Cognitive test results in pediatric MS

Heterogeneity in physical and cognitive outcomes is a well-recognized but little understood feature of multiple sclerosis (MS). Such heterogeneity likely reflects the contribution of multiple factors including genetics, physical environment, social environment, comorbid diseases, and health behaviors. Increasingly, race and ethnicity are being studied as possible factors influencing MS-related outcomes.¹

In this issue of Neurology®, Ross et al.² examined 42 patients with pediatric-onset MS to determine whether race is associated with differences in cognition. Each study participant underwent testing to evaluate global functioning, complex attention, verbal fluency, confrontation naming, and verbal memory. The 20 African American (AA) subjects did not perform as well as the 22 Caucasian American (CA) subjects on tests of complex attention and language. Previous studies of the pediatric MS population showed a high burden of cognitive impairment and difficulties with complex attention and language; the burden of impairment increased with longer disease duration, earlier age at onset, increasing number of relapses, and level of physical disability.^3,4 Ross et al. extend earlier findings by focusing on a patient-related characteristic, race, on cognitive impairment rather than on disease-related characteristics such as age …