Abstract General Information


Pediatric Onset Multiple Sclerosis: Investigation of cognitive impairment, mood disorders and Quality of Life in a Brazilian Tertiary Referral Center


Introduction: Pediatric Onset Multiple Sclerosis (POMS) is defined as the onset of signs and symptoms of MS before the age of 18 years old, and represents 3 to 5% of all cases. The concomitant process of demyelination and development of the Central Nervous System can lead to significant damage at this age. The potential impact of cognitive impairment, affecting social and academic functioning, makes the assessment of cognitive deficits and the various aspects related to the quality of life essential for a proper approach.
Objective: To evaluate cognitive impairment, mood disorders, and quality of life in patients with POMS at a Brazilian Tertiary Referral Center.
Method: A cohort study was conducted at the University of Campinas (SP). A total of 10 patients, were followed-up from 2021 to 2022 and underwent MRI (3T), clinical evaluation, cognitive assessment (BRB-N battery), and questionnaires to investigate mood disorders, fatigue, sleep, and quality of life.
Results: Fifty percent of the patients had cognitive impairment in two or more domains, with a predominance of deficits in processing speed (70%) and visual memory (70%). The presence of depression, worse scores on the EDSS, and excessive sleepiness were associated with worse performances in verbal memory. There was a high prevalence of depression (60%) and fatigue (50%) among the analyzed patients. The thalamus size of patients with pediatric MS was smaller than that of healthy controls, but there was no association with cognitive deficits.
Conclusion: A significant proportion of cognitive deficits was noticed in the studied population. The presence of depression and sleepiness negatively influenced cognitive performance. Despite the lower thalamic volume in patients with pediatric MS, more studies are needed to understand its association with cognitive disorders in this age group.


Clinical findings