Childhood multiple sclerosis is associated with reduced brain volumes at first clinical presentation and brain growth failure
Abstract
Background:
Paediatric multiple sclerosis (pedMS) patients at a single site were shown to have reduced brain volumes and failure of age-expected brain growth compared to healthy controls. However, the precise time of onset of brain volume loss remains unclear.
Objective:
To longitudinally study brain volumes in a multi-centre European cohort at first presentation and after 2 years.
Methods:
Brain volumes of high-resolution magnetic resonance imaging (MRI) data from 37 pedMS patients at first presentation prior to steroid therapy and at 2-year follow-up (n = 21) were compared to matched longitudinal MRI data from the NIH Paediatric MRI Data Repository.
Results:
Patients showed significantly reduced whole brain, grey and white matter and increased ventricular volumes at initial presentation and at follow-up compared to controls. Over 2 years, patients exhibited significant reduction of whole brain and white matter volumes, accompanied by increased ventricular volume. Brain volume loss at follow-up correlated with a higher number of infratentorial lesions, relapses and an increased Expanded Disability Status Scale (EDSS) score.
Conclusions:
In pedMS patients, brain volume loss is present already at first clinical presentation and accelerated over 2 years. Increased disease activity is associated with more severe brain volume loss. MRI brain volume change might serve as an outcome parameter in future prospective pedMS studies.
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Article first published online: April 4, 2019
Issue published: June 2019
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History
Manuscript received: August 9, 2018
Revision received: December 4, 2018
Manuscript accepted: December 23, 2018
Published online: April 4, 2019
Issue published: June 2019
PubMed: 30945587
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