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Age of Onset as a Moderator of Cognitive Decline in Pediatric-Onset Multiple Sclerosis

Published online by Cambridge University Press:  17 July 2014

Banafsheh Hosseini ,
David B. Flora ,
Brenda L. Banwell  and
Christine Till
Banafsheh Hosseini
Affiliation:
Department of Psychology, York University, Toronto, Canada
David B. Flora
Affiliation:
Department of Psychology, York University, Toronto, Canada
Brenda L. Banwell
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Christine Till*
Affiliation:
Department of Psychology, York University, Toronto, Canada Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada
*
Correspondence and reprint requests to: Christine Till, Department of Psychology, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, E-mail: ctill@yorku.ca
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Abstract

Cognitive impairment is often reported in pediatric-onset multiple sclerosis (MS). Using serial cognitive data from 35 individuals with pediatric-onset MS, this study examined how age at disease-onset and proxies of cognitive reserve may impact cognitive maturation over the course of childhood and adolescence. Neuropsychological evaluations were conducted at baseline and up to four more assessments. Of the 35 participants, 7 completed only one assessment, 5 completed two assessments, 13 completed three assessments, 10 completed four or more assessments. Growth curve modeling was used to assess longitudinal trajectories on the Trail Making Test-Part B (TMT-B) and the Symbol Digit Modalities (SDMT; oral version) and to examine how age at disease onset, baseline Full Scale IQ, and social status may moderate rate of change on these measures. Mean number of evaluations completed per patient was 2.8. Younger age at disease onset was associated with a greater likelihood of cognitive decline on both the TMT-B (p=.001) and SDMT (p=.005). Baseline IQ and parental social status did not moderate any of the cognitive trajectories. Findings suggest that younger age at disease-onset increases the vulnerability for disrupted performance on measures of information processing, visual scanning, perceptual/motor speed, and working memory. Proxies of cognitive reserve did not protect against the progression of decline on these measures. Young patients with MS should be advised to seek follow-up cognitive evaluation to assess cognitive maturation and to screen for the potential late emergence of cognitive deficits. (JINS, 2014, 20, 1–9)

Keywords

Pediatric multiple sclerosisLongitudinal analysisProcessing speedWorking memoryCognitive reserveAge of onset
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 8 , September 2014 , pp. 796 - 804
Copyright
Copyright © The International Neuropsychological Society 2014 

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