Ekmekci Ozgul
Department of Neurology, Faculty of Medicine, Ege University, Izmir, Turkey.
Behav Neurol. 2017;2017:1463570. doi: 10.1155/2017/1463570. Epub 2017 Dec 25.
Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disease. Although cognitive impairment has been well established in adult patients with MS, its occurrence in patients with pediatric-onset MS has recently been reported. In this review, I discuss the main features of cognitive impairment in pediatric MS as determined by long-term follow-up studies, neuropsychiatric test batteries, and the results of neuroradiological imaging studies that investigated the pathogenesis of pediatric MS. The most commonly affected cognitive domains in adults are attention, processing speed, and visuomotor skills; language and intelligence are also affected in pediatric MS. A young age at disease onset is the strongest risk factor for these impairments, which may be due to the effect of inflammatory demyelination and neurodegeneration on the developing central nervous system and neural networks in children. Cognitive impairment has long-term effects on patients' academic life and the quality of their social life. Therefore, all patients with pediatric MS should be screened and monitored for cognitive impairment. This review also highlights the need for neuropsychological test batteries that assess different cognitive domains in children and adolescents with multiple sclerosis and for cognitive rehabilitation programs to improve the quality of their academic and social life.
多发性硬化症（MS）是一种炎症性脱髓鞘和神经退行性疾病。虽然成年多发性硬化症患者的认知障碍已得到充分证实，但小儿多发性硬化症患者中认知障碍的发生最近也有报道。在这篇综述中，我将讨论小儿多发性硬化症认知障碍的主要特征，这些特征是通过长期随访研究、神经心理测试组合以及研究小儿多发性硬化症发病机制的神经影像学研究结果确定的。成年人中最常受影响的认知领域是注意力、处理速度和视觉运动技能；小儿多发性硬化症患者的语言和智力也会受到影响。发病年龄较小是这些障碍的最强危险因素，这可能是由于炎症性脱髓鞘和神经变性对儿童发育中的中枢神经系统和神经网络的影响。认知障碍对患者的学业生活和社交生活质量有长期影响。因此，所有小儿多发性硬化症患者都应接受认知障碍筛查和监测。这篇综述还强调了需要有评估多发性硬化症儿童和青少年不同认知领域的神经心理测试组合，以及需要有认知康复计划来提高他们的学业和社交生活质量。
