PDF(Pubmed)
Abstract：
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).
摘要：
社会认知障碍在多发性硬化症（MS）中很常见。然而,对其他潜在相关临床症状之间的关系知之甚少(即，认知，抑郁症,疲劳)和社会认知障碍的程度，以及MS社会认知缺陷的潜在神经机制。因此,我们meta分析量化了MS的社会认知障碍。在MEDLINEOvid进行系统的文献检索，WebofScience核心合集,中部,和PsycInfo进行到2022年12月。调查情感或认知心理理论(a/cToM)的研究，包括MS患者相对于健康对照的视觉视角（VPT）和社会决策（SDM）。使用CLARITY组“队列研究中评估RoB的工具”评估偏倚风险(RoB)。中介分析调查了临床症状对社会认知障碍的贡献。总的来说,n=8534项研究进行了筛选，58人被纳入系统审查，27在荟萃分析中。大多数研究被评价为中度RoB。Meta分析证实MS患者的aToM和cToM均受损，具有更大的aToM效果大小。中介分析表明，较高的疲劳水平选择性地预测了cToM损害的程度。没有足够的数据来量化其他社会认知领域的损害。鉴定了14项结构和功能成像研究，并以大量异质性为特征。总结，这项研究证实了MS患者的实质性社会认知障碍,并强调了合并症临床症状的潜在加重作用.我们确定了一些需要在未来的大规模研究中使用社会认知参数的全面和协调评估来解决的证据差距，潜在的调解员,和神经相关。试用注册：预先注册的审查协议可以在www上进行评估。crd.约克。AC.英国/PROSPERO/（ID：CRD42020206225）。
