title: Cognitive and patient-reported outcomes in adults with pediatric-onset multiple sclerosis.
abstract: BACKGROUND
  Little is known about long-term cognitive and patient-reported outcomes of pediatric-onset multiple sclerosis (POMS).
  
  
  OBJECTIVE
  The objective of this paper is to compare cognitive and patient-reported outcomes in adults with POMS vs. adult-onset MS (AOMS).
  
  
  METHODS
  We compared standardized patient-reported measures MSQOL54, MFIS, CES-D and SDMT in adult patients with MS onset prior to and after age 18, using data gathered in the Comprehensive Longitudinal Investigations in MS at Brigham and Women's Hospital (CLIMB) study.
  
  
  RESULTS
  Fifty-one POMS and 550 AOMS patients were compared. SDMT scores were significantly lower in POMS after adjusting for age (-7.57 (-11.72, -3.43; p < 0.001), but not after adjusting for disease duration. Estimated group difference demonstrated lower normative z scores in POMS vs. AOMS in unadjusted analysis (-0.74 (95% CI: -1.18, -0.30; p = 0.0009) and after adjusting for disease duration (-0.60; 95%CI: -1.05, -0.15; p = 0.0097). Findings were unchanged in a subset of POMS diagnosed prior to age 18. In unadjusted and adjusted analyses, no significant differences were observed in health-related quality-of-life, fatigue, depression or social support between POMS and AOMS.
  
  
  CONCLUSIONS
  Younger age of onset was associated with more impairment in information-processing speed in adults with POMS compared to AOMS, and remained significant when controlling for disease duration in age-normed analysis. The two groups were similar in terms of patient-reported outcomes, suggesting similar qualitative experiences of MS.
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA.
authors.forename: Natalie F
authors.initials: NF
authors.lastname: Baruch
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, USA.
authors.forename: Ellen H
authors.initials: EH
authors.lastname: O'Donnell
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA.
authors.forename: Bonnie I
authors.initials: BI
authors.lastname: Glanz
authors.affiliation: Department of Neurology, University at Buffalo, State University of New York, USA.
authors.forename: Ralph H B
authors.initials: RH
authors.lastname: Benedict
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Musallam
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA/ Biostatistics Center, Massachusetts General Hospital, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Healy
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA.
authors.forename: David
authors.initials: D
authors.lastname: Rintell
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA tchitnis@partners.org.
authors.forename: Tanuja
authors.initials: T
authors.lastname: Chitnis
mesh_terms: D000328:Adult; D017668:Age of Onset; D002648:Child; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000523:psychology*; D000071066:Patient Reported Outcome Measures; D011795:Surveys and Questionnaires
keywords: Multiple sclerosis; cognition; outcomes; pediatric; quality of life