Abstract Details

Title Functional MRI Correlates of Intelligence Quotient and Visual-Motor Coordination in Pediatric Multiple Sclerosis

Topic Child Neurology and Developmental Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-003

Objective To evaluate the neuropsychological profile of pediatric multiple sclerosis (MS) patients and its association with resting-state functional connectivity (RS-FC) abnormalities in cognitive and motor networks.

Background

Pediatric MS differs from adult-onset disease, as the developing brain is characterized by greater compensatory mechanisms, but pathological processes can interfere with ongoing maturational processes.

Design/Methods This 3.0 T RS functional MRI study included 76 pediatric MS patients undergoing a neuropsychological evaluation testing global cognition (intelligence quotient [IQ] from the Wechsler Intelligence Scales), set-shifting (Trial Making Test [TMT] A and B), language (semantic and phonemic fluency tests [SVFT/PVFT]) and visual-motor coordination (Symbol Digit Modalities Test [SDMT], Coding [CD] and Block Design [BD]). Twenty-two age- and sex-matched healthy subjects were used as controls (HC). A seed-based correlation approach was adopted to calculate RS-FC within the executive, language, memory and motor networks. Between-group differences and correlations with cognitive scores were assessed with age- and sex-adjusted full-factorial models.

Results

In pediatric MS patients, median IQ was 97.5 and 18.4% scored below normative average (IQ<84). Patients most commonly failed CD (21.1%), TMT-B (13.2%) and TMT-A (11.8%). Compared to HC, MS patients had reduced RS-FC of the bilateral caudate nucleus and increased RS-FC of bilateral precentral gyrus in all networks. Patients also showed reduced RS-FC in several network-specific areas, such as the anterior cingulate cortex (language network) and the angular gyrus (memory and motor networks). Decreased RS-FC of the caudate nucleus was associated with higher IQ and better performance at TMT-A/B, but worse performance in BD and CD tests. Decreased RS-FC of the anterior cingulate cortex was associated with higher scores at SVFT, CD and SDMT.

Conclusions Pediatric MS patients achieve average IQ levels. Reduced RS-FC of the caudate nucleus contributes to global cognitive efficiency but also to patients' fragility in processing speed associated with visual-motor coordination skills.

Authors/Disclosures
Laura Cacciaguerra, MD, PhD (Mayo Clinic) PRESENTER	Dr. Cacciaguerra has nothing to disclose.
	No disclosure on file
Carmen Vizzino	No disclosure on file
Paola Valsasina	No disclosure on file
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi 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 Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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