Naila Makhani, M.D., M.P.H. – 2020

Multiple sclerosis is the most common cause of non-traumatic neurological disability in young adults. Children with multiple sclerosis have frequent clinical relapses and may become disabled at a young age. 

We identified a group of children with a condition termed the Radiologically Isolated Syndrome (RIS) who are at substantial risk for the subsequent development of clinical multiple sclerosis. These children underwent brain MRI scans for reasons other than suspected multiple sclerosis (e.g., for head trauma), and their MRIs unexpectedly had the typical imaging features of multiple sclerosis. There is a need to identify risk factors for the subsequent development of clinical multiple sclerosis in children with RIS and to incorporate these risk factors into prediction models, so that children at high risk for the later development of clinical multiple sclerosis can be identified, monitored closely and considered for intervention trials to prevent or to delay symptoms. 

In this study, we will, for the first time, assess whether novel MRI markers, namely, 1) central veins within MRI lesions and 2) paramagnetic rims around MRI lesions help identify those children with RIS who are at highest risk of later developing clinical multiple sclerosis. We will create prediction models for multiple sclerosis that incorporate these novel MRI markers. These models will help us determine which children with RIS are at greatest risk of subsequent clinical multiple sclerosis so that this group could be approached for enrollment in a future intervention trial to try to prevent or to delay clinical multiple sclerosis. Given the significant disability (at an early age) associated with multiple sclerosis in children, interventions to prevent or delay the clinical onset of the disease are expected to have substantial impact.