms. Ross has nothing to disclose.
Rebecca Betensky, PhD Dr. Betensky has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PTC Therapeutics. Dr. Betensky has received personal compensation in the range of $100,000-$499,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Betensky has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Natera. Dr. Betensky has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for AstraZeneca. Dr. Betensky has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Veloxis Pharmaceuticals. Dr. Betensky has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Finch Therapeutics. Dr. Betensky has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Lupin Pharmaceuticals. The institution of Dr. Betensky has received research support from NIH.
Thibo Billiet, PhD Dr. Billiet has received personal compensation for serving as an employee of icometrix.
Rachel Kenney Rachel Kenney has received personal compensation for serving as an employee of Optum. Rachel Kenney has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Minton 好色先生 LLC.
Jessica T. Lovett, MD Dr. Lovett has nothing to disclose.
Mirjana Maletic-Savatic, MD, PhD (Baylor College of Medicine) Dr. Maletic-Savatic has nothing to disclose.
Huong D. Meeks, PhD Ms. Meeks has nothing to disclose.
Anna Sosa Anna Sosa has nothing to disclose.
Michael Waltz No disclosure on file
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center) Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.