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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Onset of multiple sclerosis before adulthood leads to failure of age-expected brain growth

Bérengère Aubert-Broche1, Vladimir Fonov1, Sridar Narayanan1

  • 1From the McConnell Brain Imaging Center (B.A.-B., V.F., S.N., D.L.A., D.A., D.F., D.L.C.), Montreal Neurological Institute, McGill University; The Hospital for Sick Children (C.T., J.G.S., B.B.), University of Toronto; York University (C.T.), Toronto, Canada; and Children's Hospital of Philadelphia (B.B.), University of Pennsylvania.

Neurology
|November 8, 2014
PubMed

Insights

Pediatric multiple sclerosis (MS) hinders brain development, causing reduced brain and thalamus growth in children. Lesion volume in MS patients correlates with greater thalamic volume loss, indicating early neurodegeneration.

Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Radiology

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
  • Pediatric-onset MS (PoMS) presents unique challenges in understanding its long-term impact on brain development.
  • Assessing the effects of PoMS on brain growth is crucial for early intervention and management.

Purpose of the Study:

  • To investigate the impact of pediatric-onset multiple sclerosis (MS) on age-expected brain growth.
  • To quantify differences in brain and regional volumes between children with MS and healthy controls.
  • To explore the relationship between T2 lesion volume and brain growth deficits in PoMS.

Main Methods:

  • Longitudinal MRI scans from 36 patients with PoMS (onset < 18 years) and 25 age- and sex-matched healthy controls were analyzed.
  • Brain and regional volumes were segmented using an automated image processing pipeline.
  • Mixed-effects models incorporating age, sex, and group were used to assess growth trajectories compared to a reference cohort.

Main Results:

  • Significant group and age interactions revealed a failure of age-normative brain growth in the MS group (p < 10(-4)).
  • Thalamic growth was disproportionately affected, showing an even greater deficit compared to overall brain growth.
  • In patients with MS, T2 lesion volume correlated with reduced age-expected thalamic volume.

Conclusions:

  • Onset of MS during childhood and adolescence significantly limits primary brain growth.
  • PoMS leads to subsequent brain atrophy, suggesting an early onset of the neurodegenerative component of the disease.
  • These findings highlight the critical need for early diagnosis and treatment of pediatric MS to mitigate long-term neurological deficits.
Abstract

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