Amato M P, Goretti B, Ghezzi A, Lori S, Zipoli V, Portaccio E, Moiola L, Falautano M, De Caro M F, Lopez M, Patti F, Vecchio R, Pozzilli C, Bianchi V, Roscio M, Comi G, Trojano M
Department of Neurology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
Neurology. 2008 May 13;70(20):1891-7. doi: 10.1212/01.wnl.0000312276.23177.fa.
To assess the impact of multiple sclerosis (MS) on cognitive and psychosocial functioning in childhood and juvenile cases.
We used an extensive neuropsychological battery assessing IQ, memory, attention/concentration, executive functions, and language. Fatigue and depression were also measured. An interview on school and daily living activities was obtained from the parents. Performance of cases was compared with that of demographically matched healthy controls.
Sixty-three patients and 57 healthy controls were assessed. Five patients (8%) exhibited a particularly low IQ (<70). Criteria for cognitive impairment (failure on at least three tests) were fulfilled in 19 patients (31%), whereas 32 patients (53%) failed at least two tests. Beyond deficits in memory, complex attention, and executive functions, the profile of deficits was characterized by involvement of linguistic abilities. In the regression analysis, the only significant predictor of cognitive impairment was an IQ score lower than 90 (odds ratio [OR] 18.2, 95% CI 4.6-71.7, p < 0.001). Considering the IQ score as a dependent variable, the only significant predictor was represented by younger age at onset (OR 0.7, 95% CI 0.5-0.9, p = 0.009). Depressive symptoms were reported by 6% of the cases, and fatigue was reported by 73% of the cases. MS negatively affected school and everyday activities in 56% of the subjects.
In childhood and juvenile cases, multiple sclerosis (MS) is associated with cognitive impairment and low IQ scores, the latter related to younger age at onset. These aspects are of critical importance in helping children and adolescents with MS to manage their difficulties and psychosocial challenges.
评估多发性硬化症（MS）对儿童和青少年病例认知及心理社会功能的影响。
我们使用了一套广泛的神经心理测试组合，评估智商、记忆、注意力/专注力、执行功能和语言能力。还测量了疲劳和抑郁情况。从家长处获取了关于学校和日常生活活动的访谈信息。将病例的表现与人口统计学匹配的健康对照进行比较。
评估了63例患者和57名健康对照。5例患者（8%）智商特别低（<70）。19例患者（31%）符合认知障碍标准（至少三项测试未通过），而32例患者（53%）至少两项测试未通过。除了记忆、复杂注意力和执行功能缺陷外，缺陷特征还表现为语言能力受累。在回归分析中，认知障碍的唯一显著预测因素是智商得分低于90（优势比[OR]18.2，95%置信区间4.6 - 71.7，p < 0.001）。将智商得分作为因变量时，唯一显著的预测因素是发病时年龄较小（OR 0.7，95%置信区间0.5 - 0.9，p = 0.009）。6%的病例报告有抑郁症状，73%的病例报告有疲劳症状。56%的受试者中，MS对学校和日常活动产生了负面影响。
在儿童和青少年病例中，多发性硬化症（MS）与认知障碍和低智商得分相关，后者与发病时年龄较小有关。这些方面对于帮助患有MS的儿童和青少年应对困难及心理社会挑战至关重要。
