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Pediatric multiple sclerosis (MS) impairs gray matter (GM) development and causes atrophy, partly due to white matter lesions. Higher IQ may protect developing brains in pediatric MS patients.

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Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Radiology

Background:

  • Multiple sclerosis (MS) in children presents unique challenges compared to adults.
  • Gray matter (GM) changes are increasingly recognized as important in MS pathology.
  • Understanding early neurodevelopmental trajectories in pediatric MS is crucial.

Purpose of the Study:

  • To assess spatial patterns and temporal changes of GM atrophy in pediatric MS using MRI.
  • To investigate the clinical relevance of GM changes in relation to disability and IQ.
  • To compare GM development in pediatric MS patients with normative data.

Main Methods:

  • Longitudinal MRI scans were acquired in pediatric MS patients and compared to normative GM developmental trajectories from healthy controls (HC).
  • Linear mixed-effects models assessed deviations in GM volume at baseline and follow-up.
  • Correlations between GM volume deviations, disability, IQ, and white matter lesion volume (LV) were analyzed.

Main Results:

  • Pediatric MS patients exhibited impaired GM development and progressive atrophy in cortical and subcortical regions.
  • GM atrophy was only partially linked to focal white matter lesions.
  • Significant correlations were observed between regional GM atrophy (especially deep GM) and disability; higher IQ correlated with reduced GM volume deviations.

Conclusions:

  • Impaired GM maturation in pediatric MS is not solely driven by white matter inflammation, indicating early neurodegenerative processes.
  • Higher IQ may confer a protective effect by influencing GM remodeling and pruning in young patients.
  • These findings highlight the importance of early neurodegenerative phenomena in pediatric MS disability.