Contributions
Abstract: P348
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Cognitive impairment is common and often disabling in multiple sclerosis (MS), but the risk factors and mechanisms underlying cognitive decline remain poorly understood. Pediatric MS (MS onset < 18 years of age) is unique due to the demyelinating process occurring in the context of development.
Objectives: To compare cognitive functions in newly diagnosed patients with either adult- or pediatric-onset MS (AOMS vs. POMS).
Aim: To test performance in newly diagnosed MS patients using the Symbol Digit Modalities Test (SDMT) and a computer-based measure sensitive to processing speed deficits (Cogstate).
Methods: As part of an ongoing multi-center longitudinal cognition trial, AOMS and POMS participants were recruited from outpatient visits and matched by years of disease. At the baseline evaluation, all participants were administered the Wide Range Achievement Test-4 (WRAT-4), the SDMT and the Cogstate Brief Battery, which includes three measures of information processing speed tasks:simple (DET) and choice (IDN) reaction time and working memory (ONB). Cogstate scores were converted to z-scores and then averaged for one composite z-score.
Results: A total of n=64 participants completed baseline assessments with n= 32 in the AOMS group (mean age 33.36 ± 5.82) and n= 32 in the POMS group (mean age 11.31 ± 3.64). All participants had relapsing remitting disease and the groups were matched for disease duration (4.91 ± 3.05 years for AOMS vs. 6.38 ± 3.54 for POMS). The POMS group had higher estimated premorbid IQ (WRAT-4 reading 112.7 ± 18.5 vs. 105.4 ± 13.4), though the result did not reach significance (p=0.07).
Neither group's cognitive performances fell into the impaired range relative to age-normative means. However, the AOMS compared to the POMS group consistently performed significantly worse on the SDMT (mean z-score -0.26 ± 1.15 for AOMS vs. 0.68 ± 1.53 for POMS, p=0.01) and slower on the Cogstate composite (mean z-score of -1.04 ± 1.09 for AOMS vs. 0.35 ± 1.15 for POMS, p=0.04). Estimated premorbid IQ was correlated with SDMT, but not Cogstate performance (r=0.56 p=0.001 and r=0.13 p=0.35, respectively). Age of disease onset was significantly negatively correlated with cognitive processing (SDMT: r= -0.32, p= 0.01 and Cogstate DET: r= -0.33, p=0.02), further indicating that older age of onset is associated with greater cognitive impairment.
Conclusions: Adult MS is associated with larger cognitive involvement than pediatric MS.
Disclosure: Funding source: National MS Society
Ashley Clayton: Nothing to disclose.
Anita Belman: Nothing to disclose.
Leslie Benson: Nothing to disclose.
Charlie Casper: Nothing to disclose.
Manu Goyal: Nothing to disclose.
Jennifer Graves: Nothing to disclose.
Mark Gorman: Nothing to disclose.
Yolanda Harris: Nothing to disclose.
Soe Mar: Nothing to disclose.
Jayne Ness: Nothing to disclose.
Teri Schreiner: Nothing to disclose.
Emmanuelle Waubant; Nothing to disclose.
Bianca Weinstock-Guttman: Nothing to disclose.
Lauren Krupp: Nothing to disclose.
Leigh Charvet: Nothing to disclose.
Abstract: P348
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Cognitive impairment is common and often disabling in multiple sclerosis (MS), but the risk factors and mechanisms underlying cognitive decline remain poorly understood. Pediatric MS (MS onset < 18 years of age) is unique due to the demyelinating process occurring in the context of development.
Objectives: To compare cognitive functions in newly diagnosed patients with either adult- or pediatric-onset MS (AOMS vs. POMS).
Aim: To test performance in newly diagnosed MS patients using the Symbol Digit Modalities Test (SDMT) and a computer-based measure sensitive to processing speed deficits (Cogstate).
Methods: As part of an ongoing multi-center longitudinal cognition trial, AOMS and POMS participants were recruited from outpatient visits and matched by years of disease. At the baseline evaluation, all participants were administered the Wide Range Achievement Test-4 (WRAT-4), the SDMT and the Cogstate Brief Battery, which includes three measures of information processing speed tasks:simple (DET) and choice (IDN) reaction time and working memory (ONB). Cogstate scores were converted to z-scores and then averaged for one composite z-score.
Results: A total of n=64 participants completed baseline assessments with n= 32 in the AOMS group (mean age 33.36 ± 5.82) and n= 32 in the POMS group (mean age 11.31 ± 3.64). All participants had relapsing remitting disease and the groups were matched for disease duration (4.91 ± 3.05 years for AOMS vs. 6.38 ± 3.54 for POMS). The POMS group had higher estimated premorbid IQ (WRAT-4 reading 112.7 ± 18.5 vs. 105.4 ± 13.4), though the result did not reach significance (p=0.07).
Neither group's cognitive performances fell into the impaired range relative to age-normative means. However, the AOMS compared to the POMS group consistently performed significantly worse on the SDMT (mean z-score -0.26 ± 1.15 for AOMS vs. 0.68 ± 1.53 for POMS, p=0.01) and slower on the Cogstate composite (mean z-score of -1.04 ± 1.09 for AOMS vs. 0.35 ± 1.15 for POMS, p=0.04). Estimated premorbid IQ was correlated with SDMT, but not Cogstate performance (r=0.56 p=0.001 and r=0.13 p=0.35, respectively). Age of disease onset was significantly negatively correlated with cognitive processing (SDMT: r= -0.32, p= 0.01 and Cogstate DET: r= -0.33, p=0.02), further indicating that older age of onset is associated with greater cognitive impairment.
Conclusions: Adult MS is associated with larger cognitive involvement than pediatric MS.
Disclosure: Funding source: National MS Society
Ashley Clayton: Nothing to disclose.
Anita Belman: Nothing to disclose.
Leslie Benson: Nothing to disclose.
Charlie Casper: Nothing to disclose.
Manu Goyal: Nothing to disclose.
Jennifer Graves: Nothing to disclose.
Mark Gorman: Nothing to disclose.
Yolanda Harris: Nothing to disclose.
Soe Mar: Nothing to disclose.
Jayne Ness: Nothing to disclose.
Teri Schreiner: Nothing to disclose.
Emmanuelle Waubant; Nothing to disclose.
Bianca Weinstock-Guttman: Nothing to disclose.
Lauren Krupp: Nothing to disclose.
Leigh Charvet: Nothing to disclose.