Updated on
What did the project achieve?
Multiple sclerosis (MS) is a lifelong condition that affects the brain and spinal cord. It occurs when the body’s immune system mistakenly attacks the protective coating around nerve fibres, known as myelin. This damage disrupts the transmission of nerve signals, leading to symptoms such as problems with vision, movement, sensation or balance.
The body can naturally repair some myelin damage – and treatments that aim to boost this process are currently being tested in adults to find out if they can help slow disease progression. However, while most people are diagnosed with MS between 20 and 40 years of age, an increasing number of children are being diagnosed with the condition.1
“We have now carried out the first UK clinical study investigating nerve repair in children with MS,” says Dr Jonathon Holland of the University of Cambridge. “Our initial findings will help inform future research, including the design of clinical trials into new treatments designed to boost this process.”
The MARMALADE-C project recruited six children with MS and 16 healthy children, alongside 46 adults with MS and 32 healthy volunteers. The researchers carried out a variety of assessments, including advanced brain scans in people with MS – and specialist eye tests in all participants, at enrolment and again one year later.
“We showed that children were able to complete most of the assessments used to measure myelin repair and nerve health, and identified which of these tests provide reliable results,” says Dr Holland. “We also established the range of typical values expected in healthy children, providing an important baseline for future research and clinical trials of treatments designed to boost nerve repair.”
Due to challenges with recruiting sufficient numbers of children with MS, the study was not able to determine whether children repair myelin more effectively than adults. However, it has established a strong foundation for future research to better understand how nerve repair changes across different stages of life in people with MS.
References
- MS Trust, Childhood MS: https://mstrust.org.uk/a-z/childhood-ms [website accessed 17 June 2026]
This research was completed on
This Research Training Fellowship is jointly funded by Action Medical Research and the British Paediatric Neurology Association (BPNA).
How are children’s lives affected now?
MS is caused by the body’s immune system mistakenly attacking a protective layer called the myelin sheath that surrounds and protects nerve cells in the brain and spinal cord. This process, called ‘demyelination’, interferes with the transmission of electrical messages between the brain and other parts of the body.
“A person with MS may experience a variety of symptoms – which can include problems with their vision, movement, sensation, or balance,” says Dr Holland. “Other problems, such as tiredness and difficulties with their memory or thinking, are often more hidden but can also impact on their quality of life.”
Most people are diagnosed with MS between 20 and 40 years of age, but the number of people being diagnosed under the age of eighteen is increasing.[2]
“Although the progress, severity and specific symptoms of MS are different for everyone, they can cause significant and long-term difficulties for affected children and their families,” says Dr Holland.
How could this research help?
“We aim to find out whether children with MS could benefit from potential new treatments currently being tested in adults,” says Dr Holland.
While the body can repair some damaged myelin, this process can be impaired in people with MS – and it is hoped that treatments designed to promote remyelination can help to slow down disease progression.
“We suspect that this repair process is more effective in children with MS than adults, which would indicate that these new treatments might also be helpful for them,” says Dr Holland.
This study will involve up to 30 children with MS and a similar group of healthy children. The team will assess the children at the start of the study and after one year using advanced brain scans, specialist eye testing, and a blood test. The results will help establish how remyelination occurs over time – and whether this helps prevent nerve damage.
Gaining a better understanding of remyelination in children with MS will guide future research, including whether drugs targeting this process should be tested in children with the condition.
References
- MS Society, MS in the UK: https://www.mssociety.org.uk/what-we-do/our-work/our-evidence/ms-in-the-uk [website accessed 18 October 2022]
- MS Trust, Childhood MS: https://mstrust.org.uk/a-z/childhood-ms [website accessed 26 October 2022]
Research table
Project details
| Project Leader | Dr Jonathon AA Holland, MRCPCH, MA(Cantab) MB BChir AFHEA |
| Location | Child Development Centre, Addenbrooke’s Hospital, Cambridge University NHS Foundation Trust |
| Project Team |
Professor Alasdair J Coles, PhD MRCP BM BCh
Dr Manali V Chitre, FRCPCH MRCP(Paeds) DCH PG Cert Ed MB BS Dr Ming Lim PhD MD MRCP (UK) BM BS BMedSci |
| Other Locations |
Department of Clinical Neurosciences, University of Cambridge
Department of Paediatric Neurology, Addenbrooke’s Hospital |
| Grant Amount | £250,000 |
| Start Date | |
| End Date | |
| Duration | 36 months |
| Grant Code (GN number) | GN2945 |
We do not provide medical advice. If you would like more information about a condition or would like to talk to someone about your health, contact NHS Choices or speak to your GP.