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Cognitive and Psychiatric Status in Pediatric Multiple Sclerosis

Objective - To assess cognitive and psychiatric impairments in children and adolescents with pediatric Multiple Sclerosis (MS).

Background - Pediatric MS represents approximately 3 – 5% of the MS population and information regarding the clinical features is slowly accumulating. Cognitive and psychiatric impairments frequently occur but remain poorly understood. We, therefore, sought to examine the psychiatric, cognitive and neurologic features in a sample of pediatric MS cases.

Methods - Forty-five (45) pediatric MS patients (age range: 8.4 to 17.9 years, median: 15.6, female: 64.4%), seen at the Lourie Center for Pediatric MS between 2006-2011, underwent neuropsychological (NP), psychiatric and neurological evaluations, including an Expanded Disability Severity Scale (EDSS). A child psychiatrist administered a semi-structured psychiatric interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and evaluated individual Global Assessment Functioning (GAF).

Cognitive impairment was defined as failing (i.e. 1 SD below published norms) on 20% or more of the cognitive battery which contained the following 11 tests: Wechsler Individual Achievement Test – Second Edition (WIAT-II; word reading, pseudo word decoding, numerical operations), Wechsler Intelligence Scale for Children/ Wechsler Adult Intelligence Scale (WISC/WAIS; digit span), Contingency Naming Test (CNT; total time, total efficiency), Continuous Performance Test II (CPT-II; omissions, commissions, hit response time) Delis-Kaplan Executive Function System Trail making test (DKEFS Trails; Conditions 1-5), Tower of London (TOL; total moves, total correct, rule violations, total time), California Verbal Learning Test-Child/Second Edition (CVLT-C/II; total trials, list B, short delay free, long delay free), Visual-Motor Integration (VMI), Rey-Osterrieth Complex Figure Test (ROCF; copy, immediate, delay), Expressive One Word Vocabulary Test (EOWVT), DKEFS Verbal Fluency (FAS and animals/boys names).


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