Distinct cognitive impairments in different disease courses of multiple sclerosis—A systematic review and meta-analysis

•Cognitive impairment was contrasted between different disease courses of MS.•47 studies reporting neuropsychological data from 4460 patients with MS were included.•Patients with PPMS consistently showed more severe cognitive impairment than RRMS.•Differences in e.g. age and disability could not ful...

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Bibliographic Details
Published in:Neuroscience and biobehavioral reviews 2017-12, Vol.83, p.568-578
Main Authors: Johnen, Andreas, Landmeyer, Nils C., Bürkner, Paul-Christian, Wiendl, Heinz, Meuth, Sven G., Holling, Heinz
Format: Article
Language:English
Subjects:
Cognition
Meta-Analysis
Multiple sclerosis
Neuropsychological assessment
PPMS
RRMS
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Summary:•Cognitive impairment was contrasted between different disease courses of MS.•47 studies reporting neuropsychological data from 4460 patients with MS were included.•Patients with PPMS consistently showed more severe cognitive impairment than RRMS.•Differences in e.g. age and disability could not fully explain cognitive heterogeneity.•Patients with PPMS may need disease management specialized on cognitive deficits. Cognitive impairment (CI) is common and debilitating in patients with multiple sclerosis. However, little is known about how different disease courses affect CI, impeding prognosis and disease management. Here, we contrasted the magnitude and profile of CI measured with standardized neuropsychological tests in patients with primary progressive multiple sclerosis (PPMS) against relapsing-remitting multiple sclerosis (RRMS) while considering potentially confounding demographic and clinical differences. Systematic literature review and meta-analysis was performed finding 47 eligible studies (N=4460 patients). Effect-sizes for 12 cognitive domains were calculated as Hedges’ g. Results indicated more severe CI overall (g=−0.37, p
ISSN:0149-7634
1873-7528
DOI:10.1016/j.neubiorev.2017.09.005