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Patients with paediatric-onset multiple sclerosis are at higher risk of cognitive impairment in adulthood: An Italian
Luis Ruano1, Mariana Branco2, Emilio Portaccio3
1EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal/Departamento de Epidemiologia Clinica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Porto, Portugal/Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Insights
Adults with a history of paediatric-onset multiple sclerosis (POMS) face a higher risk of cognitive impairment and physical disability compared to those with adult-onset multiple sclerosis (AOMS). This increased risk, particularly affecting information processing speed, persists even after accounting for age.
Area of Science:
- Neurology
- Neuroscience
- Clinical Research
Background:
- Paediatric-onset multiple sclerosis (POMS) may increase the risk of long-term cognitive impairment (CI) due to neurodevelopmental effects.
- Limited data exists on the long-term cognitive outcomes for individuals with POMS.
Purpose of the Study:
- To compare the prevalence and characteristics of cognitive impairment (CI) in adults with a history of POMS versus those with classic adult-onset multiple sclerosis (AOMS).
Main Methods:
- Cognitive performance was evaluated using the Brief Repeatable Battery (BRB) and Stroop Test in 119 POMS and 712 AOMS patients across six Italian MS centers.
- Cognitive impairment (CI) was defined as deficits in two or more cognitive domains.
Main Results:
- The prevalence of CI was similar between POMS (44.5%) and AOMS (48.0%) groups.
- After adjusting for age, POMS patients showed a significantly higher risk of CI (OR=1.71) and impaired information processing speed (OR=1.86).
- POMS patients also exhibited a higher Expanded Disability Status Scale (EDSS) score compared to AOMS patients.
Conclusions:
- Individuals with a history of POMS are at an elevated risk for both cognitive and physical disability compared to AOMS patients, independent of age.
- Information processing speed is particularly affected in the POMS group.
Background:
Patients with paediatric-onset multiple sclerosis (POMS) could be at an increased risk for cognitive impairment (CI), given the potential harmful effects of disease activity in neurodevelopment. However, there is scarce information on their long-term cognitive outcomes.
Objective:
To compare the prevalence and profile of CI between adults with a history of POMS and those with classic, adult-onset multiple sclerosis (AOMS).
Methods:
Cognitive performance was assessed through the Brief Repeatable Battery (BRB) and the Stroop Test in consecutive patients referred to six Italian MS centres. CI was defined as impairment in ⩾2 cognitive domains.
Results:
In all, 119 patients with POMS and 712 with AOMS were included in this analysis. The prevalence of CI was 48.0% in AOMS, 44.5% in POMS; with similar neuropsychological profile between the two groups. However, when adjusting for current age, we found a significantly increased risk for CI (odds ratio (OR) = 1.71; p = 0.02) and for impairment in information processing speed (OR = 1.86; p < 0.01) in patients with POMS. A higher Expanded Disability Status Scale (EDSS) was also identified in POMS ( p = 0.03) compared with AOMS patients.
Conclusion:
Patients with a history of POMS appear to be at higher risk of physical and cognitive disability than AOMS patients, after correcting for age effects, with particular involvement of information processing speed.
