Neuropediatrics 2023; 54(S 01): S1-S32
DOI: 10.1055/s-0043-1777145
Neuroimmunologie

Distinction of Cognitive Phenotypes in Pediatric-Onset Multiple Sclerosis

K. Storm van's Gravesande
1   Department of Pediatric Neurology, University Children's Hospital Freiburg, Freiburg, Deutschland
2   Department of Pediatrics, Child and Adolescent Psychosomatics, Technical University Munich, Munich, Deutschland
,
A. Schwendener
3   Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Schweiz
,
P. Calabrese
4   Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Schweiz
,
A. Blaschek
5   Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Deutschland
,
K. Rostásy
6   Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Datteln, Deutschland
,
P. Huppke
7   Department of Neuropediatrics, University Hospital Jena, Jena, Deutschland
,
E. Kalbe
8   Department of Medical Psychology/Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Medical Faculty and University Hospital Cologne, Cologne, Deutschland
,
J. Kessler
9   Department of Neurology, Medical Faculty and University Hospital Cologne, Cologne, Deutschland
,
V. Mall
10   Department of Pediatrics, Child and Adolescent Psychosomatics, Technical University Munich, Munich, Deutschland
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Background/Purpose: Pediatric-onset multiple sclerosis (POMS) is a neurological disease with an increased risk of cognitive impairment. However, an exact characterization of cognitive phenotypes has not been reported in POMS yet. The aim of the study was to identify cognitive phenotypes in a well-characterized cohort of patients with POMS and examine the association with IQ, fatigue, depression, and quality of life (QoL).

Methods: In this multicenter cross-sectional study, patients with POMS aged between 12 and 18 years were tested with an extensive neuropsychological battery consisting of seven standard tests, with the Beck Depression Inventory II Revision, the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) and the PedsQL Multidimensional Fatigue Scale. Latent profile analysis was used on cognitive test z-scores to identify cognitive phenotypes. Significant differences of the mean values of demographic and clinical parameters between phenotypes were tested using a simple ANOVA or a non-parametric test.

Results: A total of 106 patients with POMS (mean age: 15.71 [SD: 1.63]) were analyzed in this study. Three cognitive phenotypes were identified: preserved cognition (n = 48, 45.2%), visuospatial impairment (n = 29, 27.4%), and multidomain involvement with severe decline in information-processing speed (n = 29, 27.4%). Statistical differences were found when comparing IQ (p ≤ 0.001), quality of life (p = 0.001), depression (p = 0.004), and fatigue (p = 0.013). Patients with global cognitive decline had the lowest IQ (mean: 90.68 [SD 12.57]) and presented with a higher cognitive fatigue (mean: 49.28 [SD: 25.34]), more severe depression (mean BDI score: 14.12 [SD: 10.08]), and lower quality of life (mean: 61.39 [SD: 8.24]).

Conclusion: Cognitive impairment is a relevant issue in children with POMS and presents with different phenotypes. One-third of patients with POMS presented with a multidomain decline that impacts quality of life and academic achievement.



Publication History

Article published online:
13 November 2023

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