Abstract
Pediatric-onset multiple sclerosis (POMS) is relatively rare, but as technology and neuroimaging advance, an increasing number of cases are identified, and our understanding of how multiple sclerosis (MS) impacts the developing brain improves. There are consistent findings in the literature highlighting the impact of MS and other demyelinating diseases on cognitive functioning and cognitive development. We also have a better understanding of how POMS impacts psychosocial functioning and functional outcomes in daily living. This paper hopes to review findings associated with cognitive and psychosocial functioning in patients with POMS, as well as explore more recent advances in the field and how they relate to cognitive and psychosocial outcomes. We also discuss the ongoing need for future studies with a focus on better understanding deficits and disease correlates, but also preventative measures and potential rehabilitation.
Highlights
Multiple sclerosis (MS) is an inflammatory neurodegenerative disease primarily affecting young adults
We found that a quarter of pediatric patients with demyelinating disorder (e.g., acute disseminated encephalomyelitis (ADEM), MS) had elevated parent-reported symptoms of depression and self-reported fatigue, and there was a higher rate of fatigue than depression in child self-report [48]
Another study using a similar task but computer based (c-symbol digits modality test (SDMT)) found that difference in total time to complete the task did not differ between Pediatric-onset multiple sclerosis (POMS) patients and controls, but that POMS patients were less likely to show faster performance across all successive eight trials compared to controls
Summary
Multiple sclerosis (MS) is an inflammatory neurodegenerative disease primarily affecting young adults. Studies have revealed a better understanding of cognitive and psychosocial outcomes in patients with POMS. The most recent consensus definition paper for POMS [9] continues to support diagnosis based on neuroimaging findings, but lesion findings including dissemination in time and space radiologically may not be enough, and added emphasis is put on clinically relevant history. Persistent anti-MOG antibodies are associated with MS, less than one quarter of POMS patients evidence this biomarker [10,11]. The presence/absence of the anti-MOG antibodies, depending on time during the disease course, can help clinicians to better understand treatment needs and prognosis. Relapses may be more frequent in POMS, recovery tends to be better, and there is a slower rate of progression of disease, potentially related to greater plasticity in the developing nervous tissue [14,15]. Literature was reviewed from sources including PubMed search, research cited in related POMS articles, and previously acquired articles
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