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.

Keywords

Paediatric multiple sclerosis magnetic resonance volumetry brain growth disease-modifying therapies

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