Evidence map›Paper›PMID 32430312›Full record

SynthesisNeurology2020

Disease-modifying treatments and cognition in relapsing-remitting multiple sclerosis: A meta-analysis.

Nils C Landmeyer, Paul-Christian Bürkner, Heinz Wiendl, Tobias Ruck, Hans-Peter Hartung, Heinz Holling, Sven G Meuth, Andreas Johnen

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 3 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 3 syntheses or guidelines pooled it, 118 citations in OpenAlex.

  1. Pooled it
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  17. Neurofilament Light Chain and Disability Measures as Predictors of Cognitive Decline in Early Multiple Sclerosis.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Article
  18. Pediatric multiple sclerosis: Improving outcome through high-efficacy therapies.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  19. Differential Validity in the Written, Oral, and Electronic SDMT in Multiple Sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Nils C LandmeyerFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany. a.johnen@uni-muenster.de nils.landmeyer@ukmuenster.de.ORCID 0000-0001-7483-0873
Paul-Christian BürknerFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.ORCID 0000-0001-5765-8995
Heinz WiendlFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.ORCID 0000-0001-5509-1075
Tobias RuckFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.ORCID 0000-0001-6332-8650
Hans-Peter HartungFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.ORCID 0000-0002-0614-6989
Heinz HollingFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.ORCID 0000-0002-0311-3970
Sven G MeuthFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.ORCID 0000-0003-2571-3501
Andreas JohnenFrom the Clinic of Neurology with Institute of Translational Neurology (N.C.L., H.W., T.R., S.G.M., A.J.), University Hospital Münster, Westphalian-Wilhelms-University Münster, Germany; Department of Statistics (P.-C.B., H.H.), Faculty of Psychology, Westphalian-Wilhelms-University Münster, Germany; and Department of Neurology (H.-P.H.), UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany. a.johnen@uni-muenster.de nils.landmeyer@ukmuenster.de.ORCID 0000-0002-1955-2169
University Hospital Münster · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDisease-modifying treatments (DMTs) are the gold standard for slowing disability progression in multiple sclerosis (MS), but their effects on cognitive impairment, a key symptom of the disease, are mostly unknown. We conducted a systematic review and meta-analysis to evaluate the differential effects of DMTs on cognitive test performance in relapsing-remitting MS (RRMS).

methodsPubMed, Scopus, and Cochrane Library were searched for studies reporting longitudinal cognitive performance data related to all major DMTs. The standardized mean difference (Hedges

resultsForty-four studies, including 55 distinct MS patient samples, were found eligible for the systematic review. Twenty-five studies were related to platform therapies (mainly β-interferon [n = 17] and glatiramer acetate [n = 4]), whereas 22 studies were related to escalation therapies (mainly natalizumab [n = 14] and fingolimod [n = 6]). Reported data were mostly confined to the cognitive domain processing speed. A meta-analysis including 41 studies and 7,131 patients revealed a small to moderate positive effect on cognitive test performance of DMTs in general (g = 0.27, 95% confidence interval [CI] = [0.21-0.33]), but no statistically significant differences between platform (g = 0.27, 95% CI = [0.18-0.35]) and escalation therapies (g = 0.28, 95% CI = [0.19-0.37]) or between any single DMT and β-interferon.

conclusionsDMTs are effective in improving cognitive test performance in RRMS, but a treatment escalation mainly to amend cognition is not supported by the current evidence. Given the multitude of DMTs and their widespread use, the available data regarding differential treatment effects on cognitive impairment are remarkably scant. Clinical drug trials that use more extensive cognitive outcome measures are urgently needed.

Indexed as

CognitionCognitive DysfunctionFingolimod HydrochlorideGlatiramer AcetateHumansImmunologic FactorsImmunosuppressive AgentsInterferon-betaMultiple Sclerosis, Relapsing-RemittingNatalizumabRandomized Controlled Trials as TopicFingolimod HydrochlorideGlatiramer AcetateImmunologic FactorsImmunosuppressive AgentsInterferon-betaNatalizumab

Identifiers

PMID32430312
OpenAlexW3026037032

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.