Frequent early cognitive impairment in both pediatric MS and MOGAD
Michiel Simon Jan Buijze1, Sandy Molenaar1, Rosa Verkerk2
1Division of Pediatric Neurology, Department of Neurology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights
Early cognitive impairment (CI) is common in pediatric multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Complex attention deficits were observed in both conditions, with MS also affecting visuospatial skills.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Cognitive Neuroscience
Background:
- Early cognitive impairment (CI) studies in pediatric multiple sclerosis (MS) lack standardization.
- Data on cognitive dysfunction in pediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are limited.
Purpose of the Study:
- To assess early cognitive dysfunction in pediatric MS and MOGAD.
- To identify distinct neurocognitive profiles for each condition.
Main Methods:
- A cross-sectional study evaluated neurocognition in children with MS and MOGAD within two years of disease onset.
- A comprehensive test battery generated Z-scores; CI was defined as Z-scores < -1.5 in at least two domains.
- Children were compared based on CI status and domain deficits using composite Z-scores.
Main Results:
- Among 67 participants (36 MS, 31 MOGAD), 47% of MS and 43% of MOGAD children met CI criteria despite normal IQ.
- Complex attention deficits were prominent in both groups (MS: Z=-1.24, MOGAD: Z=-1.12).
- MS patients additionally showed impairments in visuospatial processing and visual memory; fatigue was linked to CI.
Conclusions:
- Early cognitive impairment is prevalent in pediatric MS and MOGAD, particularly affecting complex attention.
- Visuospatial cognition represents an additional area of vulnerability for children with MS.
Background:
Studies on early cognitive impairment (CI) in pediatric multiple sclerosis (MS) are heterogeneous and data on pediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are scarce.
Objectives:
To evaluate early cognitive dysfunction in both diseases and delineate disease-specific neurocognitive profiles.
Methods:
A cross-sectional study of children with MS and MOGAD assessed neurocognition within 2 years after disease onset using a comprehensive test battery. Test results were converted to Z-scores. CI was defined as Z-scores below -1.5 in ⩾2 domains. Children were compared by CI status and domain deficits quantified with composite Z-scores.
Results:
Sixty-seven participants were analyzed (MS n = 36, MOGAD n = 31). Despite normal full-scale intelligence quotient, 47% of MS children and 43% of MOGAD children (acute disseminated encephalomyelitis excluded) met criteria for CI. Domain-specific impairments were prominent in complex attention, with significantly reduced composite Z-scores (MS: -1.24, p < 0.001; MOGAD: -1.12, p = 0.019). MS children additionally showed lower scores on tasks of visuospatial processing and visual memory. Only fatigue was significantly associated with the presence of CI (PedsQL fatigue Z-score: -2.61 vs -0.75, p = 0.005).
Conclusion:
In both pediatric MS and MOGAD, early CI is prevalent with difficulties in complex attention. Visuospatial cognition appears to be an additional vulnerable area for children with MS.
