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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.
Insights
A new clinic model for pediatric neuroimmune disorders significantly reduced neuropsychologic evaluation wait times. This integrated approach rapidly identifies cognitive impairments and emotional distress, improving patient care.
Area of Science:
- Neuroimmunology
- Neuropsychology
- Pediatric Neurology
Background:
- Pediatric neuroimmune disorders often cause unrecognized cognitive and emotional issues, delaying treatment.
- A novel multidisciplinary clinic model was developed to improve access to neuropsychologic evaluations and expedite treatment.
Purpose of the Study:
- To enhance access to neuropsychologic evaluations for pediatric patients with neuroimmune disorders.
- To identify neurocognitive impairment and facilitate expedited treatment plans.
- To assess the effectiveness of an integrated neuroimmunology-neuropsychology clinic model.
Main Methods:
- 28 pediatric patients (<18 years) with neuroimmune disorders underwent targeted neuropsychologic screenings.
- Assessments included measures of memory, processing speed, attention, fine motor skills, and language.
- Clinical data and neuropsychologic assessments were retrospectively analyzed.
Main Results:
- Wait times for neuropsychologic evaluations decreased from 15 months to 1.9 months.
- Cognitive impairments were detected in 71% of patients; 36% had anxiety or adjustment disorders.
- 65% of patients had cognitive issues identified and addressed during the clinic visit.
Conclusions:
- The integrated clinic model improves access to neuropsychologic care and facilitates early identification of neurocognitive sequelae.
- This multidisciplinary approach expedites patient-specific treatment plans, potentially enhancing well-being.
- Further studies are needed to evaluate long-term clinical outcomes.
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.
