Research Focus Overview

Research Focus Overview

Cleveland Clinic’s Pediatric MS study group is led by Co-PIs Aaron Abrams, MD and Mary Rensel, MD. They are on the Steering Committee of the US Network of Pediatric MS Centers, 12 centers sponsored by the National MS Society (NMSS) involved in specialized clinical care and research for pediatric MS. There is a national database of pediatric-onset demyelinating disorders enrolling participants since 2009. Additional projects include a puberty and obesity study, a nutritional study, and an environmental and genetic study. A 7T MRI project is recruiting patients to assess brain volume in Pediatric MS with the PI Kedar Mahajan, MD and Neuroradiology at Cleveland Clinic. We are also starting our first treatment protocol for Pediatric MS.

Pediatric MS research has been presented by our group and collaborators as posters at the 2019 AAN, 2019 ECTRIMS, and 2019 Child Neurology Society meetings. It is will also be featured as an oral platform presentation at the upcoming ECTRIMS 2022 conference.


Aaron Abrams, MD


University of Utah / NMSS, Pediatric MS Network, Rensel and Abrams (Co-PI), 2022 – 2025.
University of Utah / NMSS, Pediatric MS database, Rensel and Abrams (Co-PI), 2022 – 2025.



Impact of an electronic monitoring device and behavioral feedback on adherence to multiple sclerosis therapies in youth: results of a randomized trial. Yeh EA, Grover SA, Powell VE, Alper G, Banwell BL, Edwards K, Gorman M, Graves J, Lotze TE, Mah JK, Mednick L, Ness J, Obadia M, Slater R, Waldman A, Waubant E, Schwartz CE, Pediatric MS Adherence Study Group. Life Res. 2017 Apr 9. doi: 10.1007/s11136-017-1571-z.

Examining the contributions of environmental quality to pediatric multiple sclerosis. Mult Scler Rel Disord 2017;18:164-169. AM, Waldman AT, Casper TC, Roalstad S, Candee M, Rose J, Belman A, Weinstock-Guttman B, Aaen G, Tillema J-M, Rodriguez M, Ness J, Harris Y, Graves J, Krupp L, Benson L, Gorman M, Moodley M, Rensel M, Goyal M, Mar S, Chitnis T, Schreiner T, Lotze T, Greenberg B, Kahn I, Rubin J, Waubant E. PMID: 29141802.

Risk factors for non-adherence to disease-modifying therapy in pediatric multiple sclerosis. Mult Scler J 2018;24(2)175-85.Schwartz CE, Grover SA, Powell VE, Noguera A, Mah JK, Mar S, Mednick L, Banwell BL, Alper G. Rensel, M,Gorman M. 2017. PMID: 28273780.

Pediatric onset multiple sclerosis: A single center study. J Child Neurol 2018;33(1):98-105. E, Ginsberg M, Rensel M, Moodley M. PMID: 29246096.

Heterogeneity in association of remote herpesvirus infections and pediatric MS. Nourbakhsh, B., Rutatangwa, A., Waltz, M., Rensel, M., Moodley, M., Graves, J., Casper, T.C., Waldman, A., Belman, A., Greenberg, B., Goyal, M., Harris, Y., Kahn, I., Lotze, T., Mar, S., Schreiner, T., Aaen, G., Hart, J., Ness, J., Rubin, J., Tillema, J.-M., Krupp, L., Gorman, M., Benson, L., Rodriguez, M., Chitnis, T., Rose, J., Candee, M., Weinstock-Guttman, B., Shao, X., Barcellos, L., James, J., Waubant, E., US Network of Pediatric MS Centers, 2018. Ann Clin Transl Neurol 5, 1222–1228.

Use of newer disease-modifying therapies in pediatric multiple sclerosis in the US. Krysko, K.M., Graves, J., Rensel, M., Weinstock-Guttman, B., Aaen, G., Benson, L., Chitnis, T., Gorman, M., Goyal, M., Krupp, L., Lotze, T., Mar, S., Rodriguez, M., Rose, J., Waltz, M., Charles Casper, T., Waubant, E., US Network of Pediatric MS Centers, 2018. Neurology 91, e1778–e1787.

Several household chemical exposures are associated with pediatric-onset multiple sclerosis. Mar, S., Liang, S., Waltz, M., Casper, T.C., Goyal, M., Greenberg, B., Weinstock-Guttman, B., Rodriguez, M., Aaen, G., Belman, A., Barcellos, L.F., Rose, J., Gorman, M., Benson, L., Candee, M., Chitnis, T., Harris, Y., Kahn, I., Roalsted, S., Hart, J., Lotze, T., Moodley, M., Ness, J., Rensel, M., Rubin, J., Schreiner, T., Tillema, J.-M., Waldman, A., Krupp, L., Graves, J.S., Waubant, E., U.S. Network of Pediatric Multiple Sclerosis Centers, 2018. Ann Clin Transl Neurol 5, 1513–1521.

Acquisition of early developmental milestones and need for special education services in pediatric multiple sclerosis. Aaen, G., Waltz, M., Vargas, W., Makhani, N., Ness, J., Harris, Y., Casper, T.C., Benson, L., Candee, M., Chitnis, T., Gorman, M., Graves, J., Greenberg, B., Lotze, T., Mar, S., Tillema, J.-M., Rensel, M., Rodriguez, M., Rose, J., Rubin, J., Schreiner, T., Waldman, A., Weinstock-Guttman, B., Belman, A., Waubant, E., Krupp, L., 2018. J. Child Neurol. 883073818815041.

Admixture mapping reveals evidence of differential multiple sclerosis risk by genetic ancestry. Chi, C., Shao, X., Rhead, B., Gonzales, E., Smith, J.B., Xiang, A.H., Graves, J., Waldman, A., Lotze, T., Schreiner, T., Weinstock-Guttman, B., Aaen, G., Tillema, J.-M., Ness, J., Candee, M., Krupp, L., Gorman, M., Benson, L., Chitnis, T., Mar, S., Belman, A., Casper, T.C., Rose, J., Moodley, M., Rensel, M., Rodriguez, M., Greenberg, B., Kahn, L., Rubin, J., Schaefer, C., Waubant, E., Langer-Gould, A., Barcellos, L.F., 2019. PLoS Genet. 15, e1007808.

Long term treatment strategies of pediatric multiple sclerosis, Including the use of disease modifying therapies. Rensel M, 2019, Children 2019, 6(6), 73;

Review of the safety, efficacy and tolerability of fingolimod in pediatric onset MS. Feng J, Rensel M, 12 November 2019 Volume 2019:10 Pages 141—146, Pediatric Health, Medicine and Therapeutics.

Technology-enabled assessments to enhance multiple sclerosis clinical care and research. Macaron G, Moss BP, Li H, Baldassari LE, Rao SM, Schindler D, Alberts JL, Weber M, Ayers M, Bethoux F, Boissy A, Chizmadia D, Conway DS, Fink C, Fox RJ, Gales S, Green B, Hara-Cleaver C, Jordan N, Mahajan KR, McGinley MP, Miller DM, Namey M, Rae-Grant A, Rensel M, Young H, Willis MA, Ontaneda D, Cohen JA, Bermel RA. Neurology: Clinical Practice 2019; DOI:

Newer treatment approaches in pediatric-onset multiple sclerosis. Macaron G, Feng J, Macaron G, Feng J, Moodley M, Rensel M. Curr Treat Options Neurol. 2019 Sep 27;21(10):50. doi: 10.1007/s11940-019-0592-z.

Cognitive processing speed in pediatric-onset multiple sclerosis: baseline characteristics of impairment and prediction of decline. Wallach, Asya I, Michael Waltz, T Charles Casper, Gregory Aaen, Anita Belman, Leslie Benson, Tanuja Chitnis, Mark Gorman, Yolanda Harris, Timothy Lotke, Soe Mar, Manikum Moodley, Jayne Ness, Mary Rensel, Moses Rodriquez, John Rose, Teri Schreiner, Jan Mendelt-Tillema, Emmanuelle Waubant, Bianca Weinstock Guttman, Lauren Krupp , on behalf of the US Network of Pediatric Multiple Sclerosis Centers, Multiple Sclerosis Journal, (November 2019). doi:10.1177/1352458519891984.

Treatment updates in paediatric-onset multiple sclerosis. Abrams A, March A, Porat D, Bhayana, Kriti, Rensel M. TouchREVIEWS in Neurology. 2022;18(1):42–8.

High titers of myelin-oligodendrocyte glycoprotein antibody are only observed close to clinical events in pediatrics. Lui A, Chong J, Flanagan E, Abrams AW, Krysko KM, Arikan B, Francisco C, Rutatangwa A, Waubant E, Ziaei A. Mult Scler Relat Disord. 2021 Nov;56:103253. doi: 10.1016/j.msard.2021.103253. Epub 2021 Sep 4. PubMed PMID: 34517190; PubMed Central PMCID: PMC8678350.

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