A-57Psychological and Clinical Predictors of Executive Dysfunction in Pediatric Multiple Sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults, particularly with increased disease duration. Existing research suggests such problems in pediatric MS, but has not investigated relationships between these variables. The objective was to determine influence of fatigue, depression, anxiety, and disease duration on executive functioning in pediatric MS. It was hypothesized that these variables would predict parent-reported and performance-based executive function. Method: Eighteen MS patients, aged 7–18 with a mean disease duration of 15.5 months, were recruited through a multi-disciplinary demyelinating diseases clinic. The sample was 67% women and 55% Caucasian. Participants completed a neuropsychological screening battery including Verbal Fluency, Digit Span, and Trails A/B. Parents completed the Behavior Rating Inventory of Executive Function, Behavior Assessment System for Children-Second Edition, and Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. Results: Mean parent-reported fatigue was severe. Mean parent-reported anxiety, depression, and executive function scores were not clinically significant though scores varied widely. Means were below average on Trails B and average on Verbal Fluency and Digit Span. Multiple regression analyses indicated fatigue, depression, anxiety, and disease duration predicted variability in parent-reported cognitive flexibility (p = .02), behavioral regulation (p = .01), attention problems (p = .04), and Trails B performance (p = .05). Independently, these predictors accounted for variability in various parent-reported executive functions. Conclusions: Results indicate that pediatric MS is associated with fatigue and some degree of executive dysfunction. Disease duration, fatigue, depression, and anxiety predicted more parent-reported than performance-based executive dysfunction. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.