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Volume 14
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10.3390/jcm14082630
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Background:
Systematic Review

Cognitive Impairment in Newly Diagnosed Patients with Multiple Sclerosis: A Systematic Review of Related Molecular Biomarkers and a Meta-Analysis of Associated Demographic and Disease-Related Characteristics

by
Konstantina Stavrogianni
1,2,
Vasileios Giannopapas
1,3,4,
Dimitrios K. Kitsos
1,
Niki Christouli
1,
Vassiliki Smyrni
1,
Athanasios K. Chasiotis
1,3,4,
Alexandra Akrivaki
1,
Evangelia-Makrina Dimitriadou
1,
John S. Tzartos
1,
Georgios Tsivgoulis
1,
George P. Paraskevas
1,
Dimitrios Peschos
2,
Konstantinos I. Tsamis
2 and
Sotirios Giannopoulos
1,*
1
Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
2
Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
3
Department of Physical Therapy, University of West Attica, 12243 Athens, Greece
4
Laboratory of Neuromuscular and Cardiovascular Study of Motion (LANECASM), University of West Attica, 12243 Athens, Greece
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(8), 2630; https://doi.org/10.3390/jcm14082630
Submission received: 28 February 2025 / Revised: 30 March 2025 / Accepted: 9 April 2025 / Published: 11 April 2025
(This article belongs to the Special Issue Biomarkers and Diagnostics in Neurological Diseases)
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Abstract

Background/Objectives: Neuropsychological impairment (NI) is common in newly diagnosed patients with multiple sclerosis (pwMS). This study has two main objectives; the systematic review aims to describe the relationship between NI and molecular biomarkers in newly diagnosed pwMS, and the meta-analysis aims to explore the relationship between NI, age, disability status, and disease duration in this patient group. Methods: We conducted a systematic review, with 20 studies meeting the inclusion criteria. Out of these, 12 studies were included in the meta-analysis. We analyzed three key cognitive measures—the Symbol Digit Modalities Test (SDMT), the Paced Auditory Serial Addition Test (PASAT), and the Selective Reminding Test–long-term storage (SRT-LTS)—in relation to demographic and MS-related characteristics. Results: Neurofilament light chain (NfL) levels were consistently associated with NI, especially a slower information processing speed (IPS). Other biomarkers, including chitinase 3-like 1 (CHI3L1), brain-derived neurotrophic factor (BDNF), apolipoprotein E4 allele (APOE4), and vitamin D, also showed promising correlations with NI. A meta-regression analysis of 2380 pwMS indicated a negative association between SDMT score and disability status (p = 0.01). No significant associations were found for the PASAT with age, disability status, or disease duration (p > 0.05). Conclusions: These findings highlight the role of NfL as a biomarker related to NI in newly diagnosed pwMS and the association between IPS and disability status. Further research is needed with more homogeneous samples in terms of the disease duration, along with standardized cognitive assessments and a broader range of biomarkers, to improve our understanding and management of cognitive difficulties in the early stages of MS.
Keywords: multiple sclerosis; neuropsychological impairment; processing speed; biomarkers; neurofilament light chain (NfL) multiple sclerosis; neuropsychological impairment; processing speed; biomarkers; neurofilament light chain (NfL)

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MDPI and ACS Style

Stavrogianni, K.; Giannopapas, V.; Kitsos, D.K.; Christouli, N.; Smyrni, V.; Chasiotis, A.K.; Akrivaki, A.; Dimitriadou, E.-M.; Tzartos, J.S.; Tsivgoulis, G.; et al. Cognitive Impairment in Newly Diagnosed Patients with Multiple Sclerosis: A Systematic Review of Related Molecular Biomarkers and a Meta-Analysis of Associated Demographic and Disease-Related Characteristics. J. Clin. Med. 2025, 14, 2630. https://doi.org/10.3390/jcm14082630

AMA Style

Stavrogianni K, Giannopapas V, Kitsos DK, Christouli N, Smyrni V, Chasiotis AK, Akrivaki A, Dimitriadou E-M, Tzartos JS, Tsivgoulis G, et al. Cognitive Impairment in Newly Diagnosed Patients with Multiple Sclerosis: A Systematic Review of Related Molecular Biomarkers and a Meta-Analysis of Associated Demographic and Disease-Related Characteristics. Journal of Clinical Medicine. 2025; 14(8):2630. https://doi.org/10.3390/jcm14082630

Chicago/Turabian Style

Stavrogianni, Konstantina, Vasileios Giannopapas, Dimitrios K. Kitsos, Niki Christouli, Vassiliki Smyrni, Athanasios K. Chasiotis, Alexandra Akrivaki, Evangelia-Makrina Dimitriadou, John S. Tzartos, Georgios Tsivgoulis, and et al. 2025. "Cognitive Impairment in Newly Diagnosed Patients with Multiple Sclerosis: A Systematic Review of Related Molecular Biomarkers and a Meta-Analysis of Associated Demographic and Disease-Related Characteristics" Journal of Clinical Medicine 14, no. 8: 2630. https://doi.org/10.3390/jcm14082630

APA Style

Stavrogianni, K., Giannopapas, V., Kitsos, D. K., Christouli, N., Smyrni, V., Chasiotis, A. K., Akrivaki, A., Dimitriadou, E.-M., Tzartos, J. S., Tsivgoulis, G., Paraskevas, G. P., Peschos, D., Tsamis, K. I., & Giannopoulos, S. (2025). Cognitive Impairment in Newly Diagnosed Patients with Multiple Sclerosis: A Systematic Review of Related Molecular Biomarkers and a Meta-Analysis of Associated Demographic and Disease-Related Characteristics. Journal of Clinical Medicine, 14(8), 2630. https://doi.org/10.3390/jcm14082630

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