2014
DOI: 10.1212/wnl.0000000000001045
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Onset of multiple sclerosis before adulthood leads to failure of age-expected brain growth

Abstract: Objective: To determine the impact of pediatric-onset multiple sclerosis (MS) on age-expected brain growth.Methods: Whole brain and regional volumes of 36 patients with relapsing-remitting MS onset prior to 18 years of age were segmented in 185 longitudinal MRI scans (2-11 scans per participant, 3-month to 2-year scan intervals). MRI scans of 25 age-and sex-matched healthy normal controls (NC) were also acquired at baseline and 2 years later on the same scanner as the MS group. A total of 874 scans from 339 pa… Show more

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Cited by 125 publications
(90 citation statements)
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“…[20][21][22] Defining the more global aspects of MS effect, such as the effect on brain growth, is even more challenging for pediatric than adult MS, since estimations of pathologic brain volume changes during development will require complex algorithms that incorporate expected physiologic brain growth. 23,24 Incorporating the effects of MS on cognitive development is also difficult. 25 Although specific pediatric NEDA criteria are still under development, the authors agree that the following elements are critical-absence of new, enlarging, or enhancing lesions on MRI; clinical relapses; and confirmed disability progression-and suggest that consideration be given to preservation of ageexpected global and regional brain growth and to age-expected cognitive maturation and function.…”
Section: Definition Of No Evidence Of Diseasementioning
confidence: 99%
“…[20][21][22] Defining the more global aspects of MS effect, such as the effect on brain growth, is even more challenging for pediatric than adult MS, since estimations of pathologic brain volume changes during development will require complex algorithms that incorporate expected physiologic brain growth. 23,24 Incorporating the effects of MS on cognitive development is also difficult. 25 Although specific pediatric NEDA criteria are still under development, the authors agree that the following elements are critical-absence of new, enlarging, or enhancing lesions on MRI; clinical relapses; and confirmed disability progression-and suggest that consideration be given to preservation of ageexpected global and regional brain growth and to age-expected cognitive maturation and function.…”
Section: Definition Of No Evidence Of Diseasementioning
confidence: 99%
“…Studies of hypomyelinating conditions and leukodystrophies may provide additional insights into mechanisms of myelin injury and repair of particular relevance to pediatric-onset MS. 52 Of concern are hints from imaging studies that progressive disease mechanisms are already in play at the earliest stage of the pediatric MS spectrum. 53,54 Atrophy is present at the initial clinical presentation of children with MS, and their skull sizes appear on average smaller than controls, raising the question of how early the CNS injury process actually starts in these children. 55 Therefore, patients with pediatric MS require treatments that would target both aberrant immune responses as well as the neurobiology of disease.…”
Section: Cns-directed Antibodies In Pediatricmentioning
confidence: 99%
“…Changes in brain volume in children have to be interpreted in the context of age-expected brain growth using growth trajectory modeling. 36 Normative data should be obtained using the same standardized pulse sequences.…”
Section: 36mentioning
confidence: 99%