Cognitive and psychosocial features of childhood and juvenile MS
Cognitive and psychosocial features of childhood and juvenile MS
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DOI：
10.1212/01.wnl.0000312276.23177.fa
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发表时间：
2008-05-13
期刊：
影响因子：
9.9
通讯作者：
Trojano, M.
中科院分区：
文献类型：
--
作者：
Amato, M. P.;Goretti, B.;Trojano, M.
目的：评估多发性硬化症(MS)对儿童和青少年认知和心理社会功能的影响。方法：我们使用广泛的神经心理学组合评估智商、记忆力、注意力/注意力、执行功能和语言。疲劳和抑郁也被测量。从家长那里获得了关于学校和日常生活活动的访谈。结果：共调查63例患者和57例健康对照。5名患者(8%)表现出特别低的智商(70)。19名患者(31%)达到了认知障碍的标准(至少三次测试失败)，而32名患者(53%)至少两次测试失败。除了记忆、复杂注意力和执行功能方面的缺陷外，缺陷的特征还包括语言能力的参与。在回归分析中，唯一有意义的认知障碍预测因素是智商低于90分(优势比[OR]18.2，95%CI4.6-71.7，p<；0.001)。以智商得分为因变量，发病年龄较小(OR0.7，95%CI0.5-0.9，p=0.009)是唯一有意义的预测因素。6%的病例报告了抑郁症状，73%的病例报告了疲劳。结论：在儿童和青少年中，多发性硬化症(MS)与认知障碍和低智商有关，后者与发病年龄较小有关。这些方面对于帮助患有多发性硬化症的儿童和青少年处理他们的困难和心理社会挑战至关重要。
Objective: To assess the impact of multiple sclerosis (MS) on cognitive and psychosocial functioning in childhood and juvenile cases.Methods: We used an extensive neuropsychological battery assessing IQ, memory, attention/concentration, executive functions, and language. Fatigue and depression were also measured. An interview on school and daily living activities was obtained from the parents. Performance of cases was compared with that of demographically matched healthy controls.Results: Sixty-three patients and 57 healthy controls were assessed. Five patients (8%) exhibited a particularly low IQ (< 70). Criteria for cognitive impairment (failure on at least three tests) were fulfilled in 19 patients (31%), whereas 32 patients (53%) failed at least two tests. Beyond deficits in memory, complex attention, and executive functions, the profile of deficits was characterized by involvement of linguistic abilities. In the regression analysis, the only significant predictor of cognitive impairment was an IQ score lower than 90 (odds ratio [OR] 18.2,95% CI 4.6-71.7, p < 0.001). Considering the IQ score as a dependent variable, the only significant predictor was represented by younger age at onset (OR 0.7, 95% CI 0.5-0.9, p = 0.009). Depressive symptoms were reported by 6% of the cases, and fatigue was reported by 73% of the cases. MS negatively affected school and everyday activities in 56% of the subjects.Conclusions: In childhood and juvenile cases, multiple sclerosis (MS) is associated with cognitive impairment and low IQ scores, the latter related to younger age at onset. These aspects are of critical importance in helping children and adolescents with MS to manage their difficulties and psychosocial challenges.