Abstract
Background
No data are available on the occurrence of gray matter lesions (GML) in the cerebellum of pediatric multiple sclerosis (pedMS).
Objectives
We analyzed frequency, number and topography of GML, and their correlation with cerebellar-related disability in pedMS at clinical onset.
Methods
Fifteen adolescents with pedMS (12F/3M; mean age 14.9 ± 2.2, range 11–17) were studied. Neurological and cognitive evaluations were done by means of EDSS, Trail Making Test—Part B (TMT-B) and Symbol Digit Modalities Test—oral version (SDMT). Cerebellar GML were investigated with double inversion recovery (DIR) and phase-sensitive inversion recovery (PSIR) sequences obtained with a 3 T-MRI scan.
Results
All patients had white matter lesions (WML) and/or GML in the cerebellum. A significantly higher GML number was observed on PSIR compared to DIR (mean 2.3 ± 2.3 vs 1.1 ± 1.6; median 2.0 (IQR 1.0–2.0) vs 1.0 (IQR 0.0–1.5); p = 0.004). GML were observed in 14/15 (93.3%) patients and were more frequent in the posterior than in the anterior lobe (mean 1.8 ± 2.2 vs 0.47 ± 0.74; median 2.0 (IQR 0.5–2.0) vs 0.0 (IQR 0.0–1.0); p = 0.044). No correlation was found between lesion number or topography and EDSS (r = 0.12, p = 0.69), TMT-B and SDMT.
Conclusion
At clinical onset, cerebellar GML are common in pedMS, are very often asymptomatic, do not correlate with physical and cognitive disability, and more frequently affect the posterior lobe.
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Monica Margoni reports grants from Teva, grants from Genzyme Sanofi, grants from Merck Serono, grants from Biogen Idec, and grants and personal fees from Novartis, during the conduct of the study. Silvia Franciotta, Davide Poggiali, Alice Riccardi, Margherita Nosadini, Stefano Sartori, Maria Giulia Anglani, and Francesco Causin have nothing to disclose. Francesca Rinaldi reports grants and personal fees from Genzyme Sanofi, grants and personal fees from Merck Serono, grants and personal fees from Biogen Idec, and grants from Novartis, during the conduct of the study. Paola Perini reports grants and personal fees from Merck Serono, grants and personal fees from Biogen Idec, grants and personal fees from Genzyme Sanofi, grants and personal fees from Bayer Schering Pharma, grants and personal fees from Novartis, and grants and personal fees from Teva, during the conduct of the study. Paolo Gallo reports grants and personal fees from Merck Serono, grants and personal fees from Biogen Idec, grants and personal fees from Genzyme Sanofi, grants and personal fees from Bayer Schering Pharma, grants and personal fees from Novartis, grants and personal fees from Teva, grants from University of Padua, Department of Neurosciences DNS, grants from Veneto Region of Italy, grants from Italian Association for Multiple Sclerosis (AISM), and grants from Italian Ministry of Public Health, during the conduct of the study.
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This study was approved by the local Ethics Committee and was performed according to the Declaration of Helsinki.
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Participants received an explanatory statement and gave their written informed consent to participate in the study.
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Margoni, M., Franciotta, S., Poggiali, D. et al. Cerebellar gray matter lesions are common in pediatric multiple sclerosis at clinical onset. J Neurol 267, 1824–1829 (2020). https://doi.org/10.1007/s00415-020-09776-6
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DOI: https://doi.org/10.1007/s00415-020-09776-6