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Cognitive problems for 1 in 3 kids with MS

STONY BROOK (US) — One of the largest studies to assess cognitive function of children with multiple sclerosis finds one-third have a cognitive impairment.

Researchers studied 187 children and adolescents with MS, and 44 who experienced their first neurologic episode (clinically isolated syndrome) indicative of MS. They found that 35 percent of the patients with MS and 18 percent of those with clinically isolated syndrome met criteria for cognitive impairment. All patients were younger than 18 with an average disease duration of about two years.

“This study is important because it represents the largest study to date to apply a comprehensive neuropsychological battery of tests to evaluate the cognitive functioning of children with MS,” says Lauren Krupp, professor of neurology at Stony Brook University School of Medicine.

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“The results clearly show us that cognitive issues are widespread and can occur early on in the disease course of these patients. These are critically important findings that emphasize the need for prompt recognition of our patients’ cognitive problems and for neurologists and other MS specialists to discover ways to intervene and help improve the cognitive abilities of these children while they are in school and beyond.”

For the study published in the Journal of Child Neurology, researchers used a comprehensive battery of 11 tests where the scores addressed cognitive domains such as general ability, reading and language, attention, working memory and speed processing, executive functioning, verbal learning and recall, visual-motor integration, and fine motor speed and coordination.

Testing took approximately 2.5 hours to complete. A participant was considered impaired when the proportion of impaired scores from the categorized tests was greater than one-third.

The most common areas of impairment were fine motor coordination (54 percent), visual-motor integration (50 percent), and speeded information processing (35 percent). Among the various tests that showed the most frequent rate of impairment were the grooved peg board, a measure of fine motor speed and coordination, and a test for visual-motor integration, a measure that is dependent in part on fine motor coordination.

The researchers factored in clinical variables in the analysis, including disease duration, diagnosis status, age of disease onset, and disability. A diagnosis of MS and overall neurologic disability were the only two independent predictors of cognitive impairment. Sociodemographic variables such as age, gender, and ethnicity were also factored in.

The next step is to further the research “to develop strategies for prompt identification of children with multiple sclerosis at risk for cognitive problems so that treatment can be initiated,” the researchers say.

National Pediatric MS Centers of Excellence participating in the study included the Lourie Center for Pediatric Multiple Sclerosis at Stony Brook; the University of California, San Francisco; University of Alabama, Birmingham; the Jacobs Neurological Institute, University at Buffalo; Massachusetts General Hospital in Boston, and the Mayo Clinic in Rochester, Minn.

The National Multiple Sclerosis Society supported the research.

Source: Stony Brook University

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