Longitudinal Cognitive Screening Findings in Pediatric MS vs. Pediatric Controls and Adult MS in a Multi-center Cohort
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

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


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.


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.


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).


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.