The evolution of cognitive and psychosocial difficulties in a cohort of 56 MS patients compared with 50 healthy controls was studied by researchers at the University of Florence and centers in Milan, Bari, Catania, and Rome, Italy. At a mean period of 2 years follow-up, 70% had cognitive impairment, deteriorating in 75%, especially verbal memory, attention, verbal fluency, and receptive language. Older age was a predictor of cognitive deterioration (p=0.003). Depression developed in 30%, fatigue in 21%, and interference with school activities in 30%. Regular assessment of psychosocial functioning and rehabilitation strategies in MS childhood patients are indicated. 
COMMENT. In a previous multicenter study, these investigators found a 31% prevalence of cognitive impairment and a low IQ in 28% of 63 childhood MS cases.