title: Neuropsychological features in childhood and juvenile multiple sclerosis: five-year follow-up.
abstract: OBJECTIVE
  The aim of the study was to perform a third cognitive assessment in our pediatric-onset multiple sclerosis (MS) patient cohort and determine predictors of the individual cognitive outcome.
  
  
  METHODS
  After 4.7 ± 0.7 years from baseline evaluation, 48 of 63 patients in the original cohort were reassessed on an extensive neuropsychological battery and compared with 46 healthy controls. Two alternate versions of the tests were used at different assessment points. Cognitive impairment was defined as the failure of ≥3 tests; individual change in the cognitive impairment index was measured.
  
  
  RESULTS
  At year 5, 38% of the subjects with MS fulfilled our criterion for impairment. Between years 2 and 5, regarding individual cognitive impairment index change, 66.7% of the patients improved. However, comparing baseline and 5-year testing (when the same versions of the tests were used), cognitive impairment index deterioration was observed in 56% of the patients, improvement in 25%, and stability in 18.8%. A deteriorating performance was related to male sex, younger age and age at MS onset, and lower education. None of these variables, however, was retained in the multivariate analysis.
  
  
  CONCLUSIONS
  Cognitive outcome in pediatric-onset MS can be heterogeneous. Progression of cognitive problems in a few subjects and potential for compensation and improvement in others call for systematic cognitive screening in this population and development of effective treatment strategies.
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy. mariapia.amato@unifi.it.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Amato
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Goretti
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Ghezzi
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Bahia
authors.initials: B
authors.lastname: Hakiki
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Niccolai
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lori
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Moiola
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Falautano
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Rosa G
authors.initials: RG
authors.lastname: Viterbo
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Cilia
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzilli
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Bianchi
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Roscio
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Martinelli
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Portaccio
authors.affiliation: From the Department of NEUROFARBA (M.P.A., B.G., B.H., C.N., S.L., E.P.), University of Florence; MS Centre (A.G., M.R.), Hospital of Gallarate; Neurological Department (L.M., M.F., V.M., G.C.), IRCCS Hospital San Raffaele, Milano; Department of Neuroscience and Sense Organs (R.G.V., M.T.), University of Bari; Multiple Sclerosis Centre (F.P., S.C.), University Polyclinic Hospital G. Rodolico, Catania; and Department of Neurological Sciences (C.P., V.B.), La Sapienza University, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000523:psychology*; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012737:Sex Factors; D055815:Young Adult