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Pediatric multiple sclerosis: Cognition and mood
Maria Pia Amato1, Lauren B Krupp2, Leigh E Charvet2
1From Department NEUROFARBA (M.P.A.), Section Neurosciences, University of Florence, Italy; Department of Neurology (L.B.K., L.E.C.), Stony Brook Medicine, NY; Cognitive Psychology and Methodology and Division of Paediatric Neurology and Developmental Medicine (I.P.), University Children's Hospital Basel, Switzerland; and Department of Psychology (C.T.), York University, Canada. mariapia.amato@unifi.it.
Insights
Cognitive and mood issues in pediatric-onset multiple sclerosis (POMS) are understudied. Research is growing to understand these challenges in children and adolescents with POMS.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Clinical Psychology
Background:
- Limited research exists on cognitive functioning in pediatric-onset multiple sclerosis (POMS) compared to adults.
- POMS presents unique challenges due to disease onset during critical brain development, myelination, and neural network maturation.
- Cognitive impacts in POMS cannot be directly extrapolated from adult studies.
Purpose of the Study:
- To summarize current knowledge on cognitive and mood-related difficulties in POMS.
- To identify gaps in understanding and establish priorities for future research in POMS.
- To characterize the neuropsychological patterns and functional consequences of POMS.
Main Methods:
- Review of existing literature and clinical series on POMS.
- Increased focus on systematic research in specialized MS centers over the last decade.
- Assessment of cognitive impairments and mood-related difficulties in POMS patients.
Main Results:
- Cognitive functioning and mood disturbances are growing concerns in the POMS population.
- Systematic research is emerging to assess prevalence and characterize POMS-related difficulties.
- Understanding the specific neuropsychological profile of POMS is a key research objective.
Conclusions:
- Further systematic research is crucial to fully understand and address cognitive and mood issues in POMS.
- Future studies should focus on characterizing the unique impact of POMS on developing cognitive faculties.
- Identifying functional consequences and research priorities is essential for improving POMS care.
Abstract:
In comparison with the large body of evidence on cognitive functioning in adults with multiple sclerosis (MS), there is limited information on cognition in pediatric-onset MS (POMS). Unique vulnerabilities in POMS can derive from having a disease that occurs during key periods of age-expected brain growth, active myelination in the CNS, and maturation of neural networks during the learning curve and key formative years in the academic career of the patient. Therefore, the consequences of MS on developing cognitive faculties can be assessed only in the pediatric population and cannot be simply extrapolated from studies carried on in the adult population. Until the last decade, research in the pediatric population was mainly represented by small clinical series, often limited by the narrow scope of neuropsychological assessment and lack of adequate control groups. Over the last decade, however, cognitive functioning and mood-related difficulties have become an increasing concern as awareness of this population has grown. A few specialized MS centers have begun performing more systematic research in the field in order to assess the prevalence of cognitive impairments and mood-related difficulties in patients with POMS, to better characterize the neuropsychological pattern and determine the functional consequences of these problems. This chapter summarizes our current understanding of cognitive and mood-related difficulties in POMS and highlights perceived gaps in knowledge and priorities for future research.
