Extensive @entity21 in pediatric XXXX .

@entity1 @entity21 @entity15 @entity477
OBJECTIVE: Axonal damage occurs early in @entity15 ( @entity15 ) and contributes to the degree of clinical disability. @entity1 with @entity15 more often show disabling and polyfocal neurological symptoms at disease onset than adults with @entity15 . Thus, @entity21 may differ between pediatric and adult @entity15 @entity1 . METHODS: We analyzed axonal pathology in archival brain biopsy and autopsy samples from 19 @entity1 with early @entity15 . Lesions were classified according to demyelinating activity and presence of remyelination. Axonal density and extent of @entity21 were assessed using Bielschowsky silver impregnation and immunohistochemistry for @entity477 ( @entity477 ), respectively. @entity21 was correlated with the inflammatory infiltrate as well as clinical characteristics. Results were compared with data from adult @entity15 @entity1 . RESULTS: Acute @entity21 was most extensive in early active demyelinating (EA) lesions of pediatric @entity1 and correlated positively with the Expanded Disability Status Scale at attack leading to biopsy/autopsy. Comparison with 12 adult @entity1 showed a 50% increase in the extent of @entity21 in EA lesions from @entity1 compared to adults, with the highest number of @entity477 -positive spheroids found prior to puberty. The extent of @entity21 correlated positively with the number of lesional macrophages. Axonal density was reduced in pediatric lesions irrespective of the demyelinating activity or the presence of remyelination. Axonal reduction was similar between @entity1 and adults. INTERPRETATION: Our results provide evidence for more pronounced @entity21 in inflammatory demyelinating lesions from @entity1 compared to adults. Ann Neurol 2015.
