1. Radiologically isolated syndrome in children
- Author
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Makhani, Naila, Carra Dallière, Clarisse, Seze, Jérôme, Durand Dubief, Françoise, Rojas, Juan Ignacio, Shapiro, Eugene D., Stone, Robert T., Tintoré, Mar, Okuda, Darin T., Lebrun, Christine, Siva, Aksel, Brassat, David, Dallière, Clarisse, de Sèze, Jerome, Du, Wei, Dubief, Françoise, Kantarci, Orhun, Langille, Megan, Narula, Sona, Pelletier, Jean, Rojas, Juan, Shapiro, Eugene, Stone, Robert, Uygunoglu, Ugur, Vermersch, Patrick, Wassmer, Evangeline, Okuda, Darin, Pelletier, Daniel, Yale School of Medicine [New Haven, Connecticut] (YSM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Strasbourg, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Italian Hospital of Buenos Aires, Yale School of Public Health (YSPH), University of Rochester Medical Center (URMC), Centre d'Esclerosi Múltiple de Catalunya (CemCat), University of Texas Southwestern Medical Center [Dallas], Service de Neurologie [CHU Nice], Hôpital Pasteur [Nice] (CHU)-Centre Hospitalier Universitaire de Nice (CHU Nice), Cerrahpasa Faculty of Medicine, Istanbul University, Neurologie vasculaire, pathologie neuro-dégénérative et explorations fonctionnelles du système nerveux [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], Software and Cognitive radio for telecommunications (SOCRATE), Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-CITI Centre of Innovation in Telecommunications and Integration of services (CITI), Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA), Mayo Clinic [Rochester], Children’s Hospital Los Angeles [Los Angeles], Keck School of Medicine [Los Angeles], University of Southern California (USC), Children’s Hospital of Philadelphia (CHOP ), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie et de neuropsychologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire d'Immunologie (EA 2686), Université de Lille, Droit et Santé, Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Birmingham Children’s Hospital, CTSA Grant Number UL1 TR000142 from the National Center for Advancing Translational Science (NCATS) at the National Institutes of Health and NIH roadmap for Medical Research, Yale University School of Medicine, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)-Hôpital de Hautepierre [Strasbourg]-Nouvel Hôpital Civil de Strasbourg, CITI Centre of Innovation in Telecommunications and Integration of services (CITI), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Inria Grenoble - Rhône-Alpes, and Institut National de Recherche en Informatique et en Automatique (Inria)
- Subjects
Pediatrics ,medicine.medical_specialty ,Demyelinating disease ,CNS demyelination ,[SDV]Life Sciences [q-bio] ,Article ,Multiple sclerosis ,03 medical and health sciences ,0302 clinical medicine ,Neuroimaging ,Interquartile range ,Natural history studies ,medicine ,030212 general & internal medicine ,Pediatric ,Clinical events ,business.industry ,Hazard ratio ,Spinal cord ,medicine.disease ,Confidence interval ,medicine.anatomical_structure ,Neurology ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - 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.
- Published
- 2017