Neuropediatrics 2013; 44 - FV11_03
DOI: 10.1055/s-0033-1337711

Early white matter changes in childhood multiple sclerosis

A Blaschek 1, D Keeser 2, S Müller 3, IK Koerte 3, AS Schroeder 1, W Müller-Felber 1, F Heinen 1, B Ertl-Wagner 3
  • 1Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, Munich, Germany
  • 2Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
  • 3Institute for Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany

Aims: Loss of integrity in nonlesional white matter occurs as a fundamental feature of multiple sclerosis (MS) in children and adults. The purpose of our study was to evaluate diffusion tensor imaging (DTI)-derived measures of white matter integrity in children with multiple sclerosis compared to age- and gender-matched controls.

Methods: This study investigated white matter integrity in 14 children with multiple sclerosis and age- and gender-matched healthy subjects using DTI in a 3 Tesla MR scanner. Data processing was performed using tract-based spatial statistics (TBSS).

Results: When compared to healthy age- and gender-matched controls (n = 14, 14.7 ± 1.7 years, 3 male/11 female), children with multiple sclerosis (n = 14, 15.1 ± 1.6 years, 3 male/11 female) showed a global decrease in mean fractional anisotropy (FA) (p < 0.001) with concomitant increase in mean, radial, and axial diffusivity (p < 0.001). The most pronounced FA value decrease in MS patients was found in the splenium of the corpus callosum (p < 0.001). An additional decrease in FA was identified in right temporal and bilateral parietal regions (p < 0.001). FA of the white matter skeleton was related to disease duration and may therefore serve as a diagnostic marker.

Conclusion: White matter integrity is altered early in the diseases course in childhood multiple sclerosis.