Magnetic resonance imaging features of the spinal cord in pediatric multiple sclerosis: a preliminary study
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Spinal cord lesions in adults with multiple sclerosis (MS) are thought to contribute to disability. The magnetic resonance imaging (MRI) appearance and clinical correlates of spinal cord lesions in children with MS have not been reported.
T1-weighted pre- and post-gadolinium and T2-weighted TSE/FSE spine MR images of 36 children (age, 14.3 ± 3.3) with relapsing–remitting MS (annualized relapse rate, 0.7; disease duration, 7.5 ± 3.3 years) were analyzed for total lesion count, lesion location and length, intramedullary extent, and gadolinium enhancement. Clinical, demographic, laboratory, and MRI data were correlated.
Lesions preferentially involved the cervical region, were predominantly focal, and involved only a portion of the transverse cord diameter. However, ten of 36 patients demonstrated longitudinally extensive lesions. Children with the highest clinical relapse rate also tended to have more spinal cord lesions and were more likely to accrue new lesions on serial spinal scans.
These preliminary data suggest that MS lesions of the spinal cord in children are radiographically similar to that of adult-onset MS—supporting a common biology of pediatric- and adult-onset disease. However, children with relapsing–remitting MS can also develop longitudinally extensive lesions, suggesting that such lesions may be less specific for diseases such as neuromyelitis optica in pediatric patients. All patients recovered well from spinal cord attacks, and the presence of spinal cord lesions in the first few years of disease did not correlate with physical disability. Measures of spinal cord atrophy and longer periods of observation are required to determine the impact of spinal cord involvement in pediatric-onset MS.
KeywordsMultiple sclerosis Magnetic resonance imaging Spinal cord Children
This research was funded by the Multiple Sclerosis Society of Canada, Canadian Multiple Sclerosis Scientific Research Foundation, Canadian Institutes of Health Research Canada Graduate Scholarships—Master’s Award (200802CGM-186751), and Ontario Student Opportunity Trust Fund—Hospital for Sick Children Foundation Student Scholarship Program.
We acknowledge the patients and their families for their participation and Sandra Magalhaes for her statistical advice and database support.
Conflict of interest statement
Dr. Banwell has previously received speaker’s honoraria from Biogen-IDEC, Merck Serono, and Berlex.
Copyright license statement
No copyright licenses have been applied to this study.
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