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Cognitive and Behavioral Functioning in Childhood Acquired Demyelinating Syndromes

Published online by Cambridge University Press:  01 December 2016

Christine Till ,
Austin Noguera ,
Leonard H. Verhey ,
Julia O’Mahony ,
E. Ann Yeh ,
Jean K. Mah ,
Katia J. Sinopoli ,
Brian L. Brooks ,
Berengere Aubert-Broche  and
D. Louis Collins
...Show all authors
Christine Till*
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada Department of Psychology, York University, Toronto, Canada
Austin Noguera
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada
Leonard H. Verhey
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada
Julia O’Mahony
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada Institute of Healthy Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
E. Ann Yeh
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada Division of Neurology, The Hospital for Sick Children, Toronto, Canada
Jean K. Mah
Affiliation:
Division of Neurology, Alberta Children’s Hospital, Calgary, Alberta
Katia J. Sinopoli
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada
Brian L. Brooks
Affiliation:
Neurosciences program, Alberta Children’s Hospital; Departments of Pediatrics, Clinical Neurosciences, and Psychology, University of Calgary; and Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
Berengere Aubert-Broche
Affiliation:
McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
D. Louis Collins
Affiliation:
McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
Sridar Narayanan
Affiliation:
McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
Douglas L. Arnold
Affiliation:
McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
Brenda L. Banwell
Affiliation:
Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Canada Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
*
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

Objectives: The aim of this study was to describe cognitive, academic, and psychosocial outcomes after an incident demyelinating event (acquired demyelinating syndromes, ADS) in childhood and to investigate the contribution of brain lesions and confirmed MS diagnosis on outcome. Methods: Thirty-six patients with ADS (mean age=12.2 years, SD=2.7, range: 7–16 years) underwent brain MRI scans at presentation and at 6-months follow-up. T2-weighted lesions on MRI were assessed using a binary classification. At 6-months follow-up, patients underwent neuropsychological evaluation and were compared with 42 healthy controls. Results: Cognitive, academic, and behavioral outcomes did not differ between the patients with ADS and controls. Three of 36 patients (8.3%) were identified with cognitive impairment, as determined by performance falling ≤1.5 SD below normative values on more than four independent tests in the battery. Poor performance on a visuomotor integration task was most common, observed among 6/32 patients, but this did not differ significantly from controls. Twelve of 36 patients received a diagnosis of MS within 3 years post-ADS. Patients with MS did not differ from children with monophasic ADS in terms of cognitive performance at the 6-months follow-up. Fatigue symptoms were reported in 50% of patients, irrespective of MS diagnosis. Presence of brain lesions at onset and 6 months post-incident demyelinating event did not associate with cognitive outcome. Conclusions: Children with ADS experience a favorable short-term neurocognitive outcome, even those confirmed to have MS. Longitudinal evaluations of children with monophasic ADS and MS are required to determine the possibility of late-emerging sequelae and their time course. (JINS, 2016, 22, 1050–1060)

Keywords

DemyelinationCognitionPediatricMultiple sclerosisBrain lesionsMagnetic resonance imaging
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Special Issue 10: Special Issue: Preclinical Prediction , November 2016 , pp. 1050 - 1060
Copyright
Copyright © The International Neuropsychological Society 2016 

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