Disrupted cognitive development following pediatric acquired demyelinating syndromes: a longitudinal study

Area of Science:

• Neuroscience
• Pediatric Neurology
• Cognitive Psychology

Background:

• Acquired demyelinating syndrome (ADS) can lead to long-term cognitive deficits in children.
• Understanding the trajectory of cognitive changes and the role of brain volume following ADS is crucial for early intervention.

Purpose of the Study:

• To examine cognitive functioning changes in children during the first two years after incident ADS.
• To determine if normalized brain and thalamic volume changes account for cognitive decline over time.

Main Methods:

• Longitudinal study of 25 youth (mean age 12.8 years) with ADS (9 with multiple sclerosis, 16 with monophasic ADS).
• Neuropsychological evaluations and MRI scans conducted at approximately 6 and 24 months post-ADS onset.
• Generalized linear mixed-effect regression models analyzed the association between brain volumes and cognitive z-scores.

Main Results:

• Cognitive performance remained stable and within age-expected ranges for most measures.
• Clinically significant declines were observed in 19-42% of participants on specific tests (SDMT, AWM, VisMat).
• Lower normalized brain volume at 6 months predicted cognitive decline in SDMT and AWM scores.

Conclusions:

• Cognitive decline and reduced brain volume can occur after a single demyelinating event, not solely with chronic conditions.
• Even monophasic ADS may negatively impact children's cognitive potential.
• Brain volume at 6 months post-ADS is a predictor of subsequent cognitive changes.