title: Fatigue, emotional functioning, and executive dysfunction in pediatric multiple sclerosis.
abstract: OBJECTIVE
  Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.
  
  
  METHODS
  Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient's quality of life and fatigue. Pearson's correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.
  
  
  RESULTS
  Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices-but not age of onset or disease duration-significantly correlated with various performance-based measures of executive functioning.
  
  
  CONCLUSIONS
  Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.
authors.affiliation: a Children's Medical Center Dallas , Dallas , Texas , USA.
authors.forename: Alice Ann
authors.initials: AA
authors.lastname: Holland
authors.forename: Donna
authors.initials: D
authors.lastname: Graves
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Greenberg
authors.forename: Lana L
authors.initials: LL
authors.lastname: Harder
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000209:etiology; D002648:Child; D003863:Depression / Q000209:etiology; D004644:Emotions; D056344:Executive Function; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D009103:Multiple Sclerosis / Q000523:psychology*; D009483:Neuropsychological Tests; D011788:Quality of Life; D011795:Surveys and Questionnaires