Diffusion tensor magnetic resonance imaging in very early onset pediatric multiple sclerosis

Area of Science:

• Pediatric neurology
• Neuroimaging
• White matter diseases

Background:

• Childhood myelination influences multiple sclerosis (MS) effects on brain structure.
• Understanding early-life MS impact on white matter integrity is crucial.

Purpose of the Study:

• To investigate normal-appearing white matter (NAWM) integrity in pediatric MS using diffusion tensor (DT) MRI.
• To compare brain tissue integrity in children with MS onset before age 12 years versus healthy controls.

Main Methods:

• DT MRI scans analyzed in 22 pediatric MS patients and 31 healthy controls.
• Probabilistic tractography used to assess interhemispheric, intrahemispheric, and projection tracts.
• Linear models evaluated the impact of disease and age on NAWM fractional anisotropy (FA) and mean diffusivity (MD).

Main Results:

• Pediatric MS patients exhibited reduced FA and increased MD in the superior longitudinal fasciculus and corpus callosum (CC).
• Corpus callosum NAWM FA correlated with brain T2 lesion volume.
• Healthy controls showed age-related increases in FA and decreases in MD, a pattern lost in MS patients.

Conclusions:

• DT MRI reveals differential white matter tract abnormalities in very young pediatric MS patients.
• Abnormalities are only partially linked to focal white matter lesions.
• Impaired white matter maturation with age may contribute to observed findings in pediatric MS.