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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]
Copyright of Journal of Clinical & Experimental Neuropsychology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Verbal fluency in multiple sclerosis and neuromyelitis optica spectrum disorders: a systematic review and meta-analysis.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Grigoriadis%2C+Panagiotis%22&quot;&gt;Grigoriadis, Panagiotis&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bakirtzis%2C+Christos%22&quot;&gt;Bakirtzis, Christos&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Deftereos%2C+Spyros+N%2E%22&quot;&gt;Deftereos, Spyros N.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lallas%2C+Konstantinos%22&quot;&gt;Lallas, Konstantinos&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Goulis%2C+Dimitrios+G%2E%22&quot;&gt;Goulis, Dimitrios G.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tsimpiris%2C+Athanasios%22&quot;&gt;Tsimpiris, Athanasios&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tseriotis%2C+Vasilis-Spyridon%22&quot;&gt;Tseriotis, Vasilis-Spyridon&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Anagnostis%2C+Panagiotis%22&quot;&gt;Anagnostis, Panagiotis&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Messinis%2C+Lambros%22&quot;&gt;Messinis, Lambros&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Multiple+sclerosis%22&quot;&gt;Multiple sclerosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Neuromyelitis+optica%22&quot;&gt;Neuromyelitis optica&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Verbal+behavior+testing%22&quot;&gt;Verbal behavior testing&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Evidence+synthesis%22&quot;&gt;Evidence synthesis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cognitive+rehabilitation%22&quot;&gt;Cognitive rehabilitation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Semantic+memory%22&quot;&gt;Semantic memory&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cognition+disorders%22&quot;&gt;Cognition disorders&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Phonemics%22&quot;&gt;Phonemics&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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 &lt; 0.00001) and semantic fluency (n = 46, SMD −0.81, 95% CI −0.95 to −0.68, I2 80%, p &lt; 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 &lt; 0.0001) and semantic fluency (n = 7, SMD −0.57, 95% CI −0.85 to −0.29, I2 48%, p &lt; 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 &lt; 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]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: &lt;i&gt;Copyright of Journal of Clinical &amp; Experimental Neuropsychology is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=195034530
RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1080/13803395.2026.2654022
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 493
    Subjects:
      – SubjectFull: Multiple sclerosis
        Type: general
      – SubjectFull: Neuromyelitis optica
        Type: general
      – SubjectFull: Verbal behavior testing
        Type: general
      – SubjectFull: Evidence synthesis
        Type: general
      – SubjectFull: Cognitive rehabilitation
        Type: general
      – SubjectFull: Semantic memory
        Type: general
      – SubjectFull: Cognition disorders
        Type: general
      – SubjectFull: Phonemics
        Type: general
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      – TitleFull: Verbal fluency in multiple sclerosis and neuromyelitis optica spectrum disorders: a systematic review and meta-analysis.
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              M: 07
              Text: Jul2026
              Type: published
              Y: 2026
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