TY - JOUR
T1 - Cognitive processing speed in pediatric-onset multiple sclerosis
T2 - Baseline characteristics of impairment and prediction of decline
AU - Wallach, Asya I.
AU - Waltz, Michael
AU - Casper, T. Charles
AU - Aaen, Gregory
AU - Belman, Anita
AU - Benson, Leslie
AU - Chitnis, Tanuja
AU - Gorman, Mark
AU - Graves, Jennifer
AU - Harris, Yolanda
AU - Lotze, Timothy E.
AU - Mar, Soe
AU - Moodley, Manikum
AU - Ness, Jayne M.
AU - Rensel, Mary
AU - Rodriguez, Moses
AU - Rose, John W.
AU - Schreiner, Teri
AU - Tillema, Jan Mendelt
AU - Waubant, Emmanuelle
AU - Weinstock-Guttman, Bianca
AU - Charvet, Leigh E.
AU - Krupp;, Lauren B.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by the National Multiple Sclerosis Society (HC 0165). Current projects are funded by the National Institutes of Health (R01NS071463).
Funding Information:
The authors thank the US Network of Pediatric Multiple Sclerosis Centers. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by the National Multiple Sclerosis Society (HC 0165). Current projects are funded by the National Institutes of Health (R01NS071463).
Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: G.A. has participated in clinical trials funded by Biogen. T.C. is an advisory board member for Bayer, Biogen, Novartis, and Sanofi-Genzyme; received research support from Verily, Octave, Serono, and Biogen; and has participated in clinical trials sponsored by Sanofi Genzyme and Novartis. M.G. has participated in clinical trials funded by Novartis and Biogen. J.G. has no conflict directly related to the content of the manuscript. Unrelated to the manuscript she has received compensation for grants, clinical trial adjudication service, and non-promotional educational speaking activities from Genentech, Biogen, Med Day and Genzyme. L.K. received payments as a consultant from Biogen, Novartis, Everyday Health, Genentech, Gerson Lehman, and Sanofi; served as an uncompensated consultant for Celgene; and received licensing payments from biotechnology and pharmaceutical companies for the fatigue severity scale. T.L. is a consultant/speaker for Biogen. M. Rensel is a consultant/speaker for Biogen, Teva, Genzyme, and Novartis and received research support from Medimmune. B.W.-G. is a consultant/speaker for Biogen, Teva, Novartis, Genzyme, Genentech, and EMD Serono and received research support from Biogen, Teva, Novartis, Genentech, and EMD Serono. J.R. received research support from National Multiple Sclerosis Society, NIH, Guthy Jackson Charitable Foundation, Biogen, Teva Neuroscience, Friends of MS, and Western Institute for Biomedical Research. A.W. has received educational grants from the National MS Society and Biogen. E.W. is site Principal Investigator for ongoing trials with Genentech and Biogen. She has research funding from NIH, PCORI, NMSS, and Race to Erase MS. She has received honoraria for lectures from Medscape, The Corpus, and AAN and for consulting work from Jazz Pharmaceuticals, Emerald, and DBV. She is co-chief editor for MSARD. L.B., S.M., M. Rodriguez, M.W., and T.C. report no disclosures relevant to the manuscript.
Publisher Copyright:
© The Author(s), 2019.
PY - 2020/12
Y1 - 2020/12
N2 - Background: Cognitive impairment occurs in approximately one-third of pediatric-onset multiple sclerosis (POMS) patients. The Symbol Digit Modalities Test (SDMT), a widely used cognitive screen in adults, has yet to be incorporated early into the standard care of POMS. Objective: To screen for cognitive impairment early in the course of POMS and analyze predictive factors. Methods: Of the 955 POMS or clinically isolated syndrome (CIS) patients prospectively assessed from March 2014 to July 2018, 500 POMS and 116 CIS patients met inclusion criteria (disease onset before the age of 18, one or more SDMTs, and 8 years or older at the time of testing). Those with relapse were analyzed separately from those who were relapse-free. Results: At initial assessment, the mean (interquartile range (IQR)) age at symptom onset was 13.5 years (12.0, 15.9) and the mean (±SD) disease duration was 3.0 ± 2.9 years. Impaired processing speed occurred in 23.4% of POMS and in 16.4% of CIS. On serial testing (n = 383, mean follow-up: 1.8 years), 14.1% had clinically meaningful decline predicted by older age of multiple sclerosis (MS) onset and male gender. Disease relapse or steroid use led to transient worsening on the SDMT. Conclusion: Early in the disease, some POMS and CIS patients are at risk for cognitive impairment and subsequent decline.
AB - Background: Cognitive impairment occurs in approximately one-third of pediatric-onset multiple sclerosis (POMS) patients. The Symbol Digit Modalities Test (SDMT), a widely used cognitive screen in adults, has yet to be incorporated early into the standard care of POMS. Objective: To screen for cognitive impairment early in the course of POMS and analyze predictive factors. Methods: Of the 955 POMS or clinically isolated syndrome (CIS) patients prospectively assessed from March 2014 to July 2018, 500 POMS and 116 CIS patients met inclusion criteria (disease onset before the age of 18, one or more SDMTs, and 8 years or older at the time of testing). Those with relapse were analyzed separately from those who were relapse-free. Results: At initial assessment, the mean (interquartile range (IQR)) age at symptom onset was 13.5 years (12.0, 15.9) and the mean (±SD) disease duration was 3.0 ± 2.9 years. Impaired processing speed occurred in 23.4% of POMS and in 16.4% of CIS. On serial testing (n = 383, mean follow-up: 1.8 years), 14.1% had clinically meaningful decline predicted by older age of multiple sclerosis (MS) onset and male gender. Disease relapse or steroid use led to transient worsening on the SDMT. Conclusion: Early in the disease, some POMS and CIS patients are at risk for cognitive impairment and subsequent decline.
KW - Pediatric-onset multiple sclerosis
KW - cognition
KW - cognitive processing speed
KW - multiple sclerosis
KW - pediatric MS
KW - symbol digit modalities test
UR - http://www.scopus.com/inward/record.url?scp=85076783325&partnerID=8YFLogxK
U2 - 10.1177/1352458519891984
DO - 10.1177/1352458519891984
M3 - Article
C2 - 31775571
AN - SCOPUS:85076783325
VL - 26
SP - 1938
EP - 1947
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 14
ER -