Brain, spinal cord MR imaging helps ID MS risk in children

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New research from Yale University’s School of Medicine shows scans of the brain and spinal cord can be key to identifying changes in brain activity that can lead to multiple sclerosis (MS) in children.

The researchers, led by Naila Makhani, MD MPH, assistant professor of pediatrics and director of the Pediatric MS Program at Yale, published findings in the November issue of Neurology: Neuroimmunology & Neuroinflammation. 

All 38 scans (of 27 girls and 11 boys) collected from 16 research facilities around the world were originally conducted for different medical reasons. However, the MRIs show radiologically isolated syndrome (RIS), suggestive of MS in asymptomatic patients or evidence of lesions that indicate a loss of myelin (central nervous system demyelination). 

The study subjects were followed for an average of almost five years, and 29 received spinal cord MRI.

Researchers noted 42 percent of the children in the study with MRI findings of MS developed the first clinical symptoms of the disease around two years after the abnormal MRI, indicating a faster development of the disease in children compared to adults. 

Children with abnormalities in their spinal fluid who showed lesions in their spinal cord in the MRI were at the highest risk of developing symptoms of MS. Five of the children in the study with RIS received an approved treatment for multiple sclerosis to try to prevent the disease. 

“Although this work does not address the issue of whether children with RIS should be treated with disease-modifying agents for MS, we hope that an accurate classification of the risk of clinical symptoms in children with RIS will help in the development of consensus guidelines that are urgently needed to optimize clinical care in this population,” Makhani et al. wrote.