Related Experiment Video
Updated: Jul 23, 2025
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Neurological and Psychological Sequelae Associated With Multisystem Inflammatory Syndrome in Children
Caitlin K Rollins1,2, Johanna Calderon1,3,4, David Wypij5,6,7
1Department of Neurology, Boston Children's Hospital, Boston, Massachusetts.
Insights
Children with multisystem inflammatory syndrome (MIS-C) experience lasting neurological and psychological effects, including impaired working memory and reduced quality of life, 6-12 months post-discharge.
Area of Science:
- Pediatric neurology
- Infectious diseases
- Child psychology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) can cause acute neurological issues.
- Long-term neurological, psychological, and cognitive sequelae in MIS-C survivors are not well-documented.
- Direct assessments of cognitive function 6-12 months post-discharge are lacking.
Purpose of the Study:
- To characterize neurological, psychological, and quality of life sequelae in children after MIS-C.
- To compare outcomes in MIS-C patients with sibling or community controls.
Main Methods:
- Cross-sectional cohort study in the US and Canada (November 2020-November 2021).
- Remote neurological examination and neuropsychological assessments (cognition, behavior, quality of life, daily function).
- Generalized estimating equations used for group comparisons.
Main Results:
- MIS-C patients (n=64) showed more frequent neurological abnormalities than controls (n=44) (25% vs 7%).
- MIS-C group had lower working memory scores (executive functioning) and similar performance on most other cognitive measures.
- Parents reported worse psychological outcomes (depression, somatization) and lower quality of life in MIS-C survivors.
Conclusions:
- Children with MIS-C exhibit persistent neurological and psychological deficits 6-12 months post-discharge.
- Findings include abnormal neurologic exams, impaired working memory, increased somatization/depression, and reduced quality of life.
- Enhanced monitoring is recommended for early detection and treatment of these sequelae.
Importance:
Acute neurological involvement occurs in some patients with multisystem inflammatory syndrome in children (MIS-C), but few data report neurological and psychological sequelae, and no investigations include direct assessments of cognitive function 6 to 12 months after discharge.
Objective:
To characterize neurological, psychological, and quality of life sequelae after MIS-C.
Design, Setting, And Participants:
This cross-sectional cohort study was conducted in the US and Canada. Participants included children with MIS-C diagnosed from November 2020 through November 2021, 6 to 12 months after hospital discharge, and their sibling or community controls, when available. Data analysis was performed from August 2022 to May 2023.
Exposure:
Diagnosis of MIS-C.
Main Outcomes And Measures:
A central study site remotely administered a onetime neurological examination and in-depth neuropsychological assessment including measures of cognition, behavior, quality of life, and daily function. Generalized estimating equations, accounting for matching, assessed for group differences.
Results:
Sixty-four patients with MIS-C (mean [SD] age, 11.5 [3.9] years; 20 girls [31%]) and 44 control participants (mean [SD] age, 12.6 [3.7] years; 20 girls [45%]) were enrolled. The MIS-C group exhibited abnormalities on neurological examination more frequently than controls (15 of 61 children [25%] vs 3 of 43 children [7%]; odds ratio, 4.7; 95% CI, 1.3-16.7). Although the 2 groups performed similarly on most cognitive measures, the MIS-C group scored lower on the National Institutes of Health Cognition Toolbox List Sort Working Memory Test, a measure of executive functioning (mean [SD] scores, 96.1 [14.3] vs 103.1 [10.5]). Parents reported worse psychological outcomes in cases compared with controls, particularly higher scores for depression symptoms (mean [SD] scores, 52.6 [13.1] vs 47.8 [9.4]) and somatization (mean [SD] scores, 55.5 [15.5] vs 47.0 [7.6]). Self-reported (mean [SD] scores, 79.6 [13.1] vs 85.5 [12.3]) and parent-reported (mean [SD] scores, 80.3 [15.5] vs 88.6 [13.0]) quality of life scores were also lower in cases than controls.
Conclusions And Relevance:
In this cohort study, compared with contemporaneous sibling or community controls, patients with MIS-C had more abnormal neurologic examinations, worse working memory scores, more somatization and depression symptoms, and lower quality of life 6 to 12 months after hospital discharge. Although these findings need to be confirmed in larger studies, enhanced monitoring may be warranted for early identification and treatment of neurological and psychological symptoms.
Related Concept Videos
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Post-traumatic Stress Disorder
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
01:30Dissociative Identity Disorder