| Autor: |
De Somma E; Department of Psychology, York University, Toronto, Canada., O'Mahony J; Neurosciences and Mental Health, Hospital for Sick Children, Canada Hospital for Sick Children, Toronto, Canada., Brown RA; ShadowLab Research, Toronto, ON, Canada., Brooks BL; Neurosciences Program, Alberta Children's Hospital, Calgary, Canada.; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.; Departments of Pediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Calgary, Canada., Yeh EA; Neurosciences and Mental Health, Hospital for Sick Children, Canada Hospital for Sick Children, Toronto, Canada.; Department of Neurology, Hospital for Sick Children, Toronto, Canada., Cardenas de La Parra A; McConnell Brain Imaging Centre, McGill University, Montreal, Canada., Arnold D; McConnell Brain Imaging Centre, McGill University, Montreal, Canada., Collins DL; McConnell Brain Imaging Centre, McGill University, Montreal, Canada., Maranzano J; McConnell Brain Imaging Centre, McGill University, Montreal, Canada., Narayanan S; McConnell Brain Imaging Centre, McGill University, Montreal, Canada., Marrie RA; Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada., Bar-Or A; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Banwell B; Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Till C; Department of Psychology, York University, Toronto, Canada.; Neurosciences and Mental Health, Hospital for Sick Children, Canada Hospital for Sick Children, Toronto, Canada. |
| Abstrakt: |
Long-term cognitive deficits have been observed in some children who experience an acquired demyelinating syndrome (ADS). We examined changes in cognitive functioning over the first two years following incident ADS andtested whether normalized brain and thalamic volume accounted for decline over time. Twenty-five youth (mean age 12.8 years) with ADS, 9 of whom were diagnosed with multiple sclerosis (MS) and 16 of whom experienced monophasic ADS (monoADS), underwent two neuropsychological evaluationsand MRI scans at approximately6- and 24-months post ADS-onset. We examined changes in cognitive outcomes over time and between patient groups. Generalized linear mixed-effect regression models were used to examine the association of normalized brain and thalamic volumesbetween the two timepointswith cognitive z-scores. Cognitive performance was within the age-expected range for both groups and remained stable over time on 15 measures. In the combined sample of monoADS and MS patients, declines ( p < .05) were noted on the Symbol Digit Modalities Test (SDMT), the Auditory Working Memory (AWM), and the WJ-III Visual Matching (VisMat)tests, but did not survive FDR correction. Clinically significant declines, as measured by the Reliable Change Index, were observed on the SDMT,AWM, and VisMattests by 19, 42, and 32%, respectively. Lower normalized brain volume at 6-months predicted a negative change in SDMT (B = 0.45, 95%CI: 0.07,0.83) and AWM (B = 0.30, 95%CI: 0.13, 0.47). Chronicity of demyelination is not required for cognitive decline nor for reduced brain volume, suggesting that even a single demyelinating event may negatively impact cognitive potential in children. |
