Quality of Life and Cognitive function in pediatric and young adults multiple sclerosis: a cross-sectional study

Multiple sclerosis (MS) is a chronic immune-mediated disease resulting in inflammation, demyelination, and neurodegeneration. Pediatric onset MS is an increasingly recognized disorder, identified in 3% to 5% of adults with MS [1-4].Despite the acknowledged need to consider QoL issues, its assessment remains under-utilized in MS clinical practice [13]. Pediatric MS patients report lower HRQoL score than healthy controls [14]. Little is known about the association between cognitive impairment and QoL in pediatric and juvenile multiple sclerosis patients and how clinical and demographic data could impact on them. We designed a cross sectional study aimed to assess the relationship between total and domain-specific cognitive function and HRQoL in pediatric and young multiple sclerosis patients using well-standardized testsThis is a cross-sectional study carried out on MS patients referred to Federico II University specific pediatric and young adults MS centre. Inclusion criteria were disease onset before 25 years of RRMS or CIS, diagnosed according to 2010 McDonalds criteria [15] at least 12 months before (to avoid the influence of recent communication of diagnosis on psychological status).We designed a cross sectional study, including pediatric and early onset MS patients, to explore cognitive functions and HRQoL and their relationship. We choose to include also young adults patients, still living with their families and not independent yet, because we wanted to analyze the effects of MS in patients in their evolutive phase of life, before reaching complete autonomy and realizing their objectives. We choose patients with a diagnosis at least one year old, in order to avoid the direct psychological effects of diagnosis communications, that could strongly affect out results Total HRQoL was higher in pediatric onset than early adulthood onset MS patients while it was inversely related to EDSS score and, more interestingly, to MSSS. Total QoL score was not different between MS patients with or without CI and did not correlate with any domain-specific cognitive function and the linear regression model confirmed that total QoL score was only related to MSSS and age of onset . The main result of the present study is the relevance of pediatric age of onset as a good prognostic factor for QoL and MSSS as a the main negative factor influencing HRQoL. Actually, onset of a chronic disease during the early phases of life is dramatic, but our data suggest that coping with a disease with its onset in childhood or adolescence have a lower impact on quality of life, as self reported, respect to adult onset.