Multiple sclerosis: Pediatric-onset disease impairs cognitive ability faster than adult-onset disease

Delhi: Patients with pediatric-onset multiple sclerosis (POMS) patients -- defined as onset before age 18 years -- are at higher risk for impairment in their cognitive abilities later in their life, according to a recent study.

The study, published in the journal JAMA Neurology finds that pediatric-onset multiple sclerosis patients are more likely to experience cognitive decline during adulthood than patients with adult-onset MS (AOMS). Also, POMS renders the patients with reduced information-processing efficiency over time independent of age or duration of the disease.

"Children and adolescents who develop multiple sclerosis should be monitored closely for cognitive changes and helped to manage the potential challenges that early-onset multiple sclerosis poses for cognitive abilities later in life," write the authors.

Multiple sclerosis is a chronic, immune-mediated, demyelinating and degenerative disease of the central nervous system that commonly affects the young population aged from 20-40 years of age. Although there are many treatment options available for the disease, there is no definitive cure until now due to the highly active relapsing nature of the disease and high risk of disability in some patients.

Kyla A. McKay, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and colleagues conducted this population-based longitudinal cohort study to compare long-term information-processing efficiency between patients with POMS and adult-onset MS.

For the purpose, the researchers used the Swedish MS Registry, which included data from 64 clinics. The 5704 participants [4015 female (70.4%), and 5569 had a relapsing-onset disease course (97.6%)] had a median follow-up of 3 years and 5 Symbol Digit Modality Test (SDMT) scores. Most participants were exposed to a disease-modifying therapy (DMT) during follow-up (98.8%).

For those with POMS median age was 26 years and the median age of onset was 16 years. For AOMS, the median age was 38 years and at onset was 30 years.

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Key findings of the study include:

• After adjustment for sex, age, disease duration, disease course, the total number of SDMTs completed, oral or visual SDMT form, and DMT exposure, the SDMT score for patients with POMS was significantly lower than that of patients with AOMS.


• The SDMT score for patients with POMS declined faster than that of patients with AOMS.


• The odds of cognitive impairment were also significantly elevated in the POMS group.

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