Evidence map›Paper›PMID 40990412›Full record

SynthesisAnnals of clinical and translational neurology2026

Cognitive Impairment in Multiple Sclerosis: The Role of Clinical and Sociodemographic Factors - A Systematic Review and Meta-Analysis.

Katalin Lugosi, Marie A Engh, Tamás Kói, Zsolt Molnár, Gábor Csukly, Klaudia Horváth, Emma Hargitai, Péter Hegyi, Zsolt Mezei

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Katalin LugosiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.ORCID 0009-0000-0734-906X
Marie A EnghCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Tamás KóiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Zsolt MolnárCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Gábor CsuklyCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Klaudia HorváthMultiple Sclerosis Centre, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
Emma HargitaiMultiple Sclerosis Centre, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
Péter HegyiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Zsolt MezeiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCognitive impairment (CI) affects the quality of life in multiple sclerosis (MS). Identifying influencing factors is key to improving CI monitoring. This systematic review and meta-analysis examines clinical and sociodemographic variables impacting the cognitive screening Symbol Digit Modalities Test (SDMT) performance across MS subtypes, identifying subgroups at greater risk of cognitive impairment.

methodsRegistered on PROSPERO (CRD42023451696), a literature search was conducted on August 6, 2023, using PubMed, Embase, and CENTRAL. Following the PRISMA 2020 guideline, a random-effects meta-analysis addressed heterogeneity in correlation and meta-regression analyses. Multivariable regression model results were qualitatively synthesized (systematic review). The JBI Critical Appraisal Tool assessed bias risk. Primary outcome was SDMT raw scores, with EDSS and disease duration as primary exposures, extended with age, sex, education, depression, fatigue, mobility scores, and treatment as secondary exposures, according to our protocol. Associations were evaluated via univariate study-level correlations, univariate meta-regressions, study-level multivariable regression models, and multivariate meta-regressions, assessing covariate interdependence. Heterogeneity was quantified with I

resultsA total of 155 studies with 22,828 patients were analyzed. In mixed and relapsing-remitting MS (RRMS), EDSS was the strongest negative correlate of SDMT (mixed MS: -0.44 CI:[-0.50; -0.36]; RRMS: -0.47 [-0.66; -0.23]). Education showed a moderate positive correlation (mixed MS: 0.31 [0.20; 0.42]; RRMS: 0.32 [-0.02; 0.59]). Due to cross-sectional design, heterogeneity, and potential aggregation/ecological bias, findings are exploratory.

interpretationPoor SDMT performance is mainly driven by physical disability and cognitive reserve (education), modulated by sex, depression, and age, highlighting the need to integrate clinical and sociodemographic data in MS cognitive monitoring.

Indexed as

Cognitive DysfunctionMultiple SclerosisHumansSociodemographic Factorscognitive screeningmultiple sclerosispatient characteristicsSDMT

Identifiers

PMID40990412
PMCPMC12790164

What OpenQuestion holds

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Registered trials

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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.