Abstract Details

Title Impaired Cognition without Behavioral Problems in Pediatric Clinically Isolated Syndrome (CIS)

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 113

Objective

Background BACKGROUND: Cognitive impairment is estimated to occur in one third of children with MS, but its frequency at the time of the first clinical event i.e. in CIS, is unknown. As cognitive impairment occurs in adults at this disease stage, we hypothesized that cognitive impairments would also be identified in pediatric CIS.

Design/Methods DESIGN/METHODS: We evaluated 44 children with pediatric CIS, enrolled from six pediatric MS centers across the USA. Participants completed a cognitive test battery and participants and parents completed the Behavior Assessment System for Children, Second Edition (BASC-2) as a measure of psychological distress. We defined cognitive impairment as poor test performance (one standard deviation (SD) or more below published normative values) on ? 1/3 of completed test measures.

Results RESULTS: At the time of testing, participants had a mean age of 14.8± 2.6 years , symptom duration of 0.8±1.7 years, and a median Expanded Disability Status Scale (EDSS) of 1.3 (0 to 6.5). A total of 8 (18%) with pediatric CIS met criteria for cognitive impairment. Poor test performance was most frequently found in visuomotor integration (57%) and speeded information processing (34%). Elevated symptoms of psychological distress were most commonly reported on parent ratings of depression (n=5, 11%), anxiety (n=4, 9%) and somatization (n=4, 9%). The number of behavioral scales (parent and self) rated in the clinically significant range was not associated with number test performances below 1 SD of published norms (r=.02, p>.94), EDSS (r=.20, p>.43), or presence of overall cognitive impairment. Participants in the sample who were classified with cognitive impairment had higher EDSS scores (p<0.05).

Conclusions CONCLUSIONS: Cognitive impairment is detectable in pediatric CIS, and is associated with EDSS but not patient- or parent-reported psychological distress.

Authors/Disclosures
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center) PRESENTER	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.
	No disclosure on file
Laura J. Julian, PhD (Genentech)	No disclosure on file
	No disclosure on file
	No disclosure on file
Ralph H. Benedict, PhD (University At Buffalo)	Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunic Therapeutics. Dr. Benedict has received intellectual property interests from a discovery or technology relating to health care.
Samah Abdel Baki, MD (Abdul Baki)	No disclosure on file
	No disclosure on file
	No disclosure on file
Ellen H. O'Donnell	No disclosure on file
Joy B. Parrish	An immediate family member of Ms. Parrish has received personal compensation for serving as an employee of DPK Technology. Ms. Parrish has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for National football league. Ms. Parrish has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for National Hockey League.
	No disclosure on file
	No disclosure on file
Anita L. Belman, MD, FAAN	No disclosure on file
Tanuja Chitnis, MD, FAAN (Brigham and Women's Hospital)	Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Biosciences. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave. The institution of Dr. Chitnis has received research support from Genentech-Roche. The institution of Dr. Chitnis has received research support from Tiziana Life Sciences. The institution of Dr. Chitnis has received research support from Bristol-Myers Squibb. The institution of Dr. Chitnis has received research support from Wesley Clover.
Mark Gorman, MD	The institution of Dr. Gorman has received research support from Pfizer. The institution of Dr. Gorman has received research support from Roche / Genetech .
	No disclosure on file
Jayne Ness, MD (UAB Dept of Pediatrics, Div Pediatric Neurology)	An immediate family member of Dr. Ness has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jan One. The institution of Dr. Ness has received research support from Chugai/Roche. The institution of Dr. Ness has received research support from National Multiple Sclerosis Society. The institution of an immediate family member of Dr. Ness has received research support from NIH. An immediate family member of Dr. Ness has received publishing royalties from a publication relating to health care.
Marc C. Patterson, MD, FRACP, FAAN	Dr. Patterson has received personal compensation for serving as an employee of IntraBio. The institution of Dr. Patterson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Orphazyme /KemPharm/Zevra. Dr. Patterson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Azafaros. Dr. Patterson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for IntraBio. Dr. Patterson has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sage. Dr. Patterson has or had stock in IntraBio. The institution of Dr. Patterson has received research support from Glycomine. The institution of Dr. Patterson has received research support from Orphazyme /KemPharm/Zevra. The institution of Dr. Patterson has received research support from Idorsia. The institution of Dr. Patterson has received research support from Shire-Takeda. Dr. Patterson has received publishing royalties from a publication relating to health care. Dr. Patterson has received publishing royalties from a publication relating to health care.
Moses Rodriguez, MD, FAAN (Mayo Clinic Department Of Neurology)	Dr. Rodriguez has received intellectual property interests from a discovery or technology relating to health care.
Emmanuelle Waubant, MD, PhD, FAAN (USCF MS Center)	The institution of Dr. Waubant has received research support from NIH. The institution of Dr. Waubant has received research support from NMSS. The institution of Dr. Waubant has received research support from PCORI. The institution of Dr. Waubant has received research support from Race to Erase MS. The institution of Dr. Waubant has received research support from Roche. The institution of Dr. Waubant has received research support from Department of Defense. Dr. Waubant has received publishing royalties from a publication relating to health care.
Bianca Weinstock-Guttman, MD (Department of Neurology, University At Buffalo)	Dr. Weinstock-Guttman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme &Sanofi. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving as a Reviewer with NIH.
	No disclosure on file

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