Departments of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
Department of Psychology, York University, Toronto, ON, Canada Division of Neurology, Department of Pediatrics, The Hospital for Sick Children Research Institute, University of Toronto, Toronto, ON, Canada.
Mult Scler. 2019 Jun;25(7):980-986. doi: 10.1177/1352458518779952. Epub 2018 Jun 1.
To determine the frequency of cortical lesions (CLs) in patients with pediatric-onset multiple sclerosis (POMS) using multi-contrast magnetic resonance imaging (MRI), and the relationship between frontal CL load and upper limb dexterity assessed with the Nine-Hole Peg Test (9-HPT).
Participants completed the 9-HPT and were imaged on a 3T MRI scanner to collect T1-weighted three-dimensional (3D) magnetization prepared rapid gradient echo (MPRAGE), proton density-weighted, T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. CLs were manually segmented using all MRI contrasts.
We enrolled 24 participants with POMS (mean (standard deviation) age at first symptom: 13.3 (±2.7) years; mean age at scan: 18.8 (±3) years; mean disease duration of 5 (±3.2) years). A total of 391 CLs (mean, 16.3 ± 27.2; median, 7) were identified in 19 of 24 POMS patients (79%). The total number of CLs was positively associated with white matter lesion volume ( p = 0.04) but not with thalamic volume, age at the time of the scan, or disease duration. The number of frontal CLs was associated with slower performance on the 9-HPT ( p = 0.05).
Multi-contrast 3T MRI led to a high rate of CL detection, demonstrating that cortical pathology occurs even in pediatric-onset disease. Frontal lobe CL count was associated with reduced manual dexterity, indicating that these CLs are clinically relevant.
使用多对比度磁共振成像（MRI）确定儿科发病多发性硬化症（POMS）患者皮质病变（CL）的频率，并评估额部 CL 负荷与九孔钉测试（9-HPT）评估的上肢灵巧性之间的关系。
参与者完成 9-HPT，并在 3T MRI 扫描仪上进行成像，以收集 T1 加权三维（3D）磁化准备快速梯度回波（MPRAGE）、质子密度加权、T2 加权和液体衰减反转恢复（FLAIR）图像。使用所有 MRI 对比手动分割 CL。
我们纳入了 24 名 POMS 患者（首发症状的平均（标准差）年龄：13.3（±2.7）岁；扫描时的平均年龄：18.8（±3）岁；平均病程为 5（±3.2）年）。在 24 名 POMS 患者中的 19 名患者（79%）中发现了 391 个 CL（平均 16.3±27.2；中位数 7）。CL 的总数与白质病变体积呈正相关（p=0.04），但与丘脑体积、扫描时的年龄或病程无关。额叶 CL 的数量与 9-HPT 表现较慢相关（p=0.05）。
多对比度 3T MRI 导致 CL 检测率较高，表明皮质病变甚至发生在儿科发病疾病中。额叶 CL 计数与手动灵巧性降低有关，表明这些 CL 具有临床相关性。
