BOSTON – The cognitive outcomes of patients with pediatric-onset or adult-onset relapsing-remitting multiple sclerosis were similar in a small cross-sectional study of patients matched for age, educational level, and physical disability.
The results indicate that despite children’s vulnerability to cognitive deficits during brain maturation, those with pediatric-onset multiple sclerosis (MS) appear to have enough brain plasticity to compensate for the detrimental effects of the disease on cognition, according to Dr. Bahia Hakiki of the University of Florence in Italy.
She and her colleagues found that although 14 patients with pediatric-onset disease had longer mean disease duration than did 30 patients with adult-onset disease (9.8 years vs. 3.7 years) -- as was expected -- they had similar performances on Rao’s Brief Repeatable battery -- commonly used in MS cognitive assessment – and the Stroop test. There also was no difference in the percentage of patients who were classified as cognitively impaired (14% with pediatric onset vs. 30% with adult onset).
Brain MR imaging in a subset of patients found no difference in whole-brain volume, supporting the view that patients with pediatric-onset MS have the ability to compensate for the detrimental effects of MS on cognition, Dr. Hakiki said in a video interview at the joint meeting of the European and Americas Committees for Treatment and Research in Multiple Sclerosis. However, she noted that it will be important to study the impact of age at onset on this ability to recover and if it is a risk factor for worse cognitive impairment in adulthood.