Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY.
Department of Neurology, New York University Langone Medical Center, NYU Langone Health, New York, NY.
J Neuroimaging. 2019 Jan;29(1):140-150. doi: 10.1111/jon.12566. Epub 2018 Oct 4.
Pediatric-onset multiple sclerosis (POMS) is a demyelinating disorder with unique clinical challenges. A brief computer-administered cognitive screening battery measuring processing speed (Cogstate) and the Brief International Cognitive Assessment in MS (BICAMS) detect cognitive impairment in POMS. The neuroanatomic correlates of these deficits are incompletely understood. The purpose of this study is to define the neuroanatomic underpinnings of deficits identified with cognitive screening batteries in POMS.
Participants with POMS and age-matched healthy controls (HCs) were screened with Cogstate and BICAMS. Diffusion tensor imaging assessed region-wise and tractography-based fractional anisotropy (FA).
The POMS (n = 15) and HC (n = 21) groups were matched on age (mean ages 17.9 ± 3.2 vs. 17.8 ± 3.3 years, respectively) and on an estimate of general intellectual functioning. The Cogstate composite revealed significant slowing in POMS relative to HCs (P = .004), but the BICAMS composite did not significantly distinguish the groups (P = .10). The Cogstate composite showed moderate-to-strong correlations with regional FA (r = -.67 to -.82) and significantly associated with uncinate fasciculus FA following multiple comparisons correction (P = .002) in POMS. However, the BICAMS composite measure showed only weak-to-moderate correlations with FA in POMS (r = -.19 to -.57), with none surviving multiple comparisons correction.
Computer-administered measures of cognitive processing are particularly sensitive in POMS and are closely linked to white matter FA.
小儿多发性硬化症（POMS）是一种具有独特临床挑战的脱髓鞘疾病。一种简短的计算机管理认知筛查测试（Cogstate）和多发性硬化症的简短国际认知评估（BICAMS）可以检测到 POMS 的认知障碍。这些缺陷的神经解剖学相关性尚不完全清楚。本研究的目的是确定 POMS 认知筛查测试中发现的缺陷的神经解剖学基础。
使用 Cogstate 和 BICAMS 对 POMS 患者和年龄匹配的健康对照组（HC）进行筛查。弥散张量成像评估了区域和基于轨迹的各向异性分数（FA）。
POMS（n = 15）和 HC（n = 21）组在年龄（平均年龄分别为 17.9 ± 3.2 岁和 17.8 ± 3.3 岁）和一般智力功能估计值上相匹配。Cogstate 综合评分显示 POMS 相对于 HCs 明显减慢（P =.004），但 BICAMS 综合评分并未显著区分两组（P =.10）。Cogstate 综合评分与区域 FA 呈中度至高度相关（r = -.67 至 -.82），在经过多次比较校正后，与 POMS 中的钩束 FA 显著相关（P =.002）。然而，BICAMS 综合评分仅与 POMS 中的 FA 呈弱至中度相关（r = -.19 至 -.57），在经过多次比较校正后，没有一个相关关系具有统计学意义。
计算机管理的认知处理测量在 POMS 中特别敏感，与白质 FA 密切相关。
