The diagnostic workup of children with the radiologically isolated syndrome differs by age and by sex

N Makhani*, C Lebrun-Frenay, A Siva, Observatoire Francophone de la Sclérose en Plaques (OFSEP), Société Francophone de la Sclerose Plaques (SFSEP), Radiologically Isolated Syndrome Consortium (RISC), the Pediatric Radiologically Isolated Syndrome Consortium (PARIS), V Shabanova, E Wassmer, JD Santoro, S Narula, JN Brenton, S Mar, F Durand-Dubief, H Zephir, G Mathey, JI Rojas, J de Seze, S Tenembaum, RT StoneO Casez, C Carra-Dallière, RF Neuteboom, N Ahsan, HA Arroyo, P Cabre, G Gombolay, M Inglese, C Louapre, M Margoni, F Palavra, D Pohl, DS Reich, A Ruet, E Thouvenot, N Timby, M Tintore, U Uygunoglu, W Vargas, S Venkateswaran, H Verhelst, R Wickstrom, CJ Azevedo, O Kantarci, ED Shapiro, DT Okuda, D Pelletier

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

Background: Cerebrospinal fluid (CSF) and spinal MRIs are often obtained in children with the radiologically isolated syndrome (RIS) for diagnosis and prognosis. Factors affecting the frequency and timing of these tests are unknown. Objective: To determine whether age or sex were associated with (1) having CSF or spinal MRI obtained or (2) the timing of these tests. Methods: We analyzed children (≤ 18 y) with RIS enrolled in an international longitudinal study. Index scans met 2010/2017 multiple sclerosis (MS) MRI criteria for dissemination in space (DIS). We used Fisher’s exact test and multivariable logistic regression (covariates = age, sex, MRI date, MRI indication, 2005 MRI DIS criteria met, and race). Results: We included 103 children with RIS (67% girls, median age = 14.9 y). Children ≥ 12 y were more likely than children < 12 y to have CSF obtained (58% vs. 21%, adjusted odds ratio [AOR] = 4.9, p = 0.03). Pre-2017, girls were more likely than boys to have CSF obtained (n = 70, 79% vs. 52%, AOR = 4.6, p = 0.01), but not more recently (n = 30, 75% vs. 80%, AOR = 0.2, p = 0.1; p = 0.004 for interaction). Spinal MRIs were obtained sooner in children ≥ 12 y (median 11d vs. 159d, p = 0.03). Conclusions: Younger children with RIS may be at continued risk for misdiagnosis and misclassification of MS risk. Consensus guidelines are needed.

Original languageEnglish
Pages (from-to)4019-4027
Number of pages9
JournalJournal of Neurology
Volume271
Issue number7
Early online date2 Apr 2024
DOIs
Publication statusE-pub ahead of print - 2 Apr 2024

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2024.

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