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Updated: May 11, 2026

The Subventricular Zone En-face: Wholemount Staining and Ependymal Flow
Published on: May 6, 2010
Subventricular Zone Microstructure in Pediatric-Onset Multiple Sclerosis
Monica Margoni1,2,3, Loredana Storelli1, Elisabetta Pagani1
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Insights
Subventricular zone (SVZ) microstructural changes occur early in pediatric multiple sclerosis (MS) and correlate with brain damage, but not clinical impairment. These findings highlight early disease-related alterations in the SVZ in pediatric MS patients.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- The subventricular zone (SVZ) is a critical neurogenic niche.
- Aging impacts SVZ microstructure, affecting neurogenesis and brain health.
- Pediatric-onset multiple sclerosis (MS) presents unique challenges in understanding disease progression.
Purpose of the Study:
- To investigate age-related microstructural changes in the SVZ.
- To examine the association between SVZ microstructure and clinical disability in pediatric MS.
- To explore the relationship between SVZ alterations and brain structural damage in pediatric MS.
Main Methods:
- 141 pediatric-onset MS patients and 233 healthy controls (HC) underwent 3.0T MRI.
- Fractional anisotropy (FA) and mean diffusivity (MD) were measured in the SVZ and thalamus.
- Analysis correlated microstructural metrics with clinical disability and brain lesion volume.
Main Results:
- In healthy controls, SVZ microstructure changed with age, with distinct patterns for FA and MD.
- Pediatric MS patients exhibited higher SVZ FA compared to pediatric HC, while adult patients showed no difference.
- SVZ and thalamic microstructural abnormalities in MS patients correlated with white matter lesion volume and reduced brain volumes.
Conclusions:
- SVZ microstructural changes are evident early in pediatric MS.
- These early SVZ alterations are associated with brain structural damage.
- SVZ microstructural changes in pediatric MS do not appear to correlate with clinical impairment.
Objective:
The aim of this study was to explore the microstructural dynamics of the subventricular zone (SVZ) with aging and their associations with clinical disability and brain structural damage in pediatric-onset multiple sclerosis (MS) patients.
Methods:
One-hundred and forty-one pediatric-onset MS patients (67 pediatric and 74 adults with pediatric-onset) and 233 healthy controls (HC) underwent neurological and 3.0 T MRI assessment. Fractional anisotropy (FA) and mean diffusivity (MD) were extracted from the SVZ and the thalamus (as control region).
Results:
In HC, SVZ FA was higher until age 40 then declined, whereas MD was lower until age 35 before rising (false discovery rate p value [pFDR] ≤ 0.008). Thalamic FA was higher until age 30 and then declined, whereas MD was higher until age 50 (pFDR ≤ 0.007). Pediatric MS patients showed significantly higher SVZ FA than pediatric HC (pFDR < 0.001), while adult patients showed no differences compared to adult HC (pFDR ≤ 0.724). Adult patients had lower thalamic FA and higher MD (pFDR < 0.001). Adults had lower SVZ FA and MD, but higher thalamic MD compared to pediatric patients (pFDR < 0.001). In pediatric MS, higher SVZ FA and MD were associated with higher white matter (WM) lesion volume (LV) and choroid plexus volume and lower brain and thalamic volumes (pFDR ≤ 0.047). In adult patients, higher SVZ MD associated with higher WM LV, lower brain volumes, and lower z-SDMT (pFDR≤0.019). Thalamic microstructural abnormalities were associated with more severe disability and brain damage in both groups (pFDR ≤ 0.018).
Interpretation:
Our findings suggest that microstructural changes in the SVZ occur early in pediatric MS and are associated with brain structural damage but not with clinical impairment. ANN NEUROL 2025;97:979-992.
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