A comparative assessment of cerebral white matter by magnetization transfer imaging in early- and adult-onset multiple sclerosis patients matched for disease duration

Abstract

A more favorable clinical course in early-onset (EO) multiple sclerosis (MS) than adult-onset (AO) disease is reported. Our aim was to assess white matter with/without lesions by magnetization transfer (MT) imaging in EO and AO MS patients matched for duration of the disease. Relapsing-remitting MS patients with disease onset at age < or =18 years and >18 years (n = 11 for each) were matched according to sex, age, disease duration, and 22 sex-and age-matched healthy subjects were studied with MT imaging. MT ratios (MTR) of manually outlined ROIs from T1-hypointense, T1-isointense lesions and perilesional normal appearing white matter (NAWM) as well as NAWM of the left frontal lobe of the patients and healthy subjects were calculated. MTR differences between two patient groups and control subjects, and correlation of MTR with EDSS, disease onset age, disease duration and relapse rate were analyzed statistically. In comparison with NAWM of the patients and healthy subjects, the greatest MTR reductions were observed in T1-hypointense lesions followed by T1-isointense lesions and perilesional NAWM, respectively, in EO and AO MS. Both groups' NAWM MTR were reduced; greater and more significantly in EO patients. No correlation was found between MTR of any ROI and EDSS, duration of the disease, disease onset age, or relapse rate. Although normalization does not occur, abnormality of white matter in MS decreases as distance from the lesions increases. Greater NAWM abnormality in EO MS may relate to inherent myelin abnormalities and different repair/reorganization processes in this particular group.

Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research

“…69 Abnormal MTR was also reported in normal-appearing brain tissue in a study of 11 adolescents and 11 adults with multiple sclerosis compared with 22 healthy controls. 70 Further studies of large cohorts followed for long periods of time are needed to fully appreciate MTR analyses in paediatric multiple sclerosis cohorts.…”

Age independently affects myelin integrity as detected by magnetization transfer magnetic resonance imaging in multiple sclerosis

“…Finally, in an MTR study comparing 22 age-matched controls with 22 RRMS subjects with disease onset either before age 18 (mean age at scan 21.3, range 15–29) or after age 18 (mean age at scan 37.6 years, range 25–48), Oguz et al (2010) found reduced MTR in the NAWM when compared to controls, but no age-related effect between the two MS groups.…”