MRI criteria for multiple sclerosis

Abstract

This study assessed the validity of established MRI criteria for multiple sclerosis (MS) in a cohort of 20 children with clinically definite MS. The authors found that many pediatric MS patients did not meet the MRI criteria established for adult-onset MS, particularly the McDonald MRI criteria for dissemination in space. The authors thus suggest that MRI criteria for adult MS be applied cautiously to pediatric MS patients.

Disease-Modifying Therapy of Pediatric Multiple Sclerosis

“…Only 67 % of children met the adult 2005 MS McDonald MRI criteria at the time of their MS defining attack, suggesting a low lesion burden than adults at the time of diagnosis [33]. A study recently evaluated the 2010 McDonald MRI criteria in the pediatric population, and found that in children >11 years of age and in those with non-acute disseminated encephalomyelitis (ADEM) presentations, there was high sensitivity and specificity for the dissemination in space and time criteria for the development of MS [34].…”

Vanishing MS T2-bright lesions before puberty

“…Furthermore, pediatric patients do not always meet the MRI criteria developed for adult-onset MS. 3 For example, the MRIs of pediatric patients with MS often have a lower overall number of, but more tumefactive, T2-bright lesions. 4,5 Possible explanations include a more recent biologic onset of the disease, immaturity of the immune system, incomplete myelination, or a different capacity of children to remyelinate and repair. In order to improve our understanding of MRI findings in pediatric MS, we compared initial brain MRI features in children with MS onset before the age of 11 (earlier onset pediatric MS [EOPMS]) vs those with onset between the ages of 11 and 18 (later onset pediatric MS [LOPMS]).…”

Diffusion Tensor Analysis of Pediatric Multiple Sclerosis and Clinically Isolated Syndromes

“…In most cases, children converted within a 2-year period of follow-up. 8,10 Previously published studies have suggested that patients with nonencephalopathic presentations carried a higher risk of developing MS than those with encephalopathy. In our study, baseline DTI measures of FA and ADC in major pathways in patients with CIS were not predictive of MS. We found that the strongest predictor of conversion to MS was presentation with a PCISWOE.…”

“…[1][2][3] Children with MS accumulate significant disability at an early age, 2,4 experience more frequent relapses than those with adultonset MS, 5 and demonstrate significant cognitive deficits. 6,7 These findings, along with high T2 lesion load at the time of diagnosis, 8 suggest that significant pathologic damage is present in pediatric MS.…”