June 27, 2014

MRI parameters identified for prediction of MS diagnosis in children with acute CNS demyelination

Researchers at the Hospital for Sick Children (Toronto, Ontario) and University of Toronto who lead the Canadian Pediatric Demyelinating Disease Network developed a standardized scoring tool to identify MRI predictors that can be used to diagnose MS in children with acute CNS demyelination. The ability to diagnose children using these predictors will allow for more timely access to treatment and care. [Leonard H Verhey BSc, Helen M Branson MBBS, Manohar M Shroff MD, David JA Callen MD, John G Sled PhD, Sridar Narayanan PhD, Prof A Dessa Sadovnick PhD, Amit Bar-Or MD, Prof Douglas L Arnold MD, Ruth Ann Marrie MD, Dr Brenda Banwell MD, for the Canadian Pediatric Demyelinating Disease Network. The Lancet Neurology Published online November 7, 2011 DOI:10.1016/S1474-4422(11)70250-2]

Supported by a Canadian Institutes of Health Research Doctoral Award and the Multiple Sclerosis Society of Canada, Leonard Verhey, a Canadian researcher who recently won Top Young Investigator for his platform presentation on the same topic at the 2011 ECTRIMS/ACTRIMS Congress in Amsterdam, along with Dr. Brenda Banwell and colleagues from the Canadian Pediatric Demyelinating Disease Network conducted a national prospective cohort study between September 2004 and June 2010, using a total of 1139 MRI scans from 284 children and adolescents with acquired demyelinating syndromes (ADS) to identify MRI predictors of subsequent MS diagnosis.

A standardized MRI scoring tool was designed and included parameters that represent MRI features of MS and characteristics that differentiate MS from non-demyelinating CNS inflammatory disease. Researchers gathered comprehensive clinical and MRI data at ADS onset, three, six and twelve months following onset and then annually over the next five years. They applied the scoring tool to MRI scans obtained at onset, and found that the presence of one or more T1-weighted lesions and one or more T2-weighted periventricular lesions demonstrated an increased likelihood of MS. The identified MRI parameters can be used to predict diagnosis of MS in children and adolescents with incident demyelination of the CNS, and will allow for earlier initiation of disease-modifying therapy in the pediatric MS population.