Abstract
Objective: To describe clinical and radiologic outcomes of children with incidental findings on neuroimaging suggestive of CNS demyelination (termed "radiologically isolated syndrome" or RIS). Methods: Clinical and radiologic data were obtained from a historical cohort of children with no symptoms of demyelinating disease who had MRI scans that met the 2010 MRI criteria for dissemination in space for MS. Results: We identified 38 children (27 girls and 11 boys) with RIS now being prospectively followed at 16 sites in 6 countries. The mean follow-up time was 4.8 ± 5.3 years. The most common reason for initial neuroimaging was headache (20/38, 53%). A first clinical event consistent with CNS demyelination occurred in 16/38 children (42%; 95% confidence interval [CI]: 27%-60%) in a median of 2.0 years (interquartile range [IQR] 1.0-4.3 years). Radiologic evolution developed in 23/38 children (61%; 95% CI: 44%-76%) in a median of 1.1 years (IQR 0.5-1.9 years). The presence of ≥2 unique oligoclonal bands in CSF (hazard ratio [HR] 10.9, 95% CI: 1.4-86.2, p = 0.02) and spinal cord lesions on MRI (HR 7.8, 95% CI: 1.4-43.6, p = 0.02) were associated with an increased risk of a first clinical event after adjustment for age and sex. Conclusions: We describe the clinical characteristics and outcomes of children with incidental MRI findings highly suggestive of CNS demyelination. Children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution. The presence of oligoclonal bands in CSF and spinal cord lesions on MRI were associated with an increased risk of a first clinical event.
| Original language | English (US) |
|---|---|
| Article number | e395 |
| Journal | Neurology: Neuroimmunology and NeuroInflammation |
| Volume | 4 |
| Issue number | 6 |
| DOIs | |
| State | Published - Oct 23 2017 |
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ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
Radiologically isolated syndrome in children. / Makhani, Naila; Lebrun, Christine; Siva, Aksel; Brassat, David; Carra Dallière, Clarisse; De Seze, Jérôme; Du, Wei; Durand Dubief, Françoise; Kantarci, Orhun; Langille, Megan; Narula, Sona; Pelletier, Jean; Rojas, Juan Ignacio; Shapiro, Eugene D.; Stone, Robert T.; Tintoré, Mar; Uygunoglu, Ugur; Vermersch, Patrick; Wassmer, Evangeline; Okuda, Darin T.; Pelletier, Daniel.
In: Neurology: Neuroimmunology and NeuroInflammation, Vol. 4, No. 6, e395, 23.10.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Radiologically isolated syndrome in children
AU - Makhani, Naila
AU - Lebrun, Christine
AU - Siva, Aksel
AU - Brassat, David
AU - Carra Dallière, Clarisse
AU - De Seze, Jérôme
AU - Du, Wei
AU - Durand Dubief, Françoise
AU - Kantarci, Orhun
AU - Langille, Megan
AU - Narula, Sona
AU - Pelletier, Jean
AU - Rojas, Juan Ignacio
AU - Shapiro, Eugene D.
AU - Stone, Robert T.
AU - Tintoré, Mar
AU - Uygunoglu, Ugur
AU - Vermersch, Patrick
AU - Wassmer, Evangeline
AU - Okuda, Darin T.
AU - Pelletier, Daniel
PY - 2017/10/23
Y1 - 2017/10/23
N2 - Objective: To describe clinical and radiologic outcomes of children with incidental findings on neuroimaging suggestive of CNS demyelination (termed "radiologically isolated syndrome" or RIS). Methods: Clinical and radiologic data were obtained from a historical cohort of children with no symptoms of demyelinating disease who had MRI scans that met the 2010 MRI criteria for dissemination in space for MS. Results: We identified 38 children (27 girls and 11 boys) with RIS now being prospectively followed at 16 sites in 6 countries. The mean follow-up time was 4.8 ± 5.3 years. The most common reason for initial neuroimaging was headache (20/38, 53%). A first clinical event consistent with CNS demyelination occurred in 16/38 children (42%; 95% confidence interval [CI]: 27%-60%) in a median of 2.0 years (interquartile range [IQR] 1.0-4.3 years). Radiologic evolution developed in 23/38 children (61%; 95% CI: 44%-76%) in a median of 1.1 years (IQR 0.5-1.9 years). The presence of ≥2 unique oligoclonal bands in CSF (hazard ratio [HR] 10.9, 95% CI: 1.4-86.2, p = 0.02) and spinal cord lesions on MRI (HR 7.8, 95% CI: 1.4-43.6, p = 0.02) were associated with an increased risk of a first clinical event after adjustment for age and sex. Conclusions: We describe the clinical characteristics and outcomes of children with incidental MRI findings highly suggestive of CNS demyelination. Children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution. The presence of oligoclonal bands in CSF and spinal cord lesions on MRI were associated with an increased risk of a first clinical event.
AB - Objective: To describe clinical and radiologic outcomes of children with incidental findings on neuroimaging suggestive of CNS demyelination (termed "radiologically isolated syndrome" or RIS). Methods: Clinical and radiologic data were obtained from a historical cohort of children with no symptoms of demyelinating disease who had MRI scans that met the 2010 MRI criteria for dissemination in space for MS. Results: We identified 38 children (27 girls and 11 boys) with RIS now being prospectively followed at 16 sites in 6 countries. The mean follow-up time was 4.8 ± 5.3 years. The most common reason for initial neuroimaging was headache (20/38, 53%). A first clinical event consistent with CNS demyelination occurred in 16/38 children (42%; 95% confidence interval [CI]: 27%-60%) in a median of 2.0 years (interquartile range [IQR] 1.0-4.3 years). Radiologic evolution developed in 23/38 children (61%; 95% CI: 44%-76%) in a median of 1.1 years (IQR 0.5-1.9 years). The presence of ≥2 unique oligoclonal bands in CSF (hazard ratio [HR] 10.9, 95% CI: 1.4-86.2, p = 0.02) and spinal cord lesions on MRI (HR 7.8, 95% CI: 1.4-43.6, p = 0.02) were associated with an increased risk of a first clinical event after adjustment for age and sex. Conclusions: We describe the clinical characteristics and outcomes of children with incidental MRI findings highly suggestive of CNS demyelination. Children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution. The presence of oligoclonal bands in CSF and spinal cord lesions on MRI were associated with an increased risk of a first clinical event.
UR - http://www.scopus.com/inward/record.url?scp=85034032686&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034032686&partnerID=8YFLogxK
U2 - 10.1212/NXI.0000000000000395
DO - 10.1212/NXI.0000000000000395
M3 - Article
C2 - 28959703
AN - SCOPUS:85034032686
VL - 4
JO - Neurology: Neuroimmunology and NeuroInflammation
JF - Neurology: Neuroimmunology and NeuroInflammation
SN - 2332-7812
IS - 6
M1 - e395
ER -