Brief Computer-Based Information Processing Measures are Linked to White Matter Integrity in Pediatric-Onset Multiple...

Area of Science:

• Neuroscience
• Pediatric Neurology
• Radiology

Background:

• Pediatric-onset multiple sclerosis (POMS) presents unique clinical challenges in children and adolescents.
• Cognitive impairment is a significant issue in POMS, impacting quality of life.
• Understanding the neuroanatomical basis of cognitive deficits in POMS is crucial for effective management.

Purpose of the Study:

• To investigate the neuroanatomical correlates of cognitive deficits detected by screening batteries in POMS.
• To determine if computer-administered cognitive tests are sensitive to white matter changes in POMS.

Main Methods:

• Participants with POMS and age-matched healthy controls (HCs) underwent cognitive screening using Cogstate and BICAMS.
• Diffusion tensor imaging (DTI) was employed to assess fractional anisotropy (FA) in brain regions and white matter tracts.
• Statistical analyses correlated cognitive performance with FA measures.

Main Results:

• The Cogstate composite showed significant slowing in POMS patients compared to HCs (P = .004).
• Cogstate performance strongly correlated with regional FA (r = -.67 to -.82) and specifically with uncinate fasciculus FA (P = .002) in POMS.
• BICAMS did not significantly differentiate between POMS and HCs (P = .10), and its correlations with FA were weaker and not statistically significant after correction.

Conclusions:

• Computer-administered cognitive processing measures, like Cogstate, are sensitive to cognitive impairment in POMS.
• Cognitive deficits identified by these measures are closely associated with white matter integrity, particularly fractional anisotropy (FA).
• These findings underscore the importance of assessing processing speed and its relationship to white matter microstructure in pediatric MS.