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Disease progression in pediatric multiple sclerosis: disparities between physical and neurocognitive outcomes

Eluen Ann Yeh1, Joy B Parrish, Bianca Weinstock-Guttman

  • 1Pediatric MS and Demyelinating Disorders Center of the Jacobs Neurological Institute, Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USA. ann.yeh@sympatico.ca

Expert Review of Neurotherapeutics
|March 8, 2011
PubMed

Insights

Pediatric multiple sclerosis (MS) shows a paradox: slower progression to disability but rapid cognitive decline. This review examines neuroimaging, cognition, and outcomes in pediatric MS to understand this.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Pediatric Neurology

Background:

  • Pediatric multiple sclerosis (MS) is increasingly recognized.
  • While adult MS typically leads to irreversible disability over time, pediatric MS presents unique challenges.
  • Emerging data indicate a concerning rate of cognitive impairment in young MS patients.

Purpose of the Study:

  • To explore the apparent paradox of slower physical disability progression versus rapid cognitive deficits in pediatric MS.
  • To synthesize current research on neuroimaging, cognitive function, and clinical outcomes in pediatric MS.
  • To provide a comprehensive overview of the neurocognitive burden in this population.

Main Methods:

  • Literature review focusing on neuroimaging studies in pediatric MS.
  • Analysis of cognitive assessment data from pediatric MS cohorts.
  • Examination of studies correlating neuroimaging, cognition, and long-term outcomes in young MS patients.

Main Results:

  • Neuroimaging studies reveal distinct patterns in pediatric MS compared to adults.
  • Cognitive deficits, particularly in areas like processing speed and memory, accrue relatively quickly in children and adolescents with MS.
  • Despite a potentially longer trajectory to severe physical disability, the impact on cognitive function is significant and early.

Conclusions:

  • Pediatric MS presents a unique clinical and pathological profile.
  • The rapid onset of cognitive deficits in pediatric MS warrants specific attention and management strategies.
  • Further research is needed to elucidate the mechanisms driving cognitive decline and optimize interventions for long-term neurocognitive health in pediatric MS.

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