Cognitive Impairment Occurs in Children and Adolescents With Multiple Sclerosis

TLDR

Early cognitive impairment can occur in children and adolescents with multiple sclerosis, underscoring the need for prompt recognition. The study assessed cognitive function in 187 pediatric multiple sclerosis patients and 44 with clinically isolated syndrome, recruited consecutively from six U.S. pediatric MS centers, with a mean age of 14.8 years and disease duration of 1.9 years.

Abstract

In the largest sample studied to date, we measured cognitive functioning in children and adolescents with pediatric multiple sclerosis (n = 187) as well as those with clinically isolated syndrome (n = 44). Participants were consecutively enrolled from six United States Pediatric Multiple Sclerosis Centers of Excellence. Participants had a mean of 14.8 ± 2.6 years of age and an average disease duration of 1.9 ± 2.2 years. A total of 65 (35%) children with multiple sclerosis and 8 (18%) with clinically isolated syndrome met criteria for cognitive impairment. The most frequent areas involved were fine motor coordination (54%), visuomotor integration (50%), and speeded information processing (35%). A diagnosis of multiple sclerosis (odds ratio = 3.60, confidence interval = 1.07, 12.36, P = .04) and overall neurologic disability (odds ratio = 1.47, confidence interval = 1.10, 2.10, P = .03) were the only independent predictors of cognitive impairment. Cognitive impairment may occur early in these patients, and prompt recognition is critical for their care.