cortical thinning occurs early

Fernández-Jaén A, Fernández-Mayoralas DM,
Fernández-Perrone AL, Jiménez de la Peña M, Recio Rodríguez M,
Calleja-Pérez B, Muñoz Jareño N, Arroyo R, Albert J.
Cortical thickness at the time of the initial attack in two patients with paediatric relapsing-remittingmultiple sclerosis. Eur J Paediatr Neurol. 2013 Dec 24. pii: S1090-3798(13)00204-3. doi: 10.1016/j.ejpn.2013.12.002. [Epub ahead of print] 

BACKGROUND:Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system with a low incidence in the paediatric population; cortical atrophy is often striking, even in the early stages of the disease. Evidence of cortical thinning in childhood MS is scant.
AIMS: This study aimed to assess cortical thickness in paediatric patients during the initial attack of remitting-relapsing MS.
METHODS: We report two cases of remitting-relapsing MS, with initial attacks at 12 and 16 years of age. We analysed brain cortical thickness (CTh) in these patients and compared these data to the CTh of a control group comprised of six 12-year-old females and six 16-year-old males.
RESULTS: Both cases exhibited a total brain CTh significantly below that of the control group. This difference was also observed when analysing the CTh of all lobes except the left parietal lobe in one of the cases.
CONCLUSIONS: Cortical atrophy is already present at the time of onset of MS. Studies with larger patient populations that have a more homogenous clinical presentation could identify the time of onset of cortical atrophy and use this parameter as a prognostic and/or treatment marker of MS.

This study says that there is nerve damage straight from onset.

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