title: Cortical thickness at the time of the initial attack in two patients with paediatric relapsing-remitting multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system with a low incidence in the paediatric population; cortical atrophy is often striking, even in the early stages of the disease. Evidence of cortical thinning in childhood MS is scant.
  
  
  OBJECTIVE
  This study aimed to assess cortical thickness in paediatric patients during the initial attack of remitting-relapsing MS.
  
  
  METHODS
  We report two cases of remitting-relapsing MS, with initial attacks at 12 and 16 years of age. We analysed brain cortical thickness (CTh) in these patients and compared these data to the CTh of a control group comprised of six 12-year-old females and six 16-year-old males.
  
  
  RESULTS
  Both cases exhibited a total brain CTh significantly below that of the control group. This difference was also observed when analysing the CTh of all lobes except the left parietal lobe in one of the cases.
  
  
  CONCLUSIONS
  Cortical atrophy is already present at the time of onset of MS. Studies with larger patient populations that have a more homogenous clinical presentation could identify the time of onset of cortical atrophy and use this parameter as a prognostic and/or treatment marker of MS.
authors.affiliation: Department of Neuropediatrics, Hospital Universitario Quirón, Madrid, Spain; Department of Neurology, Hospital Universitario Quirón, Madrid, Spain. Electronic address: aferjaen@telefonica.net.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-Jaén
authors.affiliation: Department of Neuropediatrics, Hospital Universitario Quirón, Madrid, Spain; Department of Neurology, Hospital Universitario Quirón, Madrid, Spain.
authors.forename: Daniel Martín
authors.initials: DM
authors.lastname: Fernández-Mayoralas
authors.affiliation: Department of Neuropediatrics, Hospital Universitario Quirón, Madrid, Spain; Department of Neurology, Hospital Universitario Quirón, Madrid, Spain.
authors.forename: Ana Laura
authors.initials: AL
authors.lastname: Fernández-Perrone
authors.affiliation: Radiodiagnostics Department, Hospital Universitario Quirón, Madrid, Spain; Department of Neuro-radiology, Hospital Universitario Quirón, Madrid, Spain; Department of Magnetic Resonance, Hospital Universitario Quirón, Madrid, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Jiménez de la Peña
authors.affiliation: Radiodiagnostics Department, Hospital Universitario Quirón, Madrid, Spain; Department of Neuro-radiology, Hospital Universitario Quirón, Madrid, Spain; Department of Magnetic Resonance, Hospital Universitario Quirón, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Recio Rodríguez
authors.affiliation: Paediatric Primary Care, Centro de Salud Doctor Cirajas, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Calleja-Pérez
authors.affiliation: Department of Neuropediatrics, Hospital Infanta Leonor de Vallecas, Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Muñoz Jareño
authors.affiliation: Department of Neurology, Hospital Universitario Quirón, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Arroyo
authors.affiliation: Human Brain Mapping Unit, Complutense University of Madrid, Spain.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Albert
mesh_terms: D000293:Adolescent; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D018450:Disease Progression; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000473:pathology*; D010372:Pediatrics; D013995:Time
keywords: Atrophy; Cortical; Gray matter; Multiple sclerosis; Paediatric