Cognitive Ability in Pediatric-Onset Multiple Sclerosis: A Case Series

Area of Science:

• Neurology
• Pediatrics
• Neuroimmunology

Background:

• Pediatric-onset multiple sclerosis (POMS) affects children during critical neurodevelopmental periods, increasing vulnerability to neurological damage and cognitive decline.
• Cognitive function is a key concern in POMS, necessitating identification of prognostic factors and effective treatments.

Purpose of the Study:

• To analyze cognitive and clinical characteristics in children with POMS.
• To identify factors influencing cognitive performance and treatment outcomes in POMS.

Main Methods:

• Retrospective descriptive study of pediatric patients with POMS (2010-2023).
• Analysis of neuropsychological assessments, clinical data, and radiological findings.

Main Results:

• Cognitive function showed overall improvement, nearing significance in visual perceptual organization and hand dexterity.
• Earlier disease onset and younger assessment age correlated with poorer nonverbal skills.
• Higher relapse rates, disability scores, lesion burden, and basal ganglia involvement predicted worse cognitive performance.
• Fingolimod therapy and longer treatment duration were linked to better cognitive outcomes.

Conclusions:

• Younger children with POMS face higher risks of cognitive impairment, especially early in the disease.
• Clinical and radiological factors can predict cognitive deficits.
• Early initiation of high-efficacy disease-modifying therapies like Fingolimod is associated with improved cognitive prognosis.