Magnetic resonance imaging characteristics of children and adults with paediatric-onset multiple sclerosis

• Published in: Brain (London, England : 1878) England : 1878), 2009-12, Vol.132 (12), p.3392-3400
• Main Authors: Yeh, E. A., Weinstock-Guttman, B., Ramanathan, M., Ramasamy, D. P., Willis, L., Cox, J. L., Zivadinov, R.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; adult-onset multiple sclerosis; Age Factors; Age of Onset; Atrophy - pathology; Atrophy - physiopathology; Biological and medical sciences; Brain - pathology; Brain - physiopathology; Brain Mapping; Child; Cohort Studies; Disability Evaluation; Disease Progression; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; multiple sclerosis; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nerve Fibers, Myelinated - pathology; Neurology; paediatric; paediatric-onset multiple sclerosis; Predictive Value of Tests; Prognosis; Prospective Studies; Severity of Illness Index
• ISSN: 0006-8950; 1460-2156
• DOI: 10.1093/brain/awp278

The purpose of this study was to compare the clinical and quantitative magnetic resonance imaging metrics of paediatric-onset multiple sclerosis to adult-onset multiple sclerosis. It was a prospective comparison of clinical and magnetic resonance imaging characteristics of two paediatric onset multiple sclerosis and two adult onset multiple sclerosis groups that were matched for disease duration. The paediatric-onset-C group consisted of children with paediatric-onset multiple sclerosis with mean disease duration of 2.7 years, whereas the paediatric onset-A group consisted of adults with mean disease duration of 20 years. The adult onset multiple sclerosis-1 and adult onset multiple sclerosis-2 groups were matched to the paediatric onset-C and paediatric onset-A groups. The brain magnetic resonance imaging measures included: T1-, T2- and gadolinium contrast-enhancing volumes and the T2-lesion volume relative magnetization transfer ratio, global and tissue specific white and grey matter brain atrophy and normal appearing grey and white matter magnetization transfer ratio. Regression analyses were employed for magnetic resonance imaging measures. The paediatric onset multiple sclerosis-C (n = 17) and adult onset multiple sclerosis-1 (n = 81) groups had mean disease duration values of 2.7 ± standard deviation 2.0 and 2.6 ± 1.1 years, respectively. The paediatric onset multiple sclerosis-A group (n = 33) and adult onset multiple sclerosis-2 group (n = 300) had mean disease durations of 20 ± standard deviation 10.9 and 20 ± 9.3 years, respectively. In regression analysis, the T2- lesion volume of the paediatric onset multiple sclerosis-C and adult onset multiple sclerosis-1 groups were similar but there was a trend toward higher T1- lesion volume (P = 0.028) in the paediatric onset group. The brain parenchymal fraction and grey matter fraction in the paediatric-onset multiple sclerosis-C group were higher than those for the adult onset multiple sclerosis-1 group (both P < 0.001). The frequency of progressive multiple sclerosis in the paediatric onset multiple sclerosis-A group (27.3%) trended lower (odds ratio = 0.43, P = 0.042) than that in the adult onset multiple sclerosis-2 group (46.3%). The Expanded Disability Status Scale (median; inter-quartile range) in the paediatric onset multiple sclerosis-A group (2.25; 2.5) trended lower (P = 0.058) compared with the adult onset multiple sclerosis-2 group (3.5; 4.0). There was a trend toward lower magnetization tr