Destructive white matter changes in early MS

MS cause destruction of tissue structure in children with MS. #MSBlog #MSResearch

Epub: Blaschek et al. Early White Matter Changes in Childhood Multiple Sclerosis: A Diffusion Tensor Imaging Study. AJNR Am J Neuroradiol. 2013 May 16.

BACKGROUND AND PURPOSE: Loss of integrity in nonlesional white matter occurs as a fundamental feature of MS in adults. The purpose of this study was to evaluate DTI-derived measures of white matter microstructure in children with MS compared with age- and sex-matched controls by using tract-based spatial statistics.

DTI = diffusion tensor imaging; DTI allows the mapping of the diffusion process of molecules, mainly water, in the brain and spinal cord non-invasively. Molecular diffusion in tissues is not free, but reflects interactions with many obstacles, such as fibres, membranes, etc. Water molecule diffusion patterns can therefore reveal microscopic details about tissue architecture, either normal or in a diseased state. The unit that DTI uses is very technical term called fractional anisotropy; the higher the fractional anisotropy the more tissue structure the lower the fractional anisotropy the less the tissue structure the greater the damage.

MATERIALS AND METHODS: 14 consecutive pediatric MSers (11 female/3 male; mean age, 15.1 ± 1.6 years; age range, 12-17 years) and age- and sex-matched healthy subjects (11 female/3 male; mean age, 14.8 ± 1.7 years) were included in the study. After they obtained DTI sequences, data processing was performed by using tract-based spatial statistics. 

RESULTS: Compared with healthy age- and sex-matched controls, children with MS showed a global decrease in mean fractional anisotropy (P ≤ .001), with a concomitant increase in mean (P < .001), radial (P < .05), and axial diffusivity (P < .001). The most pronounced fractional anisotropy value decrease in MSers was found in the splenium of the corpus callosum (P < .001). An additional decrease in fractional anisotropy was identified in the right temporal and right and left parietal regions (P < .001). Fractional anisotropy of the white matter skeleton was related to disease duration and may, therefore, serve as a diagnostic marker.

CONCLUSIONS: The microstructure of white matter is altered early in the disease course in childhood MS.


"This study confirms that MS causes destruction of microscopic tissue structure. We know this already. The worrying thing is that even in children with MS they don't have sufficient regenerative capacity to compensate. MS is bad disease no matter what age you are."

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