Brain macro- and microscopic damage in patients with paediatric MS

Area of Science:

• Neuroimaging
• Neurology
• Pediatric Neurology

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Paediatric MS presents unique challenges in characterization and understanding disease progression.

Purpose of the Study:

• To characterize brain lesions and normal-appearing white matter (NAWM) and grey matter (GM) damage in paediatric MS using MRI.
• To compare imaging findings between paediatric MS, adult MS, and healthy controls (HC).

Main Methods:

• Conventional and diffusion tensor MRI (DT MRI) were acquired from 48 paediatric MS patients and various adult MS and HC groups.
• T2-lesion probability maps and DT MRI of lesions, NAWM, and GM were analyzed and compared.

Main Results:

• T2 lesion volumes did not differ between patient groups, but lesion location varied.
• Adult MS patients showed higher lesion mean diffusivity and greater NAWM and GM involvement than paediatric MS patients.
• Paediatric MS patients exhibited less severe intrinsic lesion damage and GM involvement.

Conclusions:

• Less severe intrinsic lesion damage, distinct lesion distribution, and GM sparing in paediatric MS may contribute to favorable short- to medium-term outcomes.
• MRI findings suggest a potentially milder disease course in paediatric versus adult-onset MS.
• These imaging characteristics provide insights into the pathophysiology and prognosis of paediatric MS.