A diffusion tensor imaging investigation of white matter in pediatric multiple sclerosis patients

Background. To explore normal-appearing white matter (NAWM) in pediatric-onset multiple sclerosis (MS) patients, using diffusion tensor imaging (DTI). DTI study provides measures of WM integrity in adult MS patients. Pediatric MS patients provide a uniquely early window for exploring pathological components of myelin disruption.;Results. Altered NAWM integrity in MS patients relative to controls is demonstrated by: reduced FA values (p<0.0001) and elevated ADC values (p<0.05) throughout CC and hemispheres.;Conclusions. DTI measures show widespread disruption of WM integrity in children with MS extending beyond visible lesions. These findings implicate diffuse and potentially very early WM degeneration in MS pathobiology.;Methods. DTI data were obtained for 23 pediatric MS patients and 17 healthy children. Images were acquired using GE LX1.5T scanner (DTI parameters: 25 directions, 5mm slice thickness, b=1000s/mm2). Fractional anisotropy (FA) and apparent diffusion co-efficient (ADC) were analyzed in lesions and NAWM throughout corpus callosum (CC) and hemispheres.