Cognitive functions in pediatric multiple sclerosis: 2-years follow-up

ABSTRACT

Objective: To assess the neuropsychological status of pediatric multiple sclerosis (MS) patients and its relationship with clinical variables in a longitudinal study.

Methods: Patients with MS (n = 46) and age- and gender-matched healthy control subjects (HCs, n = 53) were given tests of non-verbal reasoning, attention/concentration, visuospatial judgement and verbal fluency at baseline visit and after 2 years of follow-up. Cognitive impairment was defined as a failure on at least three of the four tests. Patients were grouped according to the age of disease onset (≤12 years as group 1 and > 12 years as group 2).

Results: Cognitive impairment was detected in 22 of 46 patients at follow-up (47.8%). Patients with cognitive worsening had higher EDSS scores at follow-up compared to cognitively improved/stable group (0.68 ± 1.16 vs 0.04 ± 0.2, p = 0.01). The most affected domains were attention/concentration and non-verbal reasoning. Comparison between baseline and follow-up tests showed impairment in non-verbal reasoning over time in group 1 patients while other functions improved over time in patient and control groups as expected.

Conclusion: Pediatric MS is likely to affect patients’ cognition concurrently with their disability levels. This effect is significant in the non-verbal reasoning area in patients with disease onset before age 12 years. A practical method assessing this function should be part of these patients’ regular follow-up for optimal treatment, prevention and rehabilitation.

KEYWORDS:

• Multiple sclerosis
• cognitive
• non-verbal reasoning
• attention/concentration
• visuospatial judgement
• verbal fluency

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

This study was approved by the Ethics Committee of Clinical Research, Dr. Behcet Uz Pediatric and Pediatric Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey. # 016/05-05.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.