[S60.001] Evidence Of Impaired Age-Expected Growth And Atrophy Of The Cerebellum In Pediatric Patients With Monophasic Acquired Demyelinating Syndrome And Multiple Sclerosis
Katrin Weier,1Vladimir Fonov,1Bérengère Aubert-Broche,1Douglas Arnold,1Brenda Banwell,2D. Louis Collins1
1Montreal, QC, Canada, 2Philadelphia, PA, USA
Objective: To investigate the impact of a monophasic acquired demyelinating syndrome (monoADS) and pediatric-onset MS on the cerebellum in a longitudinal cohort of pediatric patients.
Background: Recent studies have shown that in comparison to adult-onset multiple sclerosis (MS) there are more inflammatory lesions in the posterior fossa of pediatric-onset patients.
Methodology: A newly developed automatic segmentation pipeline for cerebellum, using a template library and patch-based label-fusion, was used to segment cerebellar grey (CGV) and white matter volumes (CWV) from 449 longitudinal MRI scans (3m to 2y intervals) from 69 CIS and 24 MS patients (53 girls; mean age at onset 11.2 ± SD 3.4 years; mean follow-up 2.99 years). Mixed effect models were calculated using age, sex and diagnosis as well as presence of infratentorial lesions as fixed effects, and using random intercept and slope terms to account for within-subject variability of volumes.
Results: MonoADS and MS patients, all showed inverted u-shaped developmental trajectories for total cerebellar volume (TCV) and CGV, peaking around 13y for girls and 17y for boys and then declining. In all cases, males had significantly larger volumes compared to females (p < 0.01). Significant age-by-gender effect was seen for CGV (p=0.001). Furthermore, a significant age-by-diagnosis interaction (p=0.005) was found for CWV, showing a reduction of CWV in MS patients, whereas the CWV plateaus in monoADS patients over time. The effect of infratentorial lesions was significantly different between groups (p=0.04), with CWV affected only in the MS group.
Conclusion: MonoADS and MS in childhood leads to impaired age-expected growth of the cerebellum and atrophy possibly influencing sensori-motor and cognitive development. The presence of infratentorial lesions at this stage influences white matter growth in MS patients.
Category - Child Neurology and Developmental Neurology: Imaging
Thursday, May 1, 2014 3:15 PM
S60: Platform Session: Child Neurology II (3:15 PM-5:00 PM)