O'Neill Kimberly A, Charvet Leigh, Waltz Michael, George Allan, Benson Leslie A, Gorman Mark P, Mar Soe S, Ness Jayne M, Schreiner Teri, Waubant Emmanuelle, Weinstock-Guttman Bianca, Wheeler Yolanda S, Abrams Aaron W, Chitnis Tanuja, Rodriguez Moses, Rose John W, Tillema Jan-Mendelt, Virupakshaiah Akash, Casper T Charles, Krupp Lauren B
Department of Neurology, NYU Grossman School of Medicine, New York.
Department of Pediatrics, University of Utah, Salt Lake City.
Neurology. 2025 Oct 21;105(8):e214142. doi: 10.1212/WNL.0000000000214142. Epub 2025 Sep 18.
Pediatric multiple sclerosis (MS) affects children and adolescents at an important time for neurologic and cognitive development. Although cognitive impairment has been described, few longitudinal studies of cognitive functioning in pediatric MS with matched controls are available. Here, we report the 2-year follow-up cognitive results of a cohort of participants with MS and healthy controls (HCs) recruited from multiple regions of the United States.
Three cohorts-participants with pediatric MS, age-matched pediatric HC, and adults with early-onset MS-were recruited across 7 sites through the United States Network of Pediatric MS Centers. Two cognitive batteries, Cogstate Brief Battery (CBB) and Brief International Cognition Assessment for MS (BICAMS), were administered at baseline and follow-up. The primary outcome was the change in CBB composite z-score compared between groups. Change in BICAMS composite z-score was also compared, as were change in z-scores of individual measures. Reliable change indices (RCIs) were calculated to determine meaningful change over time.
A total of 63/72 (87.5%) of participants with pediatric MS, 81/99 (81.8%) of pediatric controls, and 48/66 (72.7%) of adults with MS returned for follow-up a mean 2.15 ± 0.27 years later. Participants with pediatric MS were median 17.4 years [IQR 16.0-18.3] at time of follow-up with median disease duration of 3.9 years [IQR 2.8-5.6]. 71% were female. There were no significant differences in change in CBB composite z-scores among pediatric MS and pediatric HC groups (0.10 vs 0.31, = 0.113) or between the pediatric and adult MS groups (0.10 vs 0.00, = 0.987). Although on RCI of the CBB, 80% of participants with pediatric MS were either stable or improved, more of the pediatric MS group declined relative to the control group 19.7% vs 5.1%, = 0.022.
Most individuals with pediatric MS early in their disease showed stable cognitive function over a 2-year period and had longitudinal changes that were largely similar to pediatric controls. A subset of participants with pediatric MS declined in cognitive processing speed relative to pediatric controls.
儿童多发性硬化症（MS）在神经和认知发育的重要时期影响儿童和青少年。尽管已有认知障碍的相关描述，但针对儿童MS认知功能的纵向研究较少，且缺乏匹配的对照组。在此，我们报告了一组来自美国多个地区的MS患者及健康对照（HC）的2年随访认知结果。
通过美国儿童MS中心网络，在7个地点招募了三组人群——儿童MS患者、年龄匹配的儿童HC以及早发型MS成人患者。在基线和随访时进行了两种认知测试组合，即Cogstate简短测试组合（CBB）和MS简短国际认知评估（BICAMS）。主要结局是比较两组之间CBB综合z评分的变化。还比较了BICAMS综合z评分的变化以及各单项测量z评分的变化。计算可靠变化指数（RCI）以确定随时间的有意义变化。
共有72名儿童MS患者中的63名（87.5%）、99名儿童对照中的81名（81.8%）以及66名MS成人患者中的48名（72.7%）在平均2.15±0.27年后返回进行随访。随访时儿童MS患者的年龄中位数为17.4岁[四分位间距16.0 - 18.3]，疾病持续时间中位数为3.9年[四分位间距2.8 - 5.6]。71%为女性。儿童MS组与儿童HC组之间CBB综合z评分的变化无显著差异（0.10对0.31，P = 0.113），儿童MS组与成人MS组之间也无显著差异（0.10对0.00，P = 0.987）。尽管根据CBB的RCI，80%的儿童MS患者稳定或改善，但相对于对照组，儿童MS组中更多患者出现下降（19.7%对5.1%，P = 0.022）。
大多数儿童MS患者在疾病早期的2年期间认知功能稳定，其纵向变化在很大程度上与儿童对照组相似。相对于儿童对照组，一部分儿童MS患者的认知处理速度下降。
