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Updated: Apr 21, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Magnetization transfer ratio recovery in new lesions decreases during adolescence in pediatric-onset multiple
Robert A Brown1, Sridar Narayanan1, Brenda Banwell2
1McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital 3801 Rue University, Montreal H3A 2B4, Canada.
Abstract:
Children and adolescents diagnosed with multiple sclerosis rarely accrue physical disability early in their disease. This could be explained by greater remyelination in children, a capacity that may be lost in adolescence or early adulthood. Magnetization transfer ratio (MTR) MRI can be used to quantify changes in myelin in MS. We used serial MTR imaging and longitudinal random effects analysis to quantify recovery of MTR in acute lesions and to evaluate MTR changes in normal-appearing tissue in 19 adolescent MS patients. Our objective was to determine whether younger adolescents have a greater capacity for remyelination and whether this decreases as patients approach adulthood. We detected a significant decrease in MTR recovery between ages 16 and 20 years (p = 0.023), with older subjects approaching typical recovery levels for adult-onset MS. MTR recovery in acute MS lesions decreases with age in adolescents, suggesting loss of remyelination capacity. This may be related to the conclusion of primary myelination or other developmental factors.
Insights
Children with multiple sclerosis (MS) show better myelin repair. This capacity for remyelination decreases significantly in adolescents as they approach adulthood, indicating a loss of repair potential with age.
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Background:
- Multiple sclerosis (MS) in children and adolescents typically presents with slower physical disability accrual compared to adults.
- This milder early disease course may be attributed to enhanced remyelination capacity in younger individuals, which might diminish with age.
- Magnetization transfer ratio (MTR) MRI is a valuable tool for quantifying myelin integrity and changes in MS lesions.
Purpose of the Study:
- To investigate the age-dependent changes in remyelination capacity in adolescent patients with MS.
- To determine if the ability to recover myelin, as measured by MTR, decreases as individuals transition from adolescence to early adulthood.
Main Methods:
- Serial MTR imaging was performed on 19 adolescent MS patients.
- Longitudinal random effects analysis was employed to quantify MTR recovery in acute lesions and assess changes in normal-appearing white matter.
- Patient age at the time of imaging was correlated with MTR recovery rates.
Main Results:
- A significant decrease in MTR recovery was observed in adolescents between the ages of 16 and 20 years (p = 0.023).
- Older adolescents in the study showed MTR recovery levels comparable to those typically seen in adult-onset MS.
- These findings suggest a decline in the capacity for remyelination with increasing age during adolescence.
Conclusions:
- The capacity for remyelination in acute MS lesions diminishes with age throughout adolescence.
- This age-related decline in myelin repair may be linked to the completion of primary myelination or other ongoing developmental processes.
- Understanding these developmental changes is crucial for managing MS in pediatric and adolescent populations.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:24Magnetic Resonance Imaging