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Domain-specific cognitive impairment in multiple sclerosis: A systematic review and meta-analysis
Katalin Lugosi1,2, Marie A Engh1, Zsolt Huszár1,3
1Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085, Budapest, Hungary.
Annals of Clinical and Translational Neurology
|January 12, 2024
Summary
Cognitive impairment is prevalent across all multiple sclerosis (MS) types, worsening with disease progression. Standardized cognitive testing using the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) is recommended for accurate assessment.
Area of Science:
- Neuroscience
- Clinical Neurology
- Psychology
Background:
- Cognitive measurement methods in multiple sclerosis (MS) lack standardization.
- Identifying the prevalence of cognitive domain-specific impairment (DSI) is crucial for understanding MS progression.
Approach:
- A systematic review and meta-analysis of 48 observational studies (n=3431) were conducted.
- The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) was used to assess DSI across different MS subtypes.
- Various cutoff values for defining impairment were analyzed.
Key Points:
- The most common thresholds for DSI were 2.0 SD, 1.5 SD below the mean, and scores below the fifth percentile.
- Cognitive impairment worsened progressively from Clinically Isolated Syndrome (CIS) to Relapsing-Remitting MS (RRMS), Primary Progressive MS (PPMS), and Secondary Progressive MS (SPMS).
Conclusions:
- Cognitive impairment is present in all MS phenotypes, with varying severity.
- An individualized referencing approach is recommended due to diverse patient characteristics and testing disparities.
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