Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany.
Ambulatory Assessment in Psychology, Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany.
Sci Rep. 2024 Mar 26;14(1):7096. doi: 10.1038/s41598-024-53750-5.
Socio-cognitive impairment is frequent in multiple sclerosis (MS). However, little is known about the relationship between other potentially relevant clinical symptoms (i.e., cognition, depression, fatigue) and the degree of socio-cognitive impairment, and neural mechanisms underlying socio-cognitive deficits in MS. Therefore, we meta-analytically quantified socio-cognitive impairment in MS. A systematic literature search in MEDLINE Ovid, Web of Science Core Collection, CENTRAL, and PsycInfo was conducted until December 2022. Studies investigating affective or cognitive theory of mind (a/cToM), visual perspective taking (VPT) and social decision making (SDM) in MS patients relative to healthy controls were included. Risk-of-bias (RoB) was assessed using the CLARITY group "Tool for Assessing RoB in Cohort Studies". Mediation analysis investigated the contribution of clinical symptoms to socio-cognitive impairment. In total, n = 8534 studies were screened, 58 were included in the systematic review, 27 in the meta-analyses. Most studies were rated with a moderate RoB. Meta-analyses confirmed impairment of both aToM and cToM in MS patients, with larger effect sizes for aToM. Mediation analysis demonstrated that higher levels of fatigue selectively predicted the degree of cToM impairment. There was insufficient data available to quantify impairment in other socio-cognitive domains. Fourteen structural and functional imaging studies were identified and characterized by substantial heterogeneity. Summarized, this study confirmed substantial socio-cognitive impairment in MS and highlights the potential exacerbating role of comorbid clinical symptoms. We identify several evidence gaps that need to be addressed in future large-scale studies using comprehensive and coordinated assessments of socio-cognitive parameters, potential mediators, and neural correlates.Trial registration: The pre-registered review protocol can be assessed at www.crd.york.ac.uk/PROSPERO/ (ID: CRD42020206225).
社会认知障碍在多发性硬化症（MS）中很常见。然而，人们对其他潜在相关临床症状（即认知、抑郁、疲劳）与社会认知障碍程度之间的关系，以及多发性硬化症中社会认知缺陷的神经机制知之甚少。因此，我们对 MS 中的社会认知障碍进行了荟萃分析。在 2022 年 12 月之前，我们在 MEDLINE Ovid、Web of Science Core Collection、CENTRAL 和 PsycInfo 中进行了系统的文献检索。纳入了研究 MS 患者相对于健康对照组的情感或认知心理理论（a/cToM）、视觉观点采择（VPT）和社会决策（SDM）的研究。使用 CLARITY 组“用于评估队列研究中的 RoB 的工具”评估风险偏倚（RoB）。中介分析调查了临床症状对社会认知障碍的贡献。总共筛选了 n=8534 项研究，58 项研究纳入系统评价，27 项研究纳入荟萃分析。大多数研究的 RoB 被评为中度。荟萃分析证实 MS 患者的 aToM 和 cToM 均受损，aToM 的效应量更大。中介分析表明，更高水平的疲劳选择性地预测了 cToM 损伤的程度。没有足够的数据来量化其他社会认知领域的损伤。确定了 14 项结构和功能成像研究，并对其进行了特征描述，具有很大的异质性。综上所述，这项研究证实了 MS 中存在大量的社会认知障碍，并强调了合并的临床症状可能会加剧这种障碍。我们确定了一些证据空白，需要在未来的大型研究中使用社会认知参数、潜在中介物和神经相关性的综合和协调评估来解决这些空白。试验注册：可在 www.crd.york.ac.uk/PROSPERO/（ID：CRD42020206225）评估预先注册的综述方案。
