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Verbal fluency in multiple sclerosis and neuromyelitis optica spectrum disorders: a systematic review and meta-analysis.

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Title: Verbal fluency in multiple sclerosis and neuromyelitis optica spectrum disorders: a systematic review and meta-analysis.
Authors: Grigoriadis, Panagiotis (AUTHOR), Bakirtzis, Christos (AUTHOR), Deftereos, Spyros N. (AUTHOR), Lallas, Konstantinos (AUTHOR), Goulis, Dimitrios G. (AUTHOR), Tsimpiris, Athanasios (AUTHOR), Tseriotis, Vasilis-Spyridon (AUTHOR), Anagnostis, Panagiotis (AUTHOR), Messinis, Lambros (AUTHOR)
Source: Journal of Clinical & Experimental Neuropsychology. Jul2026, Vol. 48 Issue 5, p493-506. 14p.
Subjects: Multiple sclerosis, Neuromyelitis optica, Verbal behavior testing, Evidence synthesis, Cognitive rehabilitation, Semantic memory, Cognition disorders, Phonemics
Abstract: Background: Cognitive impairment is common in people with multiple sclerosis and neuromyelitis optica spectrum disorders. Verbal fluency in particular has been receiving increasing attention over the last couple of years. Objective: This meta-analysis summarizes the existing evidence from previous studies on verbal fluency in people with multiple sclerosis and neuromyelitis optica spectrum disorders. Methods: The MOOSE guidelines for meta-analyses of observational studies were followed. A systematic literature search was conducted in MEDLINE, Scopus, and the Cochrane Library from January 1990 to March 2025. Sixty-nine (69) studies were included in the synthesis. Results: People with multiple sclerosis performed significantly worse than healthy controls in both phonemic (n = 50, SMD −0.82, 95% CI −0.94 to −0.71, I2 68%, p < 0.00001) and semantic fluency (n = 46, SMD −0.81, 95% CI −0.95 to −0.68, I2 80%, p < 0.00001). Similar results were observed in people with neuromyelitis optica spectrum disorders for phonemic (n = 5; SMD −0.49, 95% CI −0.73 to −0.26, I2 27%, p < 0.0001) and semantic fluency (n = 7, SMD −0.57, 95% CI −0.85 to −0.29, I2 48%, p < 0.0001). No significant differences in performance were found between the two clinical entities for either phonemic (n = 5, SMD −0.01, 95% CI −0.21 to −0.19, I2 0%, p = 0.92) or semantic fluency (n = 5, SMD −0.01, 95% CI −0.39 to −0.41, I2 58%, p = 0.97). Analysis within the group of people with multiple sclerosis indicated poorer performance in those with the progressive forms than in those with relapsing-remitting multiple sclerosis in both phonemic (n = 10, SMD −0.43, 95% CI −0.13 to −0.73, I2 81%, p = 0.005) and semantic fluency (n = 10, SMD −0.55, 95% CI −0.32 to −0.79, I2 64%, p < 0.00001). Conclusions: Verbal fluency may be a clinically relevant marker of cognitive dysfunction in multiple sclerosis and neuromyelitis optica spectrum disorders. Routine testing may help identify patients who could benefit from targeted cognitive rehabilitation interventions. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Background: Cognitive impairment is common in people with multiple sclerosis and neuromyelitis optica spectrum disorders. Verbal fluency in particular has been receiving increasing attention over the last couple of years. Objective: This meta-analysis summarizes the existing evidence from previous studies on verbal fluency in people with multiple sclerosis and neuromyelitis optica spectrum disorders. Methods: The MOOSE guidelines for meta-analyses of observational studies were followed. A systematic literature search was conducted in MEDLINE, Scopus, and the Cochrane Library from January 1990 to March 2025. Sixty-nine (69) studies were included in the synthesis. Results: People with multiple sclerosis performed significantly worse than healthy controls in both phonemic (n = 50, SMD −0.82, 95% CI −0.94 to −0.71, I2 68%, p < 0.00001) and semantic fluency (n = 46, SMD −0.81, 95% CI −0.95 to −0.68, I2 80%, p < 0.00001). Similar results were observed in people with neuromyelitis optica spectrum disorders for phonemic (n = 5; SMD −0.49, 95% CI −0.73 to −0.26, I2 27%, p < 0.0001) and semantic fluency (n = 7, SMD −0.57, 95% CI −0.85 to −0.29, I2 48%, p < 0.0001). No significant differences in performance were found between the two clinical entities for either phonemic (n = 5, SMD −0.01, 95% CI −0.21 to −0.19, I2 0%, p = 0.92) or semantic fluency (n = 5, SMD −0.01, 95% CI −0.39 to −0.41, I2 58%, p = 0.97). Analysis within the group of people with multiple sclerosis indicated poorer performance in those with the progressive forms than in those with relapsing-remitting multiple sclerosis in both phonemic (n = 10, SMD −0.43, 95% CI −0.13 to −0.73, I2 81%, p = 0.005) and semantic fluency (n = 10, SMD −0.55, 95% CI −0.32 to −0.79, I2 64%, p < 0.00001). Conclusions: Verbal fluency may be a clinically relevant marker of cognitive dysfunction in multiple sclerosis and neuromyelitis optica spectrum disorders. Routine testing may help identify patients who could benefit from targeted cognitive rehabilitation interventions. [ABSTRACT FROM AUTHOR]
ISSN:13803395
DOI:10.1080/13803395.2026.2654022