Contributions
Abstract: P1124
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: At short-medium term, pediatric multiple sclerosis (MS) patients have a more favorable clinical course than adult ones. However, only a few studies have investigated the pathobiological basis of such a different clinical outcome. Against this background we aimed at exploring structural and functional MRI substrates underlying clinical differences between pediatric and adult MS patients.
Methods: Using a 3T scanner, brain dual-echo, 3DT1-weighted and resting state (RS) functional MRI (fMRI) scans were acquired from 31 pediatric (pedMS) and 30 adult MS (adMS) patients at baseline and after a mean follow-up of 3.2 years. Twenty-six pediatric and 30 adult healthy controls (HC) were also enrolled. Voxel-based and tensor-based morphometry were used to assess patterns of gray matter (GM) volume and their modifications, while RS functional connectivity (FC) was evaluated using independent component analysis. Correlations between MRI and clinical variables were explored using multiple regression models.
Results: At baseline, excluding age-related differences, compared to adMS, pedMS patients showed higher volumes of temporal, parietal and occipital regions. During the follow-up, compared to adMS, pedMS showed more significant GM atrophy in several frontal and parietal regions, with sparing of bilateral cerebellum and postcentral gyrus, left middle frontal gyrus and supplementary motor area. Both at baseline and follow-up, compared to adMS, pedMS showed brain regions with increased and decreased RS FC in default mode network, sensorimotor network, executive control network and salience network. During the follow-up, EDSS remained stable in pedMS and worsened in adMS. EDSS changes in adMS were correlated with RS FC modifications, but not with GM volume changes.
Conclusions: The onset of MS during childhood is likely to increase vulnerability to neurodegenerative processes, especially for brain regions with a maturation during adolescence. Functional brain plasticity is likely to protect pedMS patients from clinical disability accrual.
Funding: Partially supported by Italian Ministry of Health (GR-2009-1529671) and Fondazione Italiana Sclerosi Multipla (FISM2011/R/19, FISM 2012/R/8, FISM-2016-R-23)
Disclosure: E. De Meo, A. Meani, L. Moiola, B. Colombo, M. Rodegher, and A. Falini have nothing to disclose.
A. Ghezzi received honoraria for speaking from Biogen-Idec, Merck-Serono, Novartis, Genzyme, Teva, and Allergan, and for consultancy from Merck-Serono, Teva, Novartis, and Biogen-Idec; and received support for participation in national and international congresses from Schering, Biogen-Idec, Merck-Serono, Novartis, Genzyme, and Teva.
G. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, ExceMED.
M. Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Abstract: P1124
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: At short-medium term, pediatric multiple sclerosis (MS) patients have a more favorable clinical course than adult ones. However, only a few studies have investigated the pathobiological basis of such a different clinical outcome. Against this background we aimed at exploring structural and functional MRI substrates underlying clinical differences between pediatric and adult MS patients.
Methods: Using a 3T scanner, brain dual-echo, 3DT1-weighted and resting state (RS) functional MRI (fMRI) scans were acquired from 31 pediatric (pedMS) and 30 adult MS (adMS) patients at baseline and after a mean follow-up of 3.2 years. Twenty-six pediatric and 30 adult healthy controls (HC) were also enrolled. Voxel-based and tensor-based morphometry were used to assess patterns of gray matter (GM) volume and their modifications, while RS functional connectivity (FC) was evaluated using independent component analysis. Correlations between MRI and clinical variables were explored using multiple regression models.
Results: At baseline, excluding age-related differences, compared to adMS, pedMS patients showed higher volumes of temporal, parietal and occipital regions. During the follow-up, compared to adMS, pedMS showed more significant GM atrophy in several frontal and parietal regions, with sparing of bilateral cerebellum and postcentral gyrus, left middle frontal gyrus and supplementary motor area. Both at baseline and follow-up, compared to adMS, pedMS showed brain regions with increased and decreased RS FC in default mode network, sensorimotor network, executive control network and salience network. During the follow-up, EDSS remained stable in pedMS and worsened in adMS. EDSS changes in adMS were correlated with RS FC modifications, but not with GM volume changes.
Conclusions: The onset of MS during childhood is likely to increase vulnerability to neurodegenerative processes, especially for brain regions with a maturation during adolescence. Functional brain plasticity is likely to protect pedMS patients from clinical disability accrual.
Funding: Partially supported by Italian Ministry of Health (GR-2009-1529671) and Fondazione Italiana Sclerosi Multipla (FISM2011/R/19, FISM 2012/R/8, FISM-2016-R-23)
Disclosure: E. De Meo, A. Meani, L. Moiola, B. Colombo, M. Rodegher, and A. Falini have nothing to disclose.
A. Ghezzi received honoraria for speaking from Biogen-Idec, Merck-Serono, Novartis, Genzyme, Teva, and Allergan, and for consultancy from Merck-Serono, Teva, Novartis, and Biogen-Idec; and received support for participation in national and international congresses from Schering, Biogen-Idec, Merck-Serono, Novartis, Genzyme, and Teva.
G. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, ExceMED.
M. Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.