Difference in disease burden and activity in pediatric patients on brain magnetic resonance imaging at time of multiple sclerosis onset vs adults
To compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset. Retrospective analysis of features of first brain MRI available at MS onset in patients with pediatric-onset and adult-onset MS. A pediatric and an adult MS center. Pati...
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| Vydané v: | Archives of neurology (Chicago) Ročník 66; číslo 8; s. 967 |
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| Hlavní autori: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
01.08.2009
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| ISSN: | 1538-3687, 1538-3687 |
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| Abstract | To compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset.
Retrospective analysis of features of first brain MRI available at MS onset in patients with pediatric-onset and adult-onset MS.
A pediatric and an adult MS center.
Patients with pediatric-onset <18 years) and adult-onset (> or =18 years) MS.
We evaluated initial and second (when available) brain MRI scans obtained at the time of first MS symptoms for lesions that were T2-bright, ovoid and well defined, large (> or =1cm), or enhancing.
We identified 41 patients with pediatric-onset MS and 35 patients with adult-onset MS. Children had a higher number of total T2- (median, 21 vs 6; P < .001) and large T2-bright areas (median, 4 vs 0; P < .001) than adults. Children more frequently had T2-bright foci in the posterior fossa (68.3% vs 31.4%; P = .001) and enhancing lesions (68.4% vs 21.2%; P < .001) than adults. On the second brain MRI, children had more new T2-bright (median, 2.5 vs 0; P < .001) and gadolinium-enhancing foci (P < .001) than adults. Except for corpus callosum involvement, race/ethnicity was not strongly associated with disease burden or lesion location on the first scan, although other associations cannot be excluded because of the width of the confidence intervals.
While it is unknown whether the higher disease burden, posterior fossa involvement, and rate of new lesions in pediatric-onset MS are explained by age alone, these characteristics have been associated with worse disability progression in adults. |
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| AbstractList | To compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset.
Retrospective analysis of features of first brain MRI available at MS onset in patients with pediatric-onset and adult-onset MS.
A pediatric and an adult MS center.
Patients with pediatric-onset <18 years) and adult-onset (> or =18 years) MS.
We evaluated initial and second (when available) brain MRI scans obtained at the time of first MS symptoms for lesions that were T2-bright, ovoid and well defined, large (> or =1cm), or enhancing.
We identified 41 patients with pediatric-onset MS and 35 patients with adult-onset MS. Children had a higher number of total T2- (median, 21 vs 6; P < .001) and large T2-bright areas (median, 4 vs 0; P < .001) than adults. Children more frequently had T2-bright foci in the posterior fossa (68.3% vs 31.4%; P = .001) and enhancing lesions (68.4% vs 21.2%; P < .001) than adults. On the second brain MRI, children had more new T2-bright (median, 2.5 vs 0; P < .001) and gadolinium-enhancing foci (P < .001) than adults. Except for corpus callosum involvement, race/ethnicity was not strongly associated with disease burden or lesion location on the first scan, although other associations cannot be excluded because of the width of the confidence intervals.
While it is unknown whether the higher disease burden, posterior fossa involvement, and rate of new lesions in pediatric-onset MS are explained by age alone, these characteristics have been associated with worse disability progression in adults. To compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset.OBJECTIVETo compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset.Retrospective analysis of features of first brain MRI available at MS onset in patients with pediatric-onset and adult-onset MS.DESIGNRetrospective analysis of features of first brain MRI available at MS onset in patients with pediatric-onset and adult-onset MS.A pediatric and an adult MS center.SETTINGA pediatric and an adult MS center.Patients with pediatric-onset <18 years) and adult-onset (> or =18 years) MS.PATIENTSPatients with pediatric-onset <18 years) and adult-onset (> or =18 years) MS.We evaluated initial and second (when available) brain MRI scans obtained at the time of first MS symptoms for lesions that were T2-bright, ovoid and well defined, large (> or =1cm), or enhancing.MAIN OUTCOME MEASURESWe evaluated initial and second (when available) brain MRI scans obtained at the time of first MS symptoms for lesions that were T2-bright, ovoid and well defined, large (> or =1cm), or enhancing.We identified 41 patients with pediatric-onset MS and 35 patients with adult-onset MS. Children had a higher number of total T2- (median, 21 vs 6; P < .001) and large T2-bright areas (median, 4 vs 0; P < .001) than adults. Children more frequently had T2-bright foci in the posterior fossa (68.3% vs 31.4%; P = .001) and enhancing lesions (68.4% vs 21.2%; P < .001) than adults. On the second brain MRI, children had more new T2-bright (median, 2.5 vs 0; P < .001) and gadolinium-enhancing foci (P < .001) than adults. Except for corpus callosum involvement, race/ethnicity was not strongly associated with disease burden or lesion location on the first scan, although other associations cannot be excluded because of the width of the confidence intervals.RESULTSWe identified 41 patients with pediatric-onset MS and 35 patients with adult-onset MS. Children had a higher number of total T2- (median, 21 vs 6; P < .001) and large T2-bright areas (median, 4 vs 0; P < .001) than adults. Children more frequently had T2-bright foci in the posterior fossa (68.3% vs 31.4%; P = .001) and enhancing lesions (68.4% vs 21.2%; P < .001) than adults. On the second brain MRI, children had more new T2-bright (median, 2.5 vs 0; P < .001) and gadolinium-enhancing foci (P < .001) than adults. Except for corpus callosum involvement, race/ethnicity was not strongly associated with disease burden or lesion location on the first scan, although other associations cannot be excluded because of the width of the confidence intervals.While it is unknown whether the higher disease burden, posterior fossa involvement, and rate of new lesions in pediatric-onset MS are explained by age alone, these characteristics have been associated with worse disability progression in adults.CONCLUSIONWhile it is unknown whether the higher disease burden, posterior fossa involvement, and rate of new lesions in pediatric-onset MS are explained by age alone, these characteristics have been associated with worse disability progression in adults. |
| Author | Chabas, Dorothee Mowry, Ellen Strober, Jonathan B Waubant, Emmanuelle Henry, Roland G Pelletier, Daniel Glenn, Orit Okuda, Darin T Soares, Bruno Wintermark, Max |
| Author_xml | – sequence: 1 givenname: Emmanuelle surname: Waubant fullname: Waubant, Emmanuelle email: emmanuelle.waubant@ucsf.edu organization: UCSF Regional Pediatric Multiple Sclerosis Center, 350 Parnassus Ave, Ste 908, San Francisco, CA 94117, USA. emmanuelle.waubant@ucsf.edu – sequence: 2 givenname: Dorothee surname: Chabas fullname: Chabas, Dorothee – sequence: 3 givenname: Darin T surname: Okuda fullname: Okuda, Darin T – sequence: 4 givenname: Orit surname: Glenn fullname: Glenn, Orit – sequence: 5 givenname: Ellen surname: Mowry fullname: Mowry, Ellen – sequence: 6 givenname: Roland G surname: Henry fullname: Henry, Roland G – sequence: 7 givenname: Jonathan B surname: Strober fullname: Strober, Jonathan B – sequence: 8 givenname: Bruno surname: Soares fullname: Soares, Bruno – sequence: 9 givenname: Max surname: Wintermark fullname: Wintermark, Max – sequence: 10 givenname: Daniel surname: Pelletier fullname: Pelletier, Daniel |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/19667217$$D View this record in MEDLINE/PubMed |
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| Snippet | To compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset.
Retrospective analysis of... To compare initial brain magnetic resonance imaging (MRI) characteristics of children and adults at multiple sclerosis (MS) onset.OBJECTIVETo compare initial... |
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| SubjectTerms | Age of Onset Brain - pathology Child Cost of Illness Female Humans Image Processing, Computer-Assisted Magnetic Resonance Imaging Male Middle Aged Multiple Sclerosis - diagnosis Multiple Sclerosis - pathology Retrospective Studies |
| Title | Difference in disease burden and activity in pediatric patients on brain magnetic resonance imaging at time of multiple sclerosis onset vs adults |
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