Radiologically isolated syndrome in children

Naila Makhani, Christine Lebrun, Aksel Siva, David Brassat, Clarisse Carra Dallière, Jérôme De Seze, Wei Du, Françoise Durand Dubief, Orhun Kantarci, Megan Langille, Sona Narula, Jean Pelletier, Juan Ignacio Rojas, Eugene D. Shapiro, Robert T. Stone, Mar Tintoré, Ugur Uygunoglu, Patrick Vermersch, Evangeline Wassmer, Darin T. OkudaDaniel Pelletier

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objective: To describe clinical and radiologic outcomes of children with incidental findings on neuroimaging suggestive of CNS demyelination (termed "radiologically isolated syndrome" or RIS). Methods: Clinical and radiologic data were obtained from a historical cohort of children with no symptoms of demyelinating disease who had MRI scans that met the 2010 MRI criteria for dissemination in space for MS. Results: We identified 38 children (27 girls and 11 boys) with RIS now being prospectively followed at 16 sites in 6 countries. The mean follow-up time was 4.8 ± 5.3 years. The most common reason for initial neuroimaging was headache (20/38, 53%). A first clinical event consistent with CNS demyelination occurred in 16/38 children (42%; 95% confidence interval [CI]: 27%-60%) in a median of 2.0 years (interquartile range [IQR] 1.0-4.3 years). Radiologic evolution developed in 23/38 children (61%; 95% CI: 44%-76%) in a median of 1.1 years (IQR 0.5-1.9 years). The presence of ≥2 unique oligoclonal bands in CSF (hazard ratio [HR] 10.9, 95% CI: 1.4-86.2, p = 0.02) and spinal cord lesions on MRI (HR 7.8, 95% CI: 1.4-43.6, p = 0.02) were associated with an increased risk of a first clinical event after adjustment for age and sex. Conclusions: We describe the clinical characteristics and outcomes of children with incidental MRI findings highly suggestive of CNS demyelination. Children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution. The presence of oligoclonal bands in CSF and spinal cord lesions on MRI were associated with an increased risk of a first clinical event.

Original languageEnglish (US)
Article numbere395
JournalNeurology: Neuroimmunology and NeuroInflammation
Volume4
Issue number6
DOIs
StatePublished - Oct 23 2017

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Makhani, N., Lebrun, C., Siva, A., Brassat, D., Carra Dallière, C., De Seze, J., Du, W., Durand Dubief, F., Kantarci, O., Langille, M., Narula, S., Pelletier, J., Rojas, J. I., Shapiro, E. D., Stone, R. T., Tintoré, M., Uygunoglu, U., Vermersch, P., Wassmer, E., ... Pelletier, D. (2017). Radiologically isolated syndrome in children. Neurology: Neuroimmunology and NeuroInflammation, 4(6), [e395]. https://doi.org/10.1212/NXI.0000000000000395