Cognitive impact of pediatric multiple sclerosis varies by race

Multiple sclerosis (MS) affects some cognitive functions more severely in black children than white children, according to newly published research from an interdisciplinary team at UAB.

 

The UAB researchers say the study, published in the Dec. 7, 2010, issue of Neurology, is the first to reveal that the severity of cognitive difficulties in pediatric MS may vary between black and white children. The results provide valuable insight that could help individualize treatments for children suffering from the disease.

"We don't yet understand the biological reasons, but the bottom line is treatment options must be re-evaluated and be aggressive enough, especially with black patients, to prolong quality of life for as long as possible," says Kelly Ross, M.A, a psychology doctoral degree candidate in the UAB College of Arts and Sciences and lead author of the study.

MS is a chronic neurological disorder of the brain, spinal cord and optic nerves, which can cause subtle but debilitating impairments in learning and cognition and more apparent disruptions of motor control. Although MS in children is much less common than in adults, the disease may impact cognitive function more in younger patients because their nervous systems still are developing.

The UAB team reviewed university-collected data on the cognitive assessments of 42 children with MS, 20 black and 22 white, who were treated from April 2006 to September 2009 at the UAB Center for Pediatric Onset Demyelinating Disorders, which operates at the Children's Hospital of Alabama.

"The UAB CPODD clinic is the only one of the six Pediatric MS Centers of Excellence in the country that, based on its location, serves a considerable black population; this gave us access to unique comparative data," Ross says.

Controlling for variables like socioeconomic status and education level, the researchers found that black MS patients may be at higher risk than whites for adverse cognitive impacts in the areas of language and complex attention, i.e. the ability to juggle multiple tasks at once.

"The differential effects of the disease in children based on their race is a trend very similar to research in adults in which MS more severely affects some functions in black patients," says Jayne Ness, M.D., Ph.D., CPODD director and associate professor of pediatrics in the UAB School of Medicine and a co-author of the study.

"Whether it is treatment of MS itself, adjunctive therapies or working with school systems to see that a proper special-education curriculum is in place, the results of this research could reshape the way we help pediatric MS patients and their families manage the disease," says Joe Ackerson, Ph.D., a former UAB faculty member and co-author of the study.

In addition to Ross, Ness and Ackerson, David Schwebel, Ph.D., a professor of psychology, and John Rinker, M.D., an assistant professor of neurology, were co-authors of the study.

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