Cognitive Consequences Worse for Pediatric-Onset Multiple Sclerosis
TUESDAY, June 18, 2019 -- Patients with pediatric-onset multiple sclerosis (POMS) have a more rapid reduction in information-processing efficiency over time in adulthood, and they are more likely to experience cognitive impairment than patients with adult-onset MS (AOMS), according to a study published online June 17 in JAMA Neurology.
Kyla A. McKay, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues compared long-term information-processing efficiency between patients with POMS and those with AOMS in a longitudinal cohort study. Registered cases with definite MS and at least two Symbol Digit Modalities Test (SDMT) scores recorded were included. Data were included for 5,704 participants, of whom 5.3 percent had POMS.
Overall, a total of 46,429 unique SDMT scores were analyzed. The researchers found that SDMT scores were significantly lower for patients with POMS versus those with AOMS after adjustment for age, sex, disease duration, disease course, total number of SDMTs completed, oral or visual SDMT form, and disease-modifying therapy exposure (β coefficient, −3.59). SDMT scores decreased faster for patients with POMS versus those with AOMS (β coefficient, −0.30). In the POMS group, the odds of cognitive impairment were also significantly elevated (odds ratio, 1.44).
"Children and adolescents who develop MS should be monitored closely for cognitive changes and helped to manage the difficulties and challenges that MS poses on scholastic and work-related achievements, with a view to the long-term consequences of MS as they reach adulthood," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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Posted: June 2019