Cortical lesions in children with multiple sclerosis
Cortical lesions in children with multiple sclerosis
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DOI：
10.1212/wnl.0b013e31820f2e69
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发表时间：
2011-03-01
期刊：
影响因子：
9.9
通讯作者：
Filippi, M.
中科院分区：
文献类型：
--
作者：
Absinta, M.;Rocca, M. A.;Filippi, M.
目的：双反转恢复(DIR)序列提高了成人多发性硬化(MS)患者皮质病变(CLS)的检出能力。方法：使用3.0-T扫描仪，对24例复发缓解期MS患者、15例成人RRMS患者和10例正常儿童进行脑DIR、双回波和三维T1加权成像。确定CLS和白质(WM)病变，并测量其体积。计算脑灰质体积和白质体积。组间比较使用chi(2)、Mann-Whitney和方差分析检验。结果：与成人相比，儿童患者的病程较短，致残率较低。WM病灶数目和体积在儿童和成人患者之间没有差异。在2例(8%)儿童和10例(66%)成人患者中发现了CLS。儿童RRMS患者的CL体积中位数低于成人患者(p=0.0003)。回归分析显示，在调整了年龄、性别、扩展残疾状态量表评分和病程后，儿童患者CLS的数量比成人患者少(p=0.0003)。结论：CLS在儿童MS患者中很少见，因为儿童MS患者的临床发病比成人MS患者更接近疾病的生物学发病，我们的发现表明CL的形成可能不是这种疾病的初始事件。神经病学(R)2011；76：910-913
Objective: Double inversion recovery (DIR) sequences have improved the detection of cortical lesions (CLs) in adult patients with multiple sclerosis (MS). We evaluated the presence and frequency of CLs in pediatric patients with relapsing-remitting MS (RRMS) in comparison to adult patients with MS with the same clinical phenotype.Methods: Using a 3.0-T scanner, brain DIR, dual-echo, and 3-dimensional T1-weighted scans were acquired from 24 pediatric patients with RRMS, 15 adult patients with RRMS, and 10 pediatric healthy controls. CLs and white matter (WM) lesions were identified, and their volumes measured. Brain gray matter and WM volumes were also calculated. Between-group comparisons were performed using chi(2), Mann-Whitney, and analysis of variance tests. Poisson regressions for count data were used to model the number of lesions of the 2 groups of patients.Results: Compared to adults, pediatric patients had shorter disease duration and lower disability. WM lesion number and volume did not differ between pediatric and adult patients with MS. CLs were detected in 2 (8%) pediatric and 10 (66%) adult patients. Median CL volume was lower in pediatric than adult patients with RRMS (p = 0.0003). Regression analysis showed that pediatric patients had a lower number of CLs than adults (p = 0.0003), after adjusting for age, gender, Expanded Disability Status Scale score, and disease duration.Conclusion: CLs are rare in pediatric patients with MS. Since pediatric patients with MS have a clinical onset closer to the biological onset of the disease than adult patients with MS, our findings indicate that CL formation is likely not to be an initial event in this disease. Neurology (R) 2011; 76: 910-913