Background: Early-onset multiple sclerosis (MS) typically has a more favorable course than adult-onset disease. Objective: To assess the extent of microscopic tissue damage in the brain and cervical cord of patients with early-onset MS. Designs: During a single magnetic resonance imaging session, images of the brain and spinal cord were obtained using diffusion tensor and magnetization transfer magnetic resonance imaging. Patients: We studied 13 patients with early-onset MS and 10 healthy volunteers. Results: Compared with control subjects, patients with early-onset MS showed only a slight increase of the average mean diffusivity of the normal-appearing brain tissue. Conclusions: The relatively modest central nervous system damage detected in these patients might explain why early-onset MS typically has a more favorable clinical course than adult-onset MS.
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