2023 American Academy of Neurology Abstract Website

Kimberly O'Neill¹, Leigh Charvet¹, Michael Waltz², Theron Casper², Allan George¹, Leslie Benson³, Mark Gorman³, Manu Goyal⁴, Soe Mar⁴, Jayne Ness⁵, Teri Schreiner⁶, Emmanuelle Waubant⁷, Bianca Weinstock-Guttman⁸, Yolanda Wheeler⁵, Gregory Aaen⁹, Aaron Abrams¹⁰, Tanuja Chitnis¹¹, Timothy Lotze¹², Mary Rensel¹⁰, Moses Rodriguez¹³, John Rose², Nikita Shukla¹², Jan-Mendelt Tillema¹³, Lauren Krupp¹
¹NYU Langone Medical Center, ²University of Utah, ³Children's Hospital Boston, ⁴Washington University School of Medicine, ⁵UAB Dept of Pediatrics, Div Pediatric Neurology, ⁶Children's Hospital Colorado, ⁷USCF MS Center, ⁸Department of Neurology, University At Buffalo, ⁹Loma Linda University School of Medicine, ¹⁰Cleveland Clinic, ¹¹Brigham and Women's Hospital, ¹²Texas Children's Hospital, ¹³Mayo Clinic

Objective:

To compare longitudinal cognitive performance between pediatric patients with relapsing remitting multiple sclerosis (RRMS), pediatric healthy controls (HC), and adult patients with RRMS.

Background:

Pediatric MS affects the brain at an important time of development in children and teenagers. Studies of cognition in these patients have provided mixed results.

Design/Methods:

Consecutively eligible pediatric MS patients (n=71), pediatric healthy peers (n=99), and adult MS patients (n=66) enrolled across seven centers from the US Network of Pediatric MS Centers underwent a cognitive screening battery at baseline and 1.5-3.5 years later. Baseline cognitive test results were previously reported. Longitudinal findings on the individual measures of the BICAMS (Brief International Cognitive Assessment for MS) and Cogstate Brief Battery (CBB) were analyzed using z-scores based on available normative data.

Results:

87% of pediatric MS patients, 82% of pediatric controls, and 73% of adult MS patients returned for follow-up after a mean of 2.15 years. Those who returned had baseline demographic characteristics similar to those who did not return.

The mean change in z-scores at the end of the study for the pediatric MS patients did not differ from pediatric controls on the BICAMS or Cogstate batteries: Symbol Digit Modalities Test (SDMT) (-0.4 vs. 0.1, p=0.20); Rey Auditory Verbal Learning Test (RAVLT) (-0.6 vs. -0.6, p=0.90); and the Brief Visuospatial Memory Test-Revised (BVMT-R) (-0.0 vs. 0.1, p=0.52). Pediatric vs. adult cases showed no differences in mean change in z-scores, except on the RAVLT, where both pediatric MS and pediatric controls declined to a greater degree than adults with MS (p=0.007).

Conclusions:

This study showed relative stability in cognitive performance among pediatric and adult cases of RRMS and pediatric controls. It is reassuring that many with pediatric MS show preserved cognitive function relative to healthy peers early in their short-term disease course.