AUTHOR=Puthenparampil Marco , Scialpi Graziana , Gaggiola Marta , Zanotelli Giovanni , Miscioscia Alessandro , Berardi Angela , Riccardi Alice , Nosadini Margherita , Sartori Stefano , Perini Paola , Rinaldi Francesca , Gallo Paolo 

TITLE=A comparison of natalizumab’s effects on SDMT between pediatric-onset and adult-onset multiple sclerosis patients

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1475161

DOI=10.3389/fneur.2024.1475161

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Background</title><p>Pediatric-onset multiple sclerosis (POMS) patients often exhibit a wide range of cognitive deficits. Therefore, therapeutic approaches should aim not only to prevent cognitive decline but also to promote cognitive improvement.</p></sec><sec id="sec2"><title>Objective</title><p>This study aimed to explore the effects of natalizumab (NTZ) on cognitive function, as measured by the Symbol Digit Modalities Test (SDMT), in both POMS and adult-onset multiple sclerosis (AOMS) patients.</p></sec><sec id="sec3"><title>Method</title><p>A total of 63 patients (34 AOMS and 29 POMS) were enrolled in this retrospective, single-center study. Patients were clinically and radiologically assessed every 6 months, and they completed the SDMT at baseline and after at least 24 months of follow-up. SDMT values were reported as corrected values (cSDMT) and z-scores (zSDMT). Annualized cSDMT and zSDMT scores were calculated by dividing the change in scores by the length of the follow-up period (expressed in years).</p></sec><sec id="sec4"><title>Results</title><p>Both POMS and AOMS groups showed improvement in annualized cSDMT and zSDMT scores, but the improvement was significantly greater in the POMS group compared to the AOMS group (+3.85 ± 4.32 vs. +1.76 ± 2.80, <italic>p</italic> = 0.010 for cSDMT; 0.41 ± 0.40 vs. 0.25 ± 0.34, <italic>p</italic> = 0.026 for zSDMT). After re-baselining at 6 months, 93% of POMS patients (27 patients) and 85.3% of AOMS patients (29 patients, <italic>p</italic> = 0.84) achieved NEDA-3 (no evidence of disease activity). The NEDA-3 status, along with clinical and demographic parameters at baseline, did not account for the observed SDMT improvement.</p></sec><sec id="sec5"><title>Conclusion</title><p>The favorable clinical, radiological, and neuropsychological outcomes observed in this study support the use of natalizumab as a viable treatment option in POMS.</p></sec>