MRIs show brain changes related to multiple sclerosis before symptom onset.
Early diagnosis of multiple sclerosis (MS) gives patients the opportunity to seek early treatment, thereby delaying symptoms and disease progression. Unfortunately, many cases of MS in pediatric patients are diagnosed too late to prevent disability and relapses.
A new study published by Neurology: Neuroimmunology & Neuroinflammation suggests that MRI brain scans could identify pediatric patients at a high risk of developing MS before symptom onset. This may lead to early diagnosis and treatment.
Included in the study were 38 children who underwent MRI brain scans for a number of reasons, including headaches.
The authors noted that the MRI scans showed changes in the brain linked to MS before symptoms were experienced, according to the study. Finding MS-related brain changes without symptoms is called radiologically isolated syndrome (RIS) and has only been seen in adults before this study was conducted.
“For the first time, we have proposed a definition of RIS in children,” said lead author Naila Makhani, MD. “Children with RIS may represent a high-risk group of children that needs to be followed more closely for the later development of clinical multiple sclerosis.”
Within 2 years of the abnormal brain scan, 42% of the participants developed clinical symptoms of MS. These findings suggest that pediatric MS may develop faster than adult-onset MS, according to the study.
Additionally, the authors found that pediatric patients who had a certain marker in their spinal fluid or who had changes in the spinal cord had the largest risk of experiencing MS symptoms.
Only 5 of the patients received prophylactic treatment for MS, but the authors caution that the sample size is too small to speculate about the efficacy of the therapy, according to the study.
Overall, these findings indicate that MRIs could be used as a way to identify children with a high risk of developing MS, according to the authors.
“We hope that our work will help inform expert guidelines for how to follow up children with RIS and help us accurately inform families of the risk of later developing multiple sclerosis, something we were previously unable to do,” Dr Makhani said.