Background:Multiple sclerosis (MS) is a chronic neurological autoimmune disease; pediatric-onset multiple sclerosis (POMS) represents 5% to 10% of total MS population. Children with POMS may experience attention difficulties due to the disease’s impact on the central nervous system. However, little is known regarding Attention Deficit Hyperactivity Disorder (ADHD) in POMS, and its relation to cognitive performance.Methods:A retrospective case review was conducted using medical records of 66 children and adolescent patients diagnosed with POMS between 2012 and 2021 in a MS center of a tertiary medical center. All patients had undergone routine clinical neurological examinations and had been assessed for a diagnosis of ADHD by a department pediatric neurologist. In addition, sociodemographic data, disease-related variables, and cognitive performance were collected.Results:Of the 66 patients, 31 (47%) had a diagnosis of ADHD; 29 (44%) had cognitive impairment. Moreover, we identified four different profiles of POMS: those with only ADHD (17, 26%); only cognitive impairment (15, 23%), ADHD and cognitive impairment (14, 21%), and only POMS (20, 30%). A significant difference in disease duration was found among the four profiles [ F(3,65) = 8.17, p < .001, η² = 0.29], indicating that patients with ADHD and cognitive impairment were characterized by longer disease duration.Conclusions:ADHD may be prominently involved in POMS, even during the early stages of the disease and early diagnosis is crucial in order to provide appropriate interventions and support.

中文翻译：

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多发性硬化症儿童的注意力缺陷/多动症

背景：多发性硬化症（MS）是一种慢性神经系统自身免疫性疾病；儿童发病的多发性硬化症 (POMS) 占 MS 总人口的 5% 至 10%。由于该疾病对中枢神经系统的影响，患有 POMS 的儿童可能会出现注意力困难。然而，人们对 POMS 中的注意力缺陷多动障碍 (ADHD) 及其与认知表现的关系知之甚少。方法：对 2012 年至 2021 年间在 MS 中诊断为 POMS 的 66 名儿童和青少年患者的医疗记录进行回顾性病例审查三级医疗中心的中心。所有患者均接受了常规临床神经学检查，并由儿科神经科医生对 ADHD 的诊断进行了评估。此外，还收集了社会人口统计学数据、疾病相关变量和认知表现。 结果：66 名患者中，31 名 (47%) 被诊断为 ADHD；其中 31 名 (47%) 被诊断为注意力缺陷多动症 (ADHD)。29 人（44%）有认知障碍。此外，我们还确定了四种不同的 POMS 特征：仅患有 ADHD 的人（17%，26%）；患有多动症的人（17%，26%）；仅认知障碍 (15, 23%)、多动症和认知障碍 (14, 21%)、仅 POMS (20, 30%)。四种情况的病程存在显着差异 [F(3,65) = 8.17, p < .001, η² = 0.29]，表明 ADHD 和认知障碍患者的特点是病程较长。结论：ADHD即使在疾病的早期阶段，也可能显着参与 POMS，早期诊断对于提供适当的干预和支持至关重要。