Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Pichler, A; Enzinger, C; Fuchs, S; Plecko-Startinig, B; Gruber-Sedlmayr, U; Linortner, P; Langkammer, C; Khalil, M; Ebner, F; Ropele, S; Fazekas, F.
Differences and similarities in the evolution of morphologic brain abnormalities between paediatric and adult-onset multiple sclerosis.
Mult Scler. 2013; 19(2):167-172
Doi: 10.1177/1352458512448107
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Enzinger Christian
- Pichler Alexander
- Co-Autor*innen der Med Uni Graz
- Ebner Franz
- Fazekas Franz
- Fuchs Siegrid
- Gruber-Sedlmayr Ursula
- Khalil Michael
- Langkammer Christian
- Linortner Patricia
- Plecko Barbara
- Ropele Stefan
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- Abstract:
- Paediatric-onset multiple sclerosis (pMS) is multiple sclerosis (MS) occurring before the age of 18 years and may present and develop differently from adult-onset MS (aMS). Whether there are also differences regarding the accrual of brain changes is largely unknown. We compared the evolution of the T2- and T1-lesion load (LL), the black hole ratio (BHR), and annualised brain volume change (aBVC) between 21 pMS patients (age at onset: 14.4±2.3 years) and 21 aMS patients (age at onset: 29.4±6.5 years) matched for disease duration (pMS: 1.0±1.8 years; aMS: 1.6±1.7 years, p=0.27). Follow-up was for 4.2±3.7 years in pMS and 3.1±0.6 years in aMS. Clinical comparisons included the course of disability assessed with the Expanded Disability Status Scale (EDSS) score and annualised relapse rate (ARR). At baseline, pMS and aMS had similar EDSS, T1-LL, BHR, whereas T2-LL was higher in aMS (aMS: 9.2±11.6 ccm; pMS: 4.1±6.2 ccm, p=0.02). The change of T2-LL and T1-LL during the observation period was similar in both groups. At follow-up, disability was lower in pMS (EDSS score in pMS: 0.9±0.9; aMS: 1.7±1.3, p=0.04), despite a significantly higher accrual of destructive brain lesions (BHR in pMS: 23.7±23.7%; aMS: 5.9±4.0%, p=0.02) and a similar rate of brain volume loss. Our observation of a morphologically more aggressive disease evolution paralleled by less disability in pMS than in aMS (defined using EDSS) suggests a higher compensatory capacity in pMS. This fact may obscure the need for treatment of pMS patients with disease modifying treatments (DMTs) based solely on clinical observation.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Age of Onset -
- Biomarkers -
- Brain - pathology
- Cohort Studies -
- Data Interpretation, Statistical -
- Disability Evaluation -
- Disease Progression -
- Female -
- Forecasting -
- Humans -
- Image Processing, Computer-Assisted -
- Magnetic Resonance Imaging -
- Male -
- Multiple Sclerosis - pathology
- Recurrence -
- Regression Analysis -
- Young Adult -
- Find related publications in this database (Keywords)
- multiple sclerosis
- MRI
- black holes
- paediatric MS