Background:
As many as 5% of individuals with multiple sclerosis (MS) develop symptoms during childhood or adolescence. Understanding the cognitive impairment of pediatric MS and their association is needed to improve the recognition and prompt treatment of these issues which critical for this patients at that point of time of their development. As with adult multiple sclerosis, areas of cognitive deficit can vary but often include attention and speed processing, visuomotor functions, memory, and language.
Objectives:
To describe cognitive impairment among children and adolescents in Israel with MS referred for assessment to tertiary referral center for multiple sclerosis over a period of 4 years (2009 to 2013) all with clinically isolated symptom (CIS) or MS according to the International Pediatric MS Study Group criteria
Methods:
We performed a cross-sectional study analyzing the neuropsychological performance of 23 patients (10 boys and 13 girls) age range of 9-18 years with a main age range of 13.33 years at the time of their MS diagnosis , and main of 14.04 years at the time of their test performers.
Results:
All the 23 children preformed the NeuroTrax computerized testing ( assess performance across an array of cognitive domains including: memory, executive function, visual spatial perception, verbal function, attention, information processing speed, and motor skills) with overall findings of a normal global cognitive scoring (GCS) of 94.5, but a decrease in planning ability (score of 88.58). Other major abnormal findings were found in verbal function, mainly in rhyming (score of 87.8). Also a group of 16 children (7 girls and 9 boys ) with a main age of 14.o6 years at the time of testing performed the neuropsychological screening battery for multiple sclerosis (NSBMS). Significant difficulty were found in verbal fluency ability, which tested by word list generation (WLG) and was found beneath the normal range (20%).
Conclusions:
To our knowledge this is the largest single center report on children with MS from Israel, showing that verbal fluency and verbal memory appear to be affected earliest in children with MS. The pattern of cognitive decline is further characterized by a decrease in visuospatial learning, followed by delayed recall, and then by planning ability. As the executive function impairment differed significantly from expected normal distribution, therapeutic window during which this young patients still show a relatively preserved global cognition may benefit from different intensive interventions to maintain and preserve their cognitive health later on .
