Cognitive reserve is associated with better cognitive outcome and socio-professional attainment in both adult and pediatric-onset multiple sclerosis
ECTRIMS Online Library. Razzolini L. Oct 26, 2017; 202488; 135
Lorenzo Razzolini
Lorenzo Razzolini
Contributions
Abstract

Abstract: 135

Type: Oral

Abstract Category: Clinical aspects of MS - 3 Paediatric MS

Background: The concept of cognitive reserve (CR) has been proposed to bridge the gap between the degree of brain damage and its clinical manifestations. While the role of CR in adult-onset multiple sclerosis (AOMS) patients is being recognised, information in the pediatric-onset MS (POMS) population is limited.
Objectives: This study aims at comparing cognitive outcome and socio-professional attainment in POMS versus AOMS patients and the relevant demographic and clinical correlates, including CR.
Methods:
A group of patients with POMS and a group of “classic” AOMS patients were recruited in five Italian MS Centers. Cognitive function was assessed through the Rao's Brief Repeatable Battery and Stroop Test. Cognitive impairment (CI) was defined as the failure of at least 3 tests on the basis of the Italian normative data. CR was estimated using years of education and the Italian version of the National Adult Reading Test. Socio-professional attainment was assessed through the Work and Social Adjustment Scale and Socioeconomic Status through the Barrat Simplified Measure of Social Status. The relationships between CR, cognitive performance and occupational attainment were assessed through linear and logistic multivariable regression analyses.
Results:
111 adult POMS and 115 AOMS patients were enrolled. Compared with AOMS, adult POMS subjects were younger (32.0+/-9.7 vs 38.8+/-9.3 yrs; p< 0.001) and had a longer disease duration (16.9+/-9.8 vs 12.1+/-7.9 yrs; p< 0.001). CR tended to be decreased in POMS vs AOMS (p=0.05). Proportion of CI was 36% in POMS and 33% in AOMS (p=0.64). There was no difference in social and professional attainment between groups. In the whole sample, the multivariable analysis showed that the presence of CI was associated with older age (OR=1.03 95%CI 1.01-1.07; p=0.039), higher EDSS (OR=1.42 95%CI 1.15-1.76; p=0.001) and lower CR (OR=0.92 95%CI 0.89-0.96; p< 0.001). Better social and professional attainments were associated with CR (Beta 0.98-1.35, p< 0.01), male sex (Beta 7.79, p=0.005) and lower EDSS (Beta 0.40, p< 0.001).
Conclusions:
CR is a key, potentially modifiable, protective factor for subject cognitive and socio-professional outcome. Concurrently, CR tends to be lower in POMS subjects. Our findings underscore the importance of interventions focusing on intellectual enrichment enhancement, particularly in the pediatric MS population, in order to achieve better cognitive, social and professional performances in adulthood.
Disclosure:
L.Pasto´ received article grants from Almirall and Biogen.
B.Hakiki serves on a scientific advisory board for Novartis.
M.Giannini received grants from biogen, almirall, novartis, genzyme, teva and bayer.
I.Righini received research support from Novartis.
L. Razzolini received research support from Novartis.
A. Ghezzi has served on scientific advisory boards for Merck Serono, Novartis, Biogen Idec, Teva Pharmaceutical Industries Ltd., and has received speaker honoraria from Merck Serono, Biogen Idec, Bayer Schering Pharma, Sanofi-Genzyme, Novartis, Serono Symposia International and Almirall.
R. G. Viterbo serves on a scientific advisory board for Biogen.
M.G. Marrosu Funding for travel and speaker honoraria from: Almirall, Bayer, Biogen, Merck, Novartis and TEVA; Serving on a scientific advisory board: Almirall, Bayer, Biogen, Merck, Novartis and TEVA; speaker honoraria from: Almirall, Bayer, Biogen, Merck, Novartis and TEVA; research support from Merck, Bayer, TEVA, Genzyme and Biogen; research Support from Sardinia Region (Legge7, RAS) and Fondazione Banco di Sardegna.
E. Cocco has received honoraria for consultancy or speaking from Biogen, TEVA, Novartis, Sanofi-Aventis, Merck Serono and Bayer.G.
Fenu has received honoraria for consultancy or speaking from Merck Serono, Novartis and Teva.
F.Patti has received personal compensations for activities with Merck Serono, Bayer Schering Pharma, and Dompé Biotec.
M. Falautano has received travel grants from Fondazione Italiana Sclerosi Multipla (FISM).
E. Minacapelli has received travel and research grants from Fondazione Italiana Sclerosi Multipla (FISM) and serves as consultant for “Fondazione Cesare Serono”.
E. Portaccio serves on a scientific advisory board for Biogen, Merck Serono and Bayer, received honoraria for speaking from Biogen-Idec, teva, novartis and genzyme and receives research support from Merck Serono.
M. P. Amato received personal compensation from Merck Serono, Biogen, Genzyme, Teva and Novartis for serving on scientific advisory board and for speaking received financial support for research activites from Almirall, Merck Serono, Biogen Idec, Bayer Schering, Genzyme, Novartis, Genzyme and Teva.
Benedetta Goretti, C. Niccolai, Lorena Pippolo, C. Chisari, Marta Simone have no competing interests have no competing interests.
The study was financed by the Italian MS Foundation (FISM)

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