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A Multidisciplinary Neuropsychology-Neuroimmunology Clinic Model for Pediatric Neuroimmune Disorders
Duriel Hardy1, Karla Robles-Lopez2, Karen Evankovich1
1Pediatric Neurosciences at Dell Children's, UT Health Austin, Austin, Texas; Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, Texas.
Background:
Pediatric central nervous system neuroimmune disorders frequently lead to cognitive, emotional, and fatigue-related complications that are often unrecognized, leading to treatment delays. We describe a novel multidisciplinary neuroimmunology-neuropsychology clinic model aimed to enhance access to neuropsychologic evaluations, identify neurocognitive impairment, and facilitate expedited treatment plans.
Methods:
Between February and October 2025, 28 patients <18 years of age with neuroimmune disorders involving the brain underwent performance-based, targeted neuropsychologic screenings before their neuroimmunology appointment. Assessments included measures of verbal memory, processing speed, working memory, attention, fine motor speed, and language. Standalone and embedded performance validity measures were administered. Neuropsychologic assessments and clinical data were retrospectively analyzed.
Results:
Diagnoses included multiple sclerosis (n = 3), myelin oligodendrocyte glycoprotein antibody-associated disease (n = 11), aquaporin-4 negative neuromyelitis optica (n = 4), N-methyl-D-aspartate encephalitis (n = 3), and acute disseminated encephalomyelitis (n = 2) with 50% of patients receiving maintenance immunotherapy. Three patients (11%) had prior attention-deficit/hyperactivity disorder diagnoses and one (4%) had a prior autism diagnosis. Wait times for neuropsychologic evaluations decreased from 15 months to 1.9 months (t = 66.55, P < .0001). Cognitive impairments were detected in 71% of patients, and 36% had developed anxiety or adjustment disorders related to their disorder. Sixty-five percent of patients had cognitive issues identified and addressed during the clinic visit without need for additional evaluation.
Conclusions:
Our integrated neuropsychology-neuroimmunology multidisciplinary clinic expands access to neuropsychologic care, facilitates earlier identification of neurocognitive sequelae, and allows for development of patient-specific treatment plans. This multidisciplinary clinic model reduces appointment burden-potentially enhancing patients' and caregivers' emotional well-being and quality of life. Future studies will evaluate long-term clinical outcomes.
