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Spinal Cord Abnormalities in Early Pediatric Multiple Sclerosis
Monica Margoni1,2,3, Paola Valsasina1, Paolo Preziosa1,2,4
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Insights
Pediatric multiple sclerosis (MS) patients do not show upper cervical cord atrophy, unlike adults. Lesions in pediatric MS patients may increase cord volume due to inflammation, not atrophy.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimmunology
Background:
- Spinal cord lesions and atrophy in the cervical region are common in adult multiple sclerosis (MS) and correlate with disability.
- The occurrence of similar abnormalities in pediatric MS patients is largely unknown.
Purpose of the Study:
- To investigate whether pediatric MS patients exhibit cervical spinal cord abnormalities, specifically atrophy, similar to adult MS patients.
- To compare cervical cord measurements between pediatric MS patients and healthy controls (HC).
Main Methods:
- Clinical and MRI evaluations were performed in 38 pediatric MS patients and 13 HC.
- Upper cervical cord area and volume were assessed.
Main Results:
- No significant differences in upper cervical cord area were found between pediatric MS patients and HC.
- No significant differences in upper cervical cord area were observed between pediatric MS patients with and without lesions.
- Pediatric MS patients with lesions showed increased cord volume, co-localizing with lesions, likely reflecting inflammation.
Conclusions:
- Upper cervical cord atrophy is not a prominent feature in early pediatric MS.
- The findings underscore the inflammation-driven characteristic of pediatric MS, contrasting with the atrophy seen in adult MS.
Abstract:
Spinal cord lesions and atrophy in the cervical region are common in adult multiple sclerosis (MS) and correlate with disability. Whether similar abnormalities occur in pediatric MS patients is largely unknown. Clinical and MRI evaluations were performed in 38 pediatric MS patients and 13 healthy controls (HC). No significant differences in upper cervical cord area were found between MS patients and HC or between patients with and without lesions. Patients with lesions showed increased cord volume, co-localizing with lesions, likely reflecting inflammation. Our results suggest that upper cord atrophy is not a prominent feature in early pediatric MS, underscoring the inflammation-driven characteristic of these patients.
