Cognitive functions in pediatric multiple sclerosis: 2-years follow-up

Area of Science:

• Neuroscience
• Pediatric Neurology
• Cognitive Psychology

Background:

• Pediatric multiple sclerosis (MS) presents unique challenges in cognitive assessment.
• Longitudinal studies are crucial for understanding the progressive nature of cognitive deficits in pediatric MS.

Purpose of the Study:

• To evaluate the neuropsychological status of pediatric MS patients over time.
• To correlate cognitive function with clinical variables in a longitudinal cohort.
• To identify specific cognitive domains affected by pediatric MS.

Main Methods:

• A longitudinal study involving 46 pediatric MS patients and 53 healthy controls (HCs).
• Neuropsychological testing included non-verbal reasoning, attention/concentration, visuospatial judgment, and verbal fluency at baseline and 2-year follow-up.
• Cognitive impairment defined as failure on ≥3 of 4 tests; patients grouped by age of onset (≤12 vs >12 years).

Main Results:

• Cognitive impairment was observed in 47.8% of pediatric MS patients at follow-up.
• Worsening cognition correlated with higher Expanded Disability Status Scale (EDSS) scores.
• Attention/concentration and non-verbal reasoning were the most affected domains; non-verbal reasoning declined specifically in patients with onset ≤12 years.

Conclusions:

• Pediatric MS is associated with cognitive decline that parallels disability progression.
• Non-verbal reasoning is particularly vulnerable in patients with early disease onset (≤12 years).
• Routine assessment of non-verbal reasoning is recommended for optimal management of pediatric MS.