MRI in the evaluation of pediatric multiple sclerosis

Brenda Banwell, Douglas L. Arnold, Jan-Mendelt Tillema, Maria A. Rocca, Massimo Filippi, Bianca Weinstock-Guttman, Robert Zivadinov, Maria Pia Sormani

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

MRI plays a pivotal role in the diagnosis of multiple sclerosis (MS) in children, as it does in adults. The presence of multiple lesions in CNS locations commonly affected by MS, along with the presence of both enhancing and nonenhancing lesions, can facilitate a diagnosis of MS at the time of a first attack, whereas the accrual of serial lesions or new clinical attacks over time confirms the diagnosis in patients not meeting such criteria at onset. T2 and enhancing lesion accrual could serve as a primary outcome metric for pediatric MS clinical trials of selected therapies with anti-inflammatory activity in order to facilitate feasible trial size numbers. More-advanced MRI techniques reveal the impact of MS on tissue integrity within both T2-bright and T1-hypointense lesions and regions of normal-appearing tissue. Volumetric MRI analyses quantify the impact of MS on age-expected brain growth, and fMRI reveals activation and resting-state functional connectivity patterns in patients with pediatric MS that differ from those seen in healthy age-matched youth. Such studies are of critical importance because MS onset during childhood may profoundly influence maturing and actively myelinating neural networks. Highfield MRI visualizes MS pathology at a near-microscopic level and has the potential to more fully explain mechanisms for cognitive impairment, fatigue, and disability in patients with pediatric MS.

Original languageEnglish (US)
Pages (from-to)S88-S96
JournalNeurology
Volume87
Issue number9
DOIs
StatePublished - Aug 30 2016

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Multiple Sclerosis
Pediatrics
Fatigue
Anti-Inflammatory Agents
Magnetic Resonance Imaging
Clinical Trials
Pathology
Brain
Growth

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Banwell, B., Arnold, D. L., Tillema, J-M., Rocca, M. A., Filippi, M., Weinstock-Guttman, B., ... Sormani, M. P. (2016). MRI in the evaluation of pediatric multiple sclerosis. Neurology, 87(9), S88-S96. https://doi.org/10.1212/WNL.0000000000002787

MRI in the evaluation of pediatric multiple sclerosis. / Banwell, Brenda; Arnold, Douglas L.; Tillema, Jan-Mendelt; Rocca, Maria A.; Filippi, Massimo; Weinstock-Guttman, Bianca; Zivadinov, Robert; Sormani, Maria Pia.

In: Neurology, Vol. 87, No. 9, 30.08.2016, p. S88-S96.

Research output: Contribution to journalArticle

Banwell, B, Arnold, DL, Tillema, J-M, Rocca, MA, Filippi, M, Weinstock-Guttman, B, Zivadinov, R & Sormani, MP 2016, 'MRI in the evaluation of pediatric multiple sclerosis', Neurology, vol. 87, no. 9, pp. S88-S96. https://doi.org/10.1212/WNL.0000000000002787
Banwell B, Arnold DL, Tillema J-M, Rocca MA, Filippi M, Weinstock-Guttman B et al. MRI in the evaluation of pediatric multiple sclerosis. Neurology. 2016 Aug 30;87(9):S88-S96. https://doi.org/10.1212/WNL.0000000000002787
Banwell, Brenda ; Arnold, Douglas L. ; Tillema, Jan-Mendelt ; Rocca, Maria A. ; Filippi, Massimo ; Weinstock-Guttman, Bianca ; Zivadinov, Robert ; Sormani, Maria Pia. / MRI in the evaluation of pediatric multiple sclerosis. In: Neurology. 2016 ; Vol. 87, No. 9. pp. S88-S96.
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