Neuropsychological features in childhood and juvenile multiple sclerosis

Abstract

Cognitive outcome in pediatric-onset MS can be heterogeneous. Progression of cognitive problems in a few subjects and potential for compensation and improvement in others call for systematic cognitive screening in this population and development of effective treatment strategies.

Patients with paediatric-onset multiple sclerosis are at higher risk of cognitive impairment in adulthood: An Italian collaborative study

“…2 In this context, it is important to note that the subgroup of POMS patients with CI also presented higher disability levels although not by a large magnitude, whereas previous studies reached heterogeneous conclusions about the association of physical disability with cognitive dysfunction in patients with POMS. 8,10,12 It must be noted, however, that the AOMS patients in this sample are significantly older than POMS patients, and when stratifying by age group, the EDSS level remained consistently higher in patients with POMS ( Figure 1). In previous prognostic studies, POMS patients appeared to reach irreversible EDSS milestones with a delay of nearly 10 years of disease duration when compared with AOMS patients although these irreversible levels of disability were achieved at a younger age in POMS.…”

“…[3][4][5][6] Additionally, in POMS subjects, there is accumulating evidence of involvement of linguistic faculties 1,6 and lower intellectual efficiency in terms of intelligence quotient (IQ), particularly in those with younger age at MS onset. 7 An early MS disease onset can have a negative influence in school achievements and overall quality of life, [8][9][10][11] but it is unclear if it could lead to an increased risk for CI in later life. 3 Some studies suggest a negative impact of relapses, disease duration and physical disability in the cognitive performance of patients with POMS, 8,9,12 but these issues remain controversial.…”

“…3 Some studies suggest a negative impact of relapses, disease duration and physical disability in the cognitive performance of patients with POMS, 8,9,12 but these issues remain controversial. 10,11 There is little information about the long-term cognitive outcome in patients with POMS. Longitudinal studies published to date have relatively short followup periods (1-5 years), and suggest cognitive worsening, with variable rates of decline, although there are patients who may exhibit stable or improved cognitive function over time.…”

Therapeutic Approach to the Management of Pediatric Demyelinating Disease: Multiple Sclerosis and Acute Disseminated Encephalomyelitis

“…Despite the lack of early measurable physical disability, cognitive impairment can be noted in up to one-third of pediatric patients with MS [36][37][38]. Impairments in information processing speed, verbal memory, verbal fluency, and receptive language are seen with resultant negative effects on the patient's scholarship and daily life activities [39]. Longitudinal data are required to determine patterns of cognitive loss or improvement over time, the impact of treatment on cognitive function, and the impact of early-onset MS on academic and vocational achievement into adulthood.…”

Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

“…6,20,35,37,46 Investigations into the relationship between fatigue and neurocognitive functioning suggested that fatigue is unrelated to overall neurocognitive functioning. 6,[40][41][42] However, there was some evidence to suggest that fatigued caMS have impaired performance on some individual cognitive tasks, particularly motor-based tasks such as the Trail Making Test A and B, and on tasks requiring prolonged and complex mental activity, such as problem solving, complex attention and processing speed, and language comprehension tasks. 6,33 At present, the evidence does not substantially support a relationship between fatigue and any specific domain of cognitive functioning.…”