Childhood MS Linked to Greater Cognitive Impairment in Adulthood, Study Finds

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Childhood MS Linked to Greater Cognitive Impairment in Adulthood, Study Finds

People with pediatric-onset multiple sclerosis are more likely to have cognitive impairment than those whose disease starts in adulthood, a study found.

People with pediatric-onset multiple sclerosis (POMS) have a greater decline in cognitive function, and are more likely to experience cognitive impairment in adulthood, than those whose disease began when they were adults, a study reports.

The study, “Long-term Cognitive Outcomes in Patients With Pediatric-Onset vs Adult-Onset Multiple Sclerosis,” was published in the journal JAMA Neurology.

POMS, defined as MS that occurs before a person is 18 years old, accounts for between 2 and 10% of people with the neurodegenerative disorder. It’s known that there are some differences in how the disease tends to manifest in those affected as children compared with those with adult-onset multiple sclerosis (AOMS). Children with POMS are more likely to have more inflammation and disease activity early on.

Cognitive impairment affects both POMS and AOMS patients, and has been shown to be present in approximately a third of children with pediatric-onset MS. But, researchers asked, what about people with POMS who grow up to be adults with MS? How might cognitive impairment be different among adults with MS whose disease started when they were children, compared with those with MS whose disease began when they were adults?

To find out, a team led by researchers at the Karolinska Institutet turned to the Swedish MS Registry, which includes data from MS patients treated at all 64 neurology clinics in Sweden.

Researchers assessed data from 5,704 MS patients — 300 with POMS, and the remaining with AOMS — who had at least two available scores on the Symbol Digit Modalities Test (SDMT), a measurement of cognition that has been validated for people with MS. The lower the score, the poorer is the patient’s cognitive function.

The included patients were predominantly female (70.4%). There were no significant differences in sex ratio, disease course, region of residence, or baseline SDMT score between the POMS and AOMS groups.

People in the POMS group were, by definition, younger at the time of diagnosis. They also tended to be younger at the time the first SDMT score was recorded.

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