Neuropediatrics 2019; 50(S 02): S1-S55
DOI: 10.1055/s-0039-1698198
Poster Presentations
Poster Are a GNP Varia 1/CNS Tumours
Georg Thieme Verlag KG Stuttgart · New York

Failure of Expected Brain Growth in Children with ADEM

Birgit Baumgartner
1   Witten/Herdecke University, Department of Pediatric Neurology, Datteln, Germany
,
Frederik Bartels
2   Charité – Universitätsmedizin Berlin, Department of Neurology, Berlin, Germany
,
Eva Wendel
3   Olgahospital Stuttgart, Department of Pediatric Neurology, Stuttgart, Germany
,
Klaus Marquard
4   Olgahospital Stuttgart, Department of Pediatric Neurology, Stuttgart, Germany
,
Astrid Blaschek
5   Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, Department of Pediatric Neurolgy and Development Medicine, Munich, Germany
,
Michael Karenfort
6   University Children’s Hospital, Heinrich Heine University, Department of General Paediatrics, Neonatology and Paediatric Cardiology, Düsseldorf, Germany
,
Matthias Baumann
7   Medical University of Innsbruck, Department of Pediatric I, Pediatric Neurology, Innsbruck, Austria
,
Robert Cleaveland
8   Witten/Herdecke University, Department of Radiology, Datteln, Germany
,
Andreas Wegener-Panzer
8   Witten/Herdecke University, Department of Radiology, Datteln, Germany
,
Markus Reindl
9   Medical University of Innsbruck, Department of Neurology, Innsbruck, Austria
,
Steffen Leiz
10   Hospital Dritter Orden, Department of Pediatrics and Adolescent Medicine, Munich, Germany
,
Michela Salandin
11   Regional Hospital of Bolzano, Department Neuropediatrics, Bolzano, Italy
,
Peter Krieg
12   Städtisches Klinikum Karlsruhe, Departmet of Pediatrics, Karlsruhe, Germany
,
Tobias Reindl
13   Helios Klinik Hohenstücken, Department of Pediatrics, Brandenburg, Germany
,
Rüdiger Wentzell
14   Lukaskrankenhaus Neuss, Department of Pediatrics, Neuss, Germany
,
Carsten Finke
2   Charité – Universitätsmedizin Berlin, Department of Neurology, Berlin, Germany
,
Kevin Rostáy
1   Witten/Herdecke University, Department of Pediatric Neurology, Datteln, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
11 September 2019 (online)

Also available at
 
 

    Background: Acute disseminated encephalomyelitis (ADEM) is one of the pediatric acute demyelination disorders of the CNS defined by a polyfocal neurological presentation, encephalopathy and MRI changes which affects primarily the white matter of the brain and is often associated with serum MOG (myelin oligodendrocyte glycoprotein) antibodies (abs). Although ADEM is typically a monophasic disease, studies have recently shown a negative influence on brain growth overtime.

    Objective: Measurement of total brain and ventricular volume in children with ADEM with and without MOG antibodies at disease onset and over time.

    Methods: Twenty-four patients with ADEM between 0–15 years (median 4,5) from 12 different centers were included in the study. MOG-abs were found in 16 patients. All patients had an MRI of the brain at disease onset before steroid treatment. From 16 patients follow-up MRIs (median 3 months, range 0–33 months) were available, thus a total of 58 MRI scans were analyzed using FSL SIENAX for whole brain and ventricular volume measurements. The results were compared to age- and gender-matched healthy controls (1:10; n = 580) from the NIH Pediatric MRI Data Repository and a cohort (n = 24) from the Children’s Hospital Datteln.

    Results: Whole brain volume in children with ADEM was significantly reduced compared to matched healthy controls (median (IQR); 1677.8cm3 (175.5) vs. 1773.8 (120.7); p < 0.0001) already at onset. Correspondingly, ventricular CSF volume in patients was significantly increased (41.2 (21.2) vs. 24.1 (9.4); p < 0.0001). A longitudinal mixed-effect model also revealed failure of age-expected brain growth in children with ADEM. Preliminary analysis found no differences between MOG positive versus negative patients.

    Conclusion: Children with ADEM, including both MOG-positive and MOG-negative, exhibit significant brain volume loss compared to healthy controls at disease onset and overtime.


    #

    No conflict of interest has been declared by the author(s).