Luis Ruano1, Mariana Branco2, Emilio Portaccio3, Benedetta Goretti4, Claudia Niccolai4, Francesco Patti5, Clara Chisari5, Paolo Gallo6, Paola Grossi6, Angelo Ghezzi7, Marco Roscio7, Flavia Mattioli8, Chiara Stampatori8, Marta Simone9, Rosa Gemma Viterbo10, Maria Pia Amato4. 1. EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal/Departamento de Epidemiologia Clinica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Porto, Portugal/Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. 2. Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. 3. IRCCS 'Don Carlo Gnocchi', Florence, Italy. 4. Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy. 5. University of Catania, Catania, Italy. 6. University of Padova, Padova, Italy. 7. Gallarate Hospital, Varese, Italy. 8. Spedali Civili Brescia, Brescia, Italy. 9. Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy. 10. University of Bari Aldo Moro, Bari, Italy.
Abstract
BACKGROUND: Patients with paediatric-onset multiple sclerosis (POMS) could be at an increased risk for cognitive impairment (CI), given the potential harmful effects of disease activity in neurodevelopment. However, there is scarce information on their long-term cognitive outcomes. OBJECTIVE: To compare the prevalence and profile of CI between adults with a history of POMS and those with classic, adult-onset multiple sclerosis (AOMS). METHODS: Cognitive performance was assessed through the Brief Repeatable Battery (BRB) and the Stroop Test in consecutive patients referred to six Italian MS centres. CI was defined as impairment in ⩾2 cognitive domains. RESULTS: In all, 119 patients with POMS and 712 with AOMS were included in this analysis. The prevalence of CI was 48.0% in AOMS, 44.5% in POMS; with similar neuropsychological profile between the two groups. However, when adjusting for current age, we found a significantly increased risk for CI (odds ratio (OR) = 1.71; p = 0.02) and for impairment in information processing speed (OR = 1.86; p < 0.01) in patients with POMS. A higher Expanded Disability Status Scale (EDSS) was also identified in POMS ( p = 0.03) compared with AOMS patients. CONCLUSION: Patients with a history of POMS appear to be at higher risk of physical and cognitive disability than AOMS patients, after correcting for age effects, with particular involvement of information processing speed.
BACKGROUND:Patients with paediatric-onset multiple sclerosis (POMS) could be at an increased risk for cognitive impairment (CI), given the potential harmful effects of disease activity in neurodevelopment. However, there is scarce information on their long-term cognitive outcomes. OBJECTIVE: To compare the prevalence and profile of CI between adults with a history of POMS and those with classic, adult-onset multiple sclerosis (AOMS). METHODS: Cognitive performance was assessed through the Brief Repeatable Battery (BRB) and the Stroop Test in consecutive patients referred to six Italian MS centres. CI was defined as impairment in ⩾2 cognitive domains. RESULTS: In all, 119 patients with POMS and 712 with AOMS were included in this analysis. The prevalence of CI was 48.0% in AOMS, 44.5% in POMS; with similar neuropsychological profile between the two groups. However, when adjusting for current age, we found a significantly increased risk for CI (odds ratio (OR) = 1.71; p = 0.02) and for impairment in information processing speed (OR = 1.86; p < 0.01) in patients with POMS. A higher Expanded Disability Status Scale (EDSS) was also identified in POMS ( p = 0.03) compared with AOMS patients. CONCLUSION:Patients with a history of POMS appear to be at higher risk of physical and cognitive disability than AOMS patients, after correcting for age effects, with particular involvement of information processing speed.
Authors: Rosalind Kalb; Meghan Beier; Ralph Hb Benedict; Leigh Charvet; Kathleen Costello; Anthony Feinstein; Jeffrey Gingold; Yael Goverover; June Halper; Colleen Harris; Lori Kostich; Lauren Krupp; Ellen Lathi; Nicholas LaRocca; Ben Thrower; John DeLuca Journal: Mult Scler Date: 2018-10-10 Impact factor: 6.312