Contributions
Abstract: P1115
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Pediatric onset multiple sclerosis (POMS, referring to those diagnosed before the age of 18 years) is marked by demyelination in the context of ongoing neurodevelopment. Approximately one-third of those with POMS are estimated to have cognitive impairment. However, the risk factors and trajectory remain relatively unknown. We studied cognitive performance in a sample of POMS participants compared to age-matched healthy controls, linking to neuroimaging measures of structure and function. Cognitive functioning was assessed using the Pennsylvania Computerized Neurocognitive Battery (CNB), an approximately 1.5 hour battery assessing a range of cognitive domains. Participants then underwent MRI scanning. MRI sequences included a T1-weighted anatomical scan and 64-direction diffusion tensor imaging (DTI). Regions of interest were automatically determined using Freesurfer analysis software. These labels were used to calculate region-wise mean DTI fractional anisotropy (FA), a measure of white matter integrity. Participants were 18 consecutively-recruited POMS patients along with 24 healthy controls matched for age (18.5±4.4), gender (69%), and years of education (12.3±3.0). The POMS group did not differ from the controls on most measures across the battery. However, the POMS sample did perform more poorly on tasks of motor praxis (MP, p=0.006) and visual abstract reasoning (Conditional Exclusion Test or CET, p=0.007). Further, performance on both tasks was significantly correlated with temporal lobe FA (Motor Praxis, r=0.62, p=0.01 and visual abstract reasoning, r=0.59, p=0.02). In summary, a consecutively-recruited POMS sample was not distinguished from matched controls on most cognitive measures. However, relative impairments were found for motor praxis and visual abstract reasoning, which corresponded to decreased temporal lobe FA. This decrease in FA suggests that there is white matter fiber disruption, such as demyelination, cellular infiltration, axonal loss and/or disorganization in the temporal lobe in the POMS sample, which may be involved in the relative impairment in motor praxis and visual abstract reasoning. Decreased temporal lobe FA is also consistent with previous findings in POMS samples. Standard neuropsychological domains may not be sensitive to detecting early impairment in POMS.
Disclosure: Colleen Schwarz: Nothing to disclose
Laraib Ijaz: Nothing to disclose
Michael Shaw: Nothing to disclose
Elizabeth Bartlett: Nothing to disclose
Lauren Krupp: Consulting fees from Novartis, Biogen, Redhill science, served on the DSMB for Pfizer, Sanofi, on the steering committee of Novartis, received royalties from Janseen, Eisai, Abbvie, Amicus, and received research support from the Department of Defense, Biogen, Novartis, National Multiple Sclerosis Society, and the Lourie Foundation.
Christine DeLorenzo: Nothing to disclose
Leigh Charvet: Consultant for Biogen
Abstract: P1115
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Pediatric onset multiple sclerosis (POMS, referring to those diagnosed before the age of 18 years) is marked by demyelination in the context of ongoing neurodevelopment. Approximately one-third of those with POMS are estimated to have cognitive impairment. However, the risk factors and trajectory remain relatively unknown. We studied cognitive performance in a sample of POMS participants compared to age-matched healthy controls, linking to neuroimaging measures of structure and function. Cognitive functioning was assessed using the Pennsylvania Computerized Neurocognitive Battery (CNB), an approximately 1.5 hour battery assessing a range of cognitive domains. Participants then underwent MRI scanning. MRI sequences included a T1-weighted anatomical scan and 64-direction diffusion tensor imaging (DTI). Regions of interest were automatically determined using Freesurfer analysis software. These labels were used to calculate region-wise mean DTI fractional anisotropy (FA), a measure of white matter integrity. Participants were 18 consecutively-recruited POMS patients along with 24 healthy controls matched for age (18.5±4.4), gender (69%), and years of education (12.3±3.0). The POMS group did not differ from the controls on most measures across the battery. However, the POMS sample did perform more poorly on tasks of motor praxis (MP, p=0.006) and visual abstract reasoning (Conditional Exclusion Test or CET, p=0.007). Further, performance on both tasks was significantly correlated with temporal lobe FA (Motor Praxis, r=0.62, p=0.01 and visual abstract reasoning, r=0.59, p=0.02). In summary, a consecutively-recruited POMS sample was not distinguished from matched controls on most cognitive measures. However, relative impairments were found for motor praxis and visual abstract reasoning, which corresponded to decreased temporal lobe FA. This decrease in FA suggests that there is white matter fiber disruption, such as demyelination, cellular infiltration, axonal loss and/or disorganization in the temporal lobe in the POMS sample, which may be involved in the relative impairment in motor praxis and visual abstract reasoning. Decreased temporal lobe FA is also consistent with previous findings in POMS samples. Standard neuropsychological domains may not be sensitive to detecting early impairment in POMS.
Disclosure: Colleen Schwarz: Nothing to disclose
Laraib Ijaz: Nothing to disclose
Michael Shaw: Nothing to disclose
Elizabeth Bartlett: Nothing to disclose
Lauren Krupp: Consulting fees from Novartis, Biogen, Redhill science, served on the DSMB for Pfizer, Sanofi, on the steering committee of Novartis, received royalties from Janseen, Eisai, Abbvie, Amicus, and received research support from the Department of Defense, Biogen, Novartis, National Multiple Sclerosis Society, and the Lourie Foundation.
Christine DeLorenzo: Nothing to disclose
Leigh Charvet: Consultant for Biogen