ArticleJournal of neurology2026
Trajectories of processing speed in multiple sclerosis across disease-modifying therapies.
Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
Funding
Abstract
backgroundCognitive impairment is a common feature of multiple sclerosis (MS), affecting daily functioning and quality of life. We aimed to investigate how disease-modifying therapies (DMTs) of varying efficacy are associated with long-term cognitive trajectories in MS, as measured by the Symbol Digit Modalities Test (SDMT).
methodsUsing the data from Swedish population-based MS cohorts linked to the Swedish MS registry, we included individuals with relapsing-onset MS receiving DMT to evaluate longitudinal SDMT trajectories. From a cohort of 5467 treated individuals, several analytic subsets were defined for specific trajectory analyses. Mixed-effects models were used to examine changes in cognitive performance across treatment categories, including platform therapies, high-efficacy therapies overall, and specific high-efficacy agents.
resultsSDMT scores increased during the first years of follow-up among individuals initiating high-efficacy DMT and subsequently declined, whereas changes in the platform group were smaller over time. Differences between groups were observed at years 3 and 4, with an estimated difference of approximately 2 points, which were not sustained at later follow-up. When compared with anti-CD20 therapies, natalizumab-treated individuals showed a greater early increase (β - 0.77, 95% CI - 1.26, - 0.27) and a more pronounced subsequent decline (β 0.38, 95% CI 0.21-0.55), with trajectories converging over time. Adjustment for repeated testing attenuated early increases in SDMT scores.
conclusionsThere was limited evidence for a sustained or clinically relevant short-term effect of high-efficacy DMTs on cognitive trajectories in MS. Differences between groups and changes over time are likely influenced by underlying patient characteristics and practice effects related to repeated testing.
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