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Association between myasthenia gravis and cognitive function: A systematic review and meta-analysis
Zhifeng Mao1, Junjie Yin1, Zhengqi Lu1
1Department of Neurology, Multiple Sclerosis Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Abstract:
The course of myasthenia gravis (MG) is complicated by increased reports of cognitive defects in both human and animal models, which suggests potential central nervous system (CNS) damage. We conducted a systematic review of the relationships between MG and cognitive function. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Major databases were searched to examine the neuropsychological studies of adults with MG. Weighted effect sizes were pooled by cognitive domain. Eight studies representing 300 subjects were included. Eight cognitive domain categories were identified: (i) Mini-Mental State Examination (MMSE), (ii) language, (iii) processing speed, (iv) verbal learning and memory, (v) visual learning and memory, (vi) attention span, (vii) response fluency, and (viii) motor performance. Nine (cognitive domain categories, MMSE, language, processing speed, verbal learning and memory (except for delayed recall memory), and motor performance) of 16 cognitive tasks revealed significant moderate effect sizes. Verbal logical-delayed memory, finger tapping with the preferred hand, and the Symbol Digit Modalities Test showed a greater magnitude relationship to cognitive function than did other specific cognitive domains. Verbal learning and memory seems to be the most significant affected according to cognitive domain categories. For MG, the ability of attention, response fluency, visual learning, and memory seems to be reserved. The MG patients seem to perform significantly worse than the non-MG controls in a range of cognitive domains. Our findings should be interpreted with caution because of the clinical and methodological heterogeneity of included studies.
Insights
Myasthenia gravis (MG) patients often experience cognitive deficits, particularly in verbal learning and memory. While attention and visual memory appear preserved, overall cognitive function is impaired in MG.
Area of Science:
- Neuroscience
- Neurology
- Cognitive Science
Background:
- Myasthenia gravis (MG) is increasingly associated with cognitive dysfunction, suggesting potential central nervous system (CNS) involvement.
- Existing research indicates cognitive impairments in both human patients and animal models of MG.
Purpose of the Study:
- To systematically review and synthesize findings on the relationship between myasthenia gravis and cognitive function.
- To identify specific cognitive domains affected in individuals with MG.
Main Methods:
- A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searched major databases for neuropsychological studies involving adult MG patients.
- Pooled weighted effect sizes across eight identified cognitive domains.
Main Results:
- Eight studies involving 300 subjects were analyzed.
- Significant moderate effect sizes were observed in nine cognitive tasks, including MMSE, language, processing speed, verbal learning/memory (excluding delayed recall), and motor performance.
- Verbal learning and memory emerged as the most significantly affected domain, while attention, response fluency, and visual learning/memory appeared relatively preserved.
Conclusions:
- MG patients demonstrate significant cognitive impairments compared to controls across various domains.
- Verbal logical-delayed memory, finger tapping, and the Symbol Digit Modalities Test showed the strongest associations with cognitive function in MG.
- Findings highlight the impact of MG on cognitive abilities, though heterogeneity in studies necessitates cautious interpretation.
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