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Myasthenia Gravis: Overview and Treatment01:20

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Does myasthenia gravis impact cognitive functioning? A systematic review and meta-analysis.

Alessia Marcassoli1, Giulia Trucco2, Angelica Mazzilli3

  • 1Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milano, 20133, Italy. alessia.marcassoli@istituto-besta.it.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|January 6, 2026
PubMed
Summary

This study reveals that individuals with Myasthenia Gravis (MG) experience significant cognitive impairments, particularly in processing speed and memory. These findings highlight the importance of addressing cognitive health in MG patient care.

Keywords:
Cognitive functioningMemoryMeta-analysisMyasthenia gravisNeuropsychologyVerbal fluency

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Area of Science:

  • Neurology
  • Cognitive Science
  • Psychology

Background:

  • Myasthenia Gravis (MG) is increasingly recognized to involve non-motor symptoms, including cognitive deficits.
  • Previous research on cognitive impairment in MG is limited and shows inconsistent findings.
  • A systematic review and meta-analysis is needed to clarify the relationship between MG and cognitive performance.

Purpose of the Study:

  • To systematically review and meta-analyze existing research on cognitive functioning in individuals with Myasthenia Gravis.
  • To determine if there are significant differences in cognitive performance between MG patients and healthy controls.

Main Methods:

  • A systematic literature search was conducted across PubMed, Web of Science, and SCOPUS for studies published between 2000 and 2024.
  • Included studies compared cognitive functioning in MG patients versus healthy controls.
  • Random-effects meta-analysis was used to calculate pooled standardized mean differences and confidence intervals for cognitive domains.

Main Results:

  • Six studies involving 242 MG patients and 166 healthy controls were included.
  • MG patients demonstrated significantly poorer performance in processing speed, verbal fluency (phonemic and animal categories), visuo-spatial memory, and verbal learning compared to controls.
  • Low to moderate heterogeneity was observed across most cognitive outcome measures.

Conclusions:

  • This meta-analysis provides robust evidence for selective cognitive impairments in individuals with Myasthenia Gravis.
  • The findings emphasize the necessity of integrating cognitive and psychological health assessments into a comprehensive care strategy for MG patients.