title: Impaired growth of the cerebellum in pediatric-onset acquired CNS demyelinating disease.
abstract: Acquired demyelinating syndromes (ADS) have the potential to negatively impact cerebellar growth, given the proclivity for infratentorial lesions in pediatric-onset multiple sclerosis (MS) and ADS.
  
  
  
  To investigate cerebellar growth longitudinally in pediatric ADS.
  
  
  
  Cerebellar volumes from 472 magnetic resonance imaging (MRI) scans of 98 patients with monophasic ADS (monoADS), monophasic acute disseminated encephalomyelitis (ADEM), and MS (49 girls; mean age: 11.4 years at first scan, mean follow-up: 3.1 years) imaged serially from onset and 897 MRI scans of 418 healthy children (223 girls, mean age: 11.3 years, mean follow-up: 2.9 years) were segmented automatically, analyzed with mixed-effect models, and compared with cerebral volume.
  
  
  
  Cerebellar developmental trajectories followed a U-shaped curve, showing larger volumes in boys (p < 0.001). Cerebellar volumes in all three patient groups failed to reach age-expected trajectories, leading to significantly smaller volumes, notably in the posterior lobes. Cerebellar volume reductions were of a similar magnitude to cerebral volume reductions. Cerebellar white matter volume declined in MS and ADEM patients over time, while in monoADS patients it remained similar to controls. Cerebellar volumes did not correlate either with lesion volumes at onset or with physical disability.
  
  
  
  MonoADS, ADEM, and MS in childhood lead to impaired age-expected growth of the cerebellum.
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
authors.forename: Katrin
authors.initials: K
authors.lastname: Weier
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Fonov
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
authors.forename: Bérengère
authors.initials: B
authors.lastname: Aubert-Broche
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Arnold
authors.affiliation: Division of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Banwell
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada Louis.collins@mcgill.ca.
authors.forename: D Louis
authors.initials: DL
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000254:growth & development*; D002648:Child; D002675:Child, Preschool; D020278:Demyelinating Autoimmune Diseases, CNS / Q000000981:diagnostic imaging; D004673:Encephalomyelitis, Acute Disseminated / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging*; D009929:Organ Size
keywords: Cerebellum; acute disseminated encephalomyelitis; multiple sclerosis; pediatric; volumetric MRI