Abstract
Cognitive impairment is increasingly recognized as an important clinical issue in pediatric multiple sclerosis (MS). However, variations regarding its assessment and remediation are noted in clinical arena. This scoping review aims to collate available evidence concerning cognitive assessment tool and cognitive rehabilitation for pediatric MS. We performed a systematic search of electronic databases (MEDLINE, PubMed, CINAHL Plus, and Web of Science) from inception to February 2020. Reference lists of included articles and trial registers were also searched. We included original studies published in English that addressed cognitive assessment tools or cognitive rehabilitation for pediatric-onset MS. Fourteen studies fulfilled our inclusion criteria. Among them, 11 studies evaluated the psychometric aspects of various cognitive assessment tools in the context of pediatric MS, and different neuro-cognitive domains were emphasized across studies. There were only three pilot studies reporting cognitive rehabilitation for pediatric-onset MS, all of which used home-based computerized programs targeting working memory and attention, respectively. Overall, more systematic research on cognitive assessment tools and rehabilitation for pediatric MS is needed to inform evidence-based practice. Computer-assisted cognitive assessment and rehabilitation appear feasible and deserve further studies.
Highlights
Multiple sclerosis (MS) is a chronic central nervous system disorder characterized by inflammatory demyelination and neurodegeneration, and around 3–5% of patients have their disease onset prior to adulthood
Physical disability is rarely seen in the first decade of disease course in pediatric-onset MS (POMS) [1], cognitive impairment is fairly common in this patient population
For studies evaluating cognitive rehabilitation, we extracted the mode of intervention, study design, the characteristics of study participants, effects of intervention, and factors associated with outcomes
Summary
Multiple sclerosis (MS) is a chronic central nervous system disorder characterized by inflammatory demyelination and neurodegeneration, and around 3–5% of patients have their disease onset prior to adulthood. Physical disability is rarely seen in the first decade of disease course in pediatric-onset MS (POMS) [1], cognitive impairment is fairly common in this patient population. Findings across studies showed that around one-third of pediatric MS patients suffer from some degree of cognitive impairment, and it could be detected as early as nearing disease onset in a subset of patients [2,3,4,5]. While reports of cognitive profiles of POMS have been accumulating, direct comparisons between these studies are often hampered by differences in patient characteristics and assessment tools. Children 2020, 7, 183 group-level difference in WM performance between POMS and controls [6] This exemplifies the importance to clarify the applicability and performance of various cognitive assessment tools in this patient population. To obtain a panorama of this emerging field, we here seek to collate existing evidence on cognitive assessment tools and cognitive rehabilitation for POMS, which may serve as the basis for future directions of research and clinical practice
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