A Scoping Review on Cognition in Myelodysplastic Syndromes: Advances and Challenges.

Q1 Medicine
Anna Tsiakiri, Konstantinos Frigkas, Pinelopi Vlotinou, Menelaos Papoutselis, Foteini Christidi, Efstratios Karavasilis, Ioannis Kotsianidis, Nikolaos Kourkoutsakis, Konstantinos Vadikolias, Konstantinos Liapis
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Abstract

Background/objectives: Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis and a risk of progression to acute myeloid leukemia (AML). Cognitive impairments, including deficits in memory, attention, and executive function, are frequently reported in MDS patients. These impairments are linked to systemic inflammation, neurotoxic treatment effects, and the psychological burden of chronic disease. This review synthesizes existing evidence on cognitive dysfunction in MDS, highlighting knowledge gaps and opportunities for future research.

Methods: A scoping review was conducted following PRISMA-ScR guidelines. MEDLINE and Scopus databases were searched for studies examining cognition in MDS patients, using terms like "myelodysplastic syndromes" and "cognition." Inclusion criteria were original, English-language studies reporting cognitive outcomes in MDS. Reviews, animal studies, and abstracts were excluded. Data on study design, patient characteristics, cognitive tests, and outcomes were extracted and descriptively analyzed.

Results: The review included 25 studies involving 2390 patients with hematologic malignancies, 493 of whom had MDS. Key findings identified cognitive deficits primarily in attention, executive function, and memory. Systemic inflammation and treatment-related neurotoxicity were significant contributors, with older age compounding these effects. Longitudinal studies demonstrated persistent cognitive challenges post-treatment, though the severity varied by patient demographics and therapeutic regimens.

Conclusions: Cognitive impairments in MDS are multifactorial and significantly impact patients' quality of life. Current research highlights the need for routine cognitive assessments and targeted interventions. Future studies should focus on longitudinal designs to explore specific cognitive domains and develop therapeutic strategies to mitigate cognitive decline.

骨髓增生异常综合征认知的范围综述:进展与挑战。
背景/目的:骨髓增生异常综合征(MDS)是一种以造血功能无效为特征的克隆性造血疾病,具有发展为急性髓性白血病(AML)的风险。认知障碍,包括记忆、注意力和执行功能的缺陷,在MDS患者中经常被报道。这些损伤与全身性炎症、神经毒性治疗效果和慢性疾病的心理负担有关。本文综述了MDS认知功能障碍的现有证据,强调了知识差距和未来研究的机会。方法:根据PRISMA-ScR指南进行范围审查。使用“骨髓增生异常综合征”和“认知”等术语搜索MEDLINE和Scopus数据库,以检查MDS患者的认知能力。纳入标准是报道MDS患者认知结果的原始英语研究。综述、动物研究和摘要被排除在外。提取有关研究设计、患者特征、认知测试和结果的数据并进行描述性分析。结果:本综述纳入25项研究,涉及2390例血液系统恶性肿瘤患者,其中493例患有MDS。主要发现发现认知缺陷主要在注意力、执行功能和记忆方面。全身性炎症和治疗相关的神经毒性是重要的因素,年龄的增长使这些影响更加复杂。纵向研究显示治疗后持续的认知挑战,尽管严重程度因患者人口统计和治疗方案而异。结论:MDS患者的认知障碍是多因素的,显著影响患者的生活质量。目前的研究强调需要进行常规的认知评估和有针对性的干预。未来的研究应该集中在纵向设计上,以探索特定的认知领域,并制定治疗策略来减轻认知能力下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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