Measuring the neuropsychological consequences of thrombotic thrombocytopenic purpura: a rapid literature review

Objectives: Thrombotic thrombocytopenic purpura (TTP) is a hematological disorder associated with potentially severe long-term health outcomes, including neuropsychological consequences. Guidelines recommend cognitive assessment for people with TTP, and an understanding of how the condition affects various cognitive domains can support decision-making for clinicians when selecting assessment measures.

Methods: A rapid literature review was conducted using MEDLINE Ultimate, CINAHL Ultimate and PsycINFO to appraise the existing evidence base regarding the impact of TTP on cognition, the measures used to assess cognitive impairment, and the correlates of cognitive impairment in this population group.

Results: Fourteen articles were eligible for inclusion and the results were summarized using a narrative synthesis. TTP is associated with impairment across all assessed cognitive domains. Cognitive impairment is associated with abnormal cerebral findings but not ADAMTS13 levels or severity and frequency of acute episodes. The sensitivity of brief screening measures in detecting TTP-related cognitive change is unclear.

Conclusion: Comprehensive cognitive assessment following TTP, including an exploration of possible confounding factors such as poor mental health, is recommended. Caution when relying on brief screening measures is advised.