title: Early white matter changes in childhood multiple sclerosis: a diffusion tensor imaging study.
abstract: OBJECTIVE
  Loss of integrity in nonlesional white matter occurs as a fundamental feature of multiple sclerosis in adults. The purpose of our study was to evaluate DTI-derived measures of white matter microstructure in children with MS compared with age- and sex-matched controls by using tract-based spatial statistics.
  
  
  METHODS
  Fourteen consecutive pediatric patients with MS (11 female/3 male; mean age, 15.1 ± 1.6 years; age range, 12-17 years) and age- and sex-matched healthy subjects (11 female/3 male; mean age, 14.8 ± 1.7 years) were included in the study. After we obtained DTI sequences, data processing was performed by using tract-based spatial statistics.
  
  
  RESULTS
  Compared with healthy age- and sex-matched controls, children with multiple sclerosis showed a global decrease in mean fractional anisotropy (P ≤ .001), with a concomitant increase in mean (P < .001), radial (P < .05), and axial diffusivity (P < .001). The most pronounced fractional anisotropy value decrease in patients with MS was found in the splenium of the corpus callosum (P < .001). An additional decrease in fractional anisotropy was identified in the right temporal and right and left parietal regions (P < .001). Fractional anisotropy of the white matter skeleton was related to disease duration and may, therefore, serve as a diagnostic marker.
  
  
  CONCLUSIONS
  The microstructure of white matter is altered early in the disease course in childhood multiple sclerosis.
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, Ludwig-Maximilian-University, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Blaschek
authors.forename: D
authors.initials: D
authors.lastname: Keeser
authors.forename: S
authors.initials: S
authors.lastname: Müller
authors.forename: I K
authors.initials: IK
authors.lastname: Koerte
authors.forename: A
authors.initials: A
authors.lastname: Sebastian Schröder
authors.forename: W
authors.initials: W
authors.lastname: Müller-Felber
authors.forename: F
authors.initials: F
authors.lastname: Heinen
authors.forename: B
authors.initials: B
authors.lastname: Ertl-Wagner
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D016880:Anisotropy; D002648:Child; D015331:Cohort Studies; D056324:Diffusion Tensor Imaging; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*