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

  • Banafsheh Hosseini (a1), David B. Flora (a1), Brenda L. Banwell (a2) (a3) and Christine Till (a1) (a2)

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)

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Corresponding author

Correspondence and reprint requests to: Christine Till, Department of Psychology, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, E-mail: ctill@yorku.ca

References

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Amato, M. P., Goretti, B., Ghezzi, A., Lori, S., Zipoli, V., Portaccio, E., Trojano, M. (2008). Cognitive and psychosocial features of childhood and juvenile MS. Neurology, 70(20), 18911897.
Amato, M. P., Goretti, B., Ghezzi, A., Lori, S., Zipoli, V., Moiola, L., Trojano, M. (2010). Cognitive and psychosocial features in childhood and juvenile MS Two-year follow-up. Neurology, 75(13), 11341140.
Anderson, V., Jacobs, R., Spencer-Smith, M., Coleman, L., Anderson, P., Williams, J., Leventer, R. (2009). Journal of Pediatric Psychology, 35(7), 716727.
Archibald, C. J., & Fisk, J. D. (2000). Information processing efficiency in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 22(5), 686701.
Banwell, B. L., & Anderson, P. E. (2005). The cognitive burden of multiple sclerosis in children. Neurology, 64(5), 891894.
Barr, W. B. (2003). Neuropsychological testing of high school athletes: Preliminary norms and test-retest indices. Archives of Clinical Neuropsychology, 18, 91101.
Barratt, W. (2006). The Barratt simplified measure of social status (BSMSS): Measuring SES. Unpublished manuscript. Indiana State University. Retrieved from http://wbarratt. indstate. edu/socialclass/Barratt_Simplifed_Measure_of_Social_Status. pdf.
Benedict, R. H. B., Duquin, J. A., Jurgensen, S., Rudick, R. A., Feitcher, J., Munschauer, F. E., Weinstock-Guttman, B. (2008). Repeated assessment of neuropsychological deficits in multiple sclerosis using the Symbol Digit Modalities Test and the MS Neuropsychological Screening Questionnaire. Multiple Sclerosis, 14(7), 940946.
Benedict, R. H., Morrow, S. A., Cookfair, D., & Schretlen, D. J. (2010). Cognitive reserve moderates decline in information processing speed in multiple sclerosis patients. Journal of the International Neuropsychological Society, 16(5), 829835.
Boiko, A., Vorobeychik, G., Paty, D., Devonshire, V., & Sadovnik, D. (2002). Early onset multiple sclerosis: A longitudinal study. Neurology, 59(7), 10061010.
DeLuca, J., Chelune, G. J., Tulsky, D. S., Lengenfelder, J., & Chiaravalloti, N. D. (2004). Is speed of processing or working memory the primary information processing deficit in multiple sclerosis? Journal of Clinical and Experimental Neuropsychology, 26(4), 550562.
Demaree, H. A., DeLuca, J., Gaudino, E. A., & Diamond, B. J. (1999). Speed of information processing as a key deficit in multiple sclerosis: Implications for rehabilitation. Journal of Neurology, Neurosurgery & Psychiatry, 67(5), 661663.
Dennis, M., Yeates, K. O., Taylor, H. G., & Fletcher, J. M. (2006). Brain reserve capacity, cognitive reserve capacity, and age-based functional plasticity after congenital and acquired brain injury in children. In Y. Stern (Ed.), Cognitive reserve: Theory and applications (pp. 5383). New York: Psychology.
Drew, M. A., Starkey, N. J., & Isler, R. B. (2009). Examining the link between information processing speed and executive functioning in multiple sclerosis. Archives of Clinical Neuropsychology, 24(1), 4758.
Farmer, J. E., Kanne, S. M., Haut, J. S., Williams, J., Johnstone, B., & Kirk, K. (2002). Memory functioning following traumatic brain injury in children with premorbid learning problems. Developmental Neuropsychology, 22(2), 455469.
Fay, T. B., Yeates, K. O., Taylor, H. G., Bangert, B., Dietrich, A., Nuss, K. E., Wright, M. (2010). Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury. Journal of the International Neuropsychological Society, 16(1), 94105.
Ghezzi, A., Deplano, V., Faroni, J., Grasso, M. G., Liguori, M., Marrosu, G., Zaffaroni, M. (1997). Multiple sclerosis in childhood: clinical features of 149 cases. Multiple sclerosis, 3(1), 4346.
Hart, S. A., Petrill, S. A., Deater Keckard, K., & Thompson, L. A. (2007). SES and CHAOS as environmental mediators of cognitive ability: A longitudinal genetic analysis. Intelligence, 35, 233242.
Holland, A. A., Graves, D., Greenberg, B. M., & Harder, L. L. (2014). Fatigue, emotional functioning, and executive dysfunction in pediatric multiple sclerosis. Child Neuropsychology, 20(1), 7185.
Kesler, S. R., Tanaka, H., & Koovakkattu, K. (2010). Cognitive reserve and brain volumes in pediatric acute lymphoblastic leukemia. Brain Imaging and Behavior, 4, 256269.
Krupp, L. B., Banwell, B., & Tenembaum, S. (2007). Consensus definitions proposed for pediatric multiple sclerosis and related disorders. Neurology, 68(16 Suppl. 2), S7S12.
Leavitt, V. M., Lengenfelder, J., Moore, N. B., Chiaravalloti, N. D., & DeLuca, J. (2011). The relative contributions of processing speed and cognitive load to working memory accuracy in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 33(5), 580586.
MacAllister, W. S., Christodoulou, C., Milazzo, M., & Krupp, L. B. (2007). Longitudinal neuropsychological assessment in pediatric multiple sclerosis. Developmental Neuropsychology, 32(2), 625644.
MacAllister, W. S., Belman, A L., & Milazzo, M. (2005). Cognitive functioning in children and adolescents with multiple sclerosis. Neurology, 64(8), 14221425.
Marin, S. E., Banwell, B. B., & Till, C. (2012). Cognitive trajectories in 4 patients with pediatric-onset multiple sclerosis serial evaluation over a decade. Journal of Child Neurology, 28(12), 15771586.
Marrie, R. A., Horwitz, R., Cutter, G., Tyry, T., Campagnolo, D., & Vollmer, T. (2008). Comorbidity, socioeconomic status and multiple sclerosis. Multiple Sclerosis, 14, 10911098.
Portaccio, E., Goretti, B., Lori, S., Zipoli, V., Centorrino, S., Ghezzi, A., Amato, M. P., for the Multiple Sclerosis Study Group of the Italian Neurological Society. (2009). The brief neuropsychological battery for children: a screening tool for cognitive impairment in childhood and juvenile multiple sclerosis. Multiple Sclerosis, 15, 620626.
Reitan, R. M. (1959). A manual for the administrating and scoring of the Trail Making Test. Indianapolis: Indiana University Press.
Sánchez-Cubillo, I., Periáňez, J. A., Adrover-Roig, D., Rodríguez-Sánchez, J. M., Ríos-Lago, M., Tirapu, J., & Barceló, F. (2009). Construct validity of the Trail Making Test: Role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. Journal of the International Neuropsychological Society, 15, 438450.
Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. Cambridge: Oxford University Press.
Smith, A. (Ed.). (2002). Symbol Digit Modalities Test (SDMT). Los Angeles: Western Psychological Services.
Statz, P. (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology, 7(3), 273295.
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448460.
Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary (3rd ed.). New York: Oxford University Press.
Sumowski, J. F., Chiaravalloti, N., Wylie, G. R., & DeLuca, J. (2009). Cognitive reserve moderates the negative effect of brain atrophy on cognitive efficiency in multiple sclerosis. Journal of International Neuropsychiatry, 15(2), 606612.
Sumowski, J. F., Wylie, G. R., DeLuca, J., & Chiaravalloti, N. (2010). Intellectual enrichment is linked to cerebral efficiency in multiple sclerosis: functional magnetic resonance imaging evidence for cognitive reserve. Brain, 133(2), 362374.
Till, C., Ghassemi, R., Aubert-Broche, B., Kerbrat, A., Collins, D. L., Narayanan, S., Banwell, B. L. (2011). MRI correlates of cognitive impairment in childhood-onset multiple sclerosis. Neuropsychology, 25(3), 319332.
Till, C., Ho, C., Dudani, A., Garcia-Lorenzo, D., Collins, D. L., & Banwell, B. L. (2012). Magnetic resonance imaging predictors of executive functioning in patients with pediatric-onset multiple sclerosis. Archives of Clinical Neuropsychology, 27(5), 459509.
Till, C., Racine, N., Araujo, D., Narayanan, S., Collins, D. L., Aubert-Broche, B., Banwell, B. (2013). Changes in cognitive performance over a 1-year period in children and adolescents with multiple sclerosis. Neuropsychology, 27(2), 210219.
Wechsler, D. (1997). Wechsler Adult Intelligence Scale–third edition: Administration and scoring manual. San Antonio, TX: Psychological Corporation.
Wechsler, D. (1991). WISC-III: Wechsler intelligence scale for children. San Antonio, TX: Psychological Corporation.
Weiss, L. G., Saklofske, D. H., Prifitera, A., Chen, H. Y. & Hildebrand, D. (1999). The calculation of the WISC-III General Ability Index using Canadian norms. Canadian Journal of School Psychology, 14(2), 110.

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