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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Cortical lesions in children with multiple sclerosis.

M Absinta1, M A Rocca, L Moiola

  • 1Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy.

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Cortical lesions (CLs) are rare in pediatric multiple sclerosis (MS) patients compared to adults. This suggests CL formation may not be an initial event in pediatric MS development.

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Area of Science:

  • Neurology
  • Radiology
  • Pediatric Medicine

Background:

  • Double inversion recovery (DIR) sequences enhance cortical lesion (CL) detection in adult multiple sclerosis (MS).
  • Understanding CL prevalence in pediatric MS is crucial for disease characterization.

Purpose of the Study:

  • To compare the presence and frequency of CLs in pediatric relapsing-remitting MS (RRMS) patients versus adult MS patients.
  • To investigate the role of CLs in the early stages of pediatric MS.

Main Methods:

  • Brain MRI scans (DIR, dual-echo, 3D T1-weighted) were acquired from pediatric RRMS, adult RRMS, and pediatric healthy controls.
  • CLs and white matter (WM) lesions were identified and quantified; gray matter and WM volumes were calculated.
  • Statistical analyses included chi-squared, Mann-Whitney, ANOVA, and Poisson regression to compare lesion burden and characteristics.

Main Results:

  • Pediatric MS patients had shorter disease duration and lower disability scores than adults.
  • White matter lesion number and volume did not significantly differ between pediatric and adult MS patients.
  • CLs were detected in only 8% of pediatric patients versus 66% of adult patients, with significantly lower volume and count in children.

Conclusions:

  • Cortical lesions are infrequent in pediatric MS.
  • The rarity of CLs in pediatric MS suggests they are not an early pathological event in the disease's natural history.