DOI: 10.1177/13524585261465586 ISSN: 1352-4585

Frequent early cognitive impairment in both pediatric MS and MOGAD

Michiel Simon Jan Buijze, Sandy Molenaar, Rosa Verkerk, Maud Alida Quist, Willemijn Marije Carolien van der Vlugt, Rinze Frederik Neuteboom
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Background:

Studies on early cognitive impairment (CI) in pediatric multiple sclerosis (MS) are heterogeneous and data on pediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are scarce.

Objectives:

To evaluate early cognitive dysfunction in both diseases and delineate disease-specific neurocognitive profiles.

Methods:

A cross-sectional study of children with MS and MOGAD assessed neurocognition within 2 years after disease onset using a comprehensive test battery. Test results were converted to Z -scores. CI was defined as Z -scores below −1.5 in ⩾2 domains. Children were compared by CI status and domain deficits quantified with composite Z -scores.

Results:

Sixty-seven participants were analyzed (MS n  = 36, MOGAD n  = 31). Despite normal full-scale intelligence quotient, 47% of MS children and 43% of MOGAD children (acute disseminated encephalomyelitis excluded) met criteria for CI. Domain-specific impairments were prominent in complex attention, with significantly reduced composite Z -scores (MS: −1.24, p  < 0.001; MOGAD: −1.12, p  = 0.019). MS children additionally showed lower scores on tasks of visuospatial processing and visual memory. Only fatigue was significantly associated with the presence of CI (PedsQL fatigue Z -score: −2.61 vs −0.75, p  = 0.005).

Conclusion:

In both pediatric MS and MOGAD, early CI is prevalent with difficulties in complex attention. Visuospatial cognition appears to be an additional vulnerable area for children with MS.

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