Neurocognitive and Executive Dysfunction in Children with Multiple Sclerosis
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Roughly 5% of persons with MS have onset before 18 years of age. Previous studies have suggested that pediatric onset MS (POMS) has a “ benign” disease course compared to adult-onset MS, however these studies only took into account motor disability. More recently, there is a growing recognition that children with POMS have significant neurocognitive (NC) disability early in their disease course. Our group has identified very low rates of motor driven disability but high rates of abnormalities on a simple test of attention, the symbol digit modality test (SDMT). Limited exploration of cognition in this population has focused largely on intelligence using cumbersome and difficult to administer measures. Yet a range of clinical phenotypes, including executive dysfunction, have been reported.
GAP: This study proposes exploration of the phenotypes of NC dysfunction in children with POMS with the goals of improving clinical care in this vulnerable population.
HYPOTHESIS: (1) Individuals with POMS will have deficits on phenotyping decision-making, executive functioning, and attention measure compared to neurotypical controls. (2) Neurocognitive function will be diminished in individuals with POMS who have more aggressive clinical and radiographic courses.
METHODS: Individuals with POMS will have baseline and follow up assessments of a neurocognitive battery aimed at phenotyping decision-making, executive functioning, and attention. Results will be compared to traditional biomarkers of disease severity.
IMPACT: This study will add to the literature on phenotyping neurocognitive dysfunction in persons with POMS, improve school-based screening and interventions for persons with frontal lobes pathology, and potentially serve as biomarkers of disease activity in future research.
Website Link: https://www.chla.org/profile/jonathan-d-santoro-md