Cognitive Impairment is Associated with Behavioral Problems in Pediatric Multiple Sclerosis (MS) (P4.025)
Bibliographic record
Abstract
OBJECTIVE: To characterize the behavioral problems in pediatric MS and their link to cognitive impairment. BACKGROUND: Pediatric MS patients represent 2-5[percnt] of all MS cases, with one-third having cognitive impairment. In adults, behavioral changes have been associated with intrinsic changes within the brain as well as the psychosocial burden of illness. DESIGN/METHODS: Participants with pediatric-onset MS were consecutively evaluated at the Lourie Center for Pediatric MS and administered the Behavioral Assessment System for Children, second edition (BASC-2), self- and parent-report forms and neuropsychological evaluation. The BASC-2 includes clinical and adaptive functioning scales, with impairment determined by scores falling greater than two standard deviations or below norms. Cognitive impairment was defined as one-third of scores falling one standard deviation or more below norms. RESULTS: There were 145 patients, with a mean age of 14.7 ± 2.7 years (range 5 to 18) and 57[percnt] female. Mean disease duration was 1.5 ± 2.3 years; the median EDSS was 1.0 (range 0 to 6.5). Behavioral concerns were frequent: 68[percnt] of children and 81[percnt] of parents rated at least one scale in the clinically significant range. However, no consistent pattern emerged with mean BASC-2 scores falling within the typical range for the sample (mean t scores between 45 and 55). For both self-/parent-reports, the most frequently reported concerns were attention problems (28[percnt]/ 29[percnt]) and somatization (35[percnt]/ 27[percnt]). Participants with cognitive impairment reported significantly higher rates of problems in school, mood disturbances and interpersonal problems, and were rated by parents as having significantly lower adaptive functioning. CONCLUSIONS: Behavioral concerns are frequent but highly variable in pediatric MS. Cognitive impairment is associated with a greater risk of reported behavioral problems affecting school, mood, and interpersonal functioning. Study Supported by: The Lourie Foundation, Inc., National Multiple Sclerosis Society, and the Slomo and Cindy Silvian Foundation
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".