The long-term neurocognitive prognosis of childhood onset acute disseminated encephalomyelitis (ADEM) is unclear. This review and quantitative synthesis of the available literature examined whether there are long-term impacts of childhood ADEM on neurocognitive functioning. A search of online databases (MEDLINE, EMBASE, EBSCO CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews) from their inception to October 2015 and reference lists identified 13 papers eligible for inclusion in the systematic review; seven of these were eligible for inclusion in meta-analyses. The systematic review indicated that, at a group level there is a positive long-term neuropsychological outcome from childhood onset ADEM. However, despite the apparent absence of long-term negative impacts of ADEM at a group level, at an individual level impairments in the areas of IQ, attention, executive functioning, processing speed, learning and memory, visuospatial skills and internalising symptoms were found in up to 43% of patients when aggregated across the studies. No significant negative effect of ADEM for any of the neuropsychological domains examined was found in meta-analyses. However, the effects for Processing Speed (r _mean = −0.296 (CI 95% = −0.605-0.013)) and Internalising symptoms (r _mean = 0.242 (CI 95% = −0.014-0.564)) approached significance (p = 0.06), suggesting a trend towards ADEM leading to long-term reduced processing speed and elevated internalising symptoms. Together, our findings suggest that despite a generally positive neurocognitive outcome post childhood ADEM there are a subset of individuals who can suffer from ongoing specific cognitive impairments. Clinical implications and research priorities are discussed.

中文翻译：

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儿童发病急性传播性脑脊髓炎（ADEM）的长期神经心理学结果：荟萃分析。

儿童期急性弥漫性脑脊髓炎（ADEM）的长期神经认知预后尚不清楚。这篇综述和现有文献的定量综合研究了儿童ADEM对神经认知功能是否有长期影响。搜索从开始到2015年10月的在线数据库（MEDLINE，EMBASE，EBSCO CINAHL，PsycINFO和Cochrane系统评价数据库）和参考文献列表，确定了13篇适合纳入系统评价的论文；其中有七项符合纳入荟萃分析的条件。系统评价表明，从儿童时期起，ADEM在小组水平上具有积极的长期神经心理学结果。但是，尽管在小组一级显然没有ADEM​​的长期负面影响，在整个研究过程中，多达43％的患者发现在个体水平上的智商，注意力，执行功能，处理速度，学习和记忆，视觉空间技能和内在症状方面受损。在荟萃分析中未发现ADEM对所检查的任何神经心理学领域有明显的负面影响。但是，对处理速度（r _均值 = -0.296（CI 95％= -0.605-0.013））和内在症状（r _均值 = 0.242（CI 95％= -0.014-0.564））接近显着性（p =  0.06），表明ADEM的趋势导致长期降低加工速度并增加内在症状。总之，我们的发现表明，尽管在儿童期ADEM后神经认知结果总体上呈阳性，但仍有一部分个体可能会遭受持续的特定认知障碍。讨论了临床意义和研究重点。