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Cognitive Issues in Pediatric Multiple Sclerosis. | LitMetric

Cognitive Issues in Pediatric Multiple Sclerosis.

Brain Sci

Section Neurosciences, Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino, University of Florence, 50139 Florence, Italy.

Published: March 2021

AI Article Synopsis

  • * Approximately one-third of pediatric MS patients experience cognitive impairments, but inconsistent definitions and testing methods complicate the identification of affected cognitive domains and hinder international research efforts.
  • * There is a need for further studies on the long-term effects of MS on brain development, as well as the impact of factors like mood disorders and lifestyle on cognitive decline, to better understand and address the cognitive profiles of young MS patients.

Article Abstract

Multiple sclerosis (MS) is one of the leading causes of disability in young adults. The onset of MS during developmental age makes pediatric patients particularly susceptible to cognitive impairment, resulting from both disease-related damage and failure of age-expected brain growth. Despite different test batteries and definitions, cognitive impairment has been consistently reported in approximately one-third of pediatric patients with MS. However, the lack of a uniform definition of cognitive impairment and the adoption of different test batteries have led to divergent results in terms of cognitive domains more frequently affected across the cohorts explored. This heterogeneity has hampered large international collaborative studies. Moreover, research aimed at the identification of risk factors (e.g., demographic, clinical, and radiological features) or protective factors (e.g., cognitive reserve, leisure activities) for cognitive decline is still scanty. Mood disorders, such as depression and anxiety, can be detected in these patients alongside cognitive decline or in isolation, and can negatively affect quality of life scores as well as academic performances. By using MRI, cognitive impairment was attributed to damage to specific brain compartments as well as to abnormal network activation patterns. However, multimodal MRI studies are still needed in order to assess the contribution of each MRI metric to cognitive impairment. Importantly, longitudinal studies have recently demonstrated failure of age-expected brain growth and of white matter (WM) and gray matter (GM) maturation plays a relevant role in determining cognitive dysfunction, in addition to MS-related direct damage. Whether these growth retardations might result in specific cognitive profiles according to the age at disease onset has not been studied, yet. A better characterization of cognitive profiles in pediatric MS patients, as well as the definition of neuroanatomical substrates of cognitive impairment and their longitudinal evolution are needed to develop efficient therapeutic strategies against cognitive impairment in this patient population.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065790PMC
http://dx.doi.org/10.3390/brainsci11040442DOI Listing

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