Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany.
Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland.
Eur J Paediatr Neurol. 2019 Nov;23(6):792-800. doi: 10.1016/j.ejpn.2019.08.006. Epub 2019 Aug 26.
Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical.
106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL.
The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively.
The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
在儿科多发性硬化症（POMS）患者的临床实践中，对认知障碍（CI）、疲劳以及健康相关生活质量（HRQoL）进行筛查至关重要。本研究的目的是建立一种新的且经过验证的儿科筛查工具“MUSICADO”，该工具易于使用且省时。
106 名 12-18 岁的 POMS 患者和 210 名年龄和教育程度匹配的健康对照者（HCs）接受神经心理学测试，包括成人的“多发性硬化症认知量表”筛查测试和 8 项标准化认知测试以及用于评估疲劳和 HRQoL 的既定量表。
语音流畅性测试（RWT“s-words”）、连线测试 A（TMT-A）和数字广度正向测试在患者和 HCs 之间有显著差异（p=0.000），并且在患者中显示出最高的测试失败比例（分别为 24.5%、17.9%和 15.1%）。因此，它们被组合在一起形成“MUSICADO”的认知部分。应用一种具有子测试平衡加权、年龄和教育校正以及损伤截断分数的评分算法后，35.8%的患者被归类为认知障碍（特异性：88.6%）。使用筛查版本分别检测到 37.1%的患者存在疲劳（特异性：94.0%）和 41.8%的患者存在 HRQoL 丧失（特异性：95.7%）。
MUSICADO 是一种新设计的简短易用的筛查测试，有助于早期识别 POMS 患者的 CI、疲劳和 HRQoL 丧失，因为为所有三个项目都提供了截断分数。进一步的研究将需要展示其在独立的 POMS 患者样本中的可用性。
