Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany/ Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
Department of Paediatric Neurology, Children's Hospital Datteln, Witten/Herdecke University, Datteln, Germany.
Mult Scler. 2019 Jun;25(7):927-936. doi: 10.1177/1352458519829698. Epub 2019 Apr 4.
Paediatric multiple sclerosis (pedMS) patients at a single site were shown to have reduced brain volumes and failure of age-expected brain growth compared to healthy controls. However, the precise time of onset of brain volume loss remains unclear.
To longitudinally study brain volumes in a multi-centre European cohort at first presentation and after 2 years.
Brain volumes of high-resolution magnetic resonance imaging (MRI) data from 37 pedMS patients at first presentation prior to steroid therapy and at 2-year follow-up ( n = 21) were compared to matched longitudinal MRI data from the NIH Paediatric MRI Data Repository.
Patients showed significantly reduced whole brain, grey and white matter and increased ventricular volumes at initial presentation and at follow-up compared to controls. Over 2 years, patients exhibited significant reduction of whole brain and white matter volumes, accompanied by increased ventricular volume. Brain volume loss at follow-up correlated with a higher number of infratentorial lesions, relapses and an increased Expanded Disability Status Scale (EDSS) score.
In pedMS patients, brain volume loss is present already at first clinical presentation and accelerated over 2 years. Increased disease activity is associated with more severe brain volume loss. MRI brain volume change might serve as an outcome parameter in future prospective pedMS studies.
与健康对照组相比，单中心的儿科多发性硬化症（pedMS）患者的脑容量减少，且大脑未能按预期年龄增长。然而，脑容量减少的确切发病时间仍不清楚。
在首次就诊时和 2 年后，对多中心欧洲队列的脑容量进行纵向研究。
将 37 名在接受类固醇治疗前首次就诊时和 2 年后（ n = 21）的 pedMS 患者的高分辨率磁共振成像（MRI）数据的脑容量与 NIH 儿科 MRI 数据存储库中的匹配纵向 MRI 数据进行比较。
与对照组相比，患者在初次就诊和随访时全脑、灰质和白质体积减少，脑室体积增加。在 2 年期间，患者的全脑和白质体积明显减少，同时脑室体积增加。随访时的脑容量丢失与幕下病变、复发和扩展残疾状况量表（EDSS）评分增加的数量相关。
在 pedMS 患者中，脑容量减少在首次临床发病时已经存在，并在 2 年内加速。疾病活动度增加与更严重的脑容量丢失相关。MRI 脑容量变化可能成为未来前瞻性 pedMS 研究中的一个结局参数。
