Profiling cognitive-motor interference in a large sample of persons with progressive multiple sclerosis and impaired processing speed: results from the CogEx study

R Veldkamp^{1

2}, M D'hooge^{3

4

5}, B M Sandroff^{6

7}, J DeLuca^{6

7}, D Kos^{5

8}, A Salter⁹, A Feinstein¹⁰, M P Amato^{11

12}, G Brichetto^{13

14}, J Chataway¹⁵, R Farrell¹⁵, N D Chiaravalloti^{6

7}, U Dalgas¹⁶, M Filippi^{17

18}, J Freeman¹⁹, R W Motl²⁰, C Meza¹⁰, M Inglese^{21

22}, M A Rocca^{17

18}, G Cutter²³, P Feys^{3

4}; CogEx Research Team

Affiliations

¹ REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium. Renee.Veldkamp@uhasselt.be.
² UMSC, Hasselt-Pelt, Belgium. Renee.Veldkamp@uhasselt.be.
³ REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
⁴ UMSC, Hasselt-Pelt, Belgium.
⁵ National MS Center Melsbroek, Steenokkerzeel, Belgium.
⁶ Kessler Foundation, East Hanover, NJ, USA.
⁷ Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.
⁸ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
⁹ Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern Medical Center, Dallas, TX, USA.
¹⁰ Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, M5R 3B6, Canada.
¹¹ Department NEUROFARBA, Section Neurosciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
¹² IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
¹³ Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149, Genoa, Italy.
¹⁴ AISM Rehabilitation Service, Italian Multiple Sclerosis Society (AISM), Via Operai 30, 16149, Genoa, Italy.
¹⁵ Queen Square MS Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK.
¹⁶ Exercise Biology, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus, Denmark.
¹⁷ Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, IRCCS, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
¹⁸ Vita-Salute San Raffaele University, Milan, Italy.
¹⁹ School of Health Professions, Faculty of Health, University of Plymouth, Devon, UK.
²⁰ Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA.
²¹ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
²² IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
²³ Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA.

PMID: 36881147
DOI: 10.1007/s00415-023-11636-y

Profiling cognitive-motor interference in a large sample of persons with progressive multiple sclerosis and impaired processing speed: results from the CogEx study

R Veldkamp et al. J Neurol. 2023 Jun.

. 2023 Jun;270(6):3120-3128.

doi: 10.1007/s00415-023-11636-y. Epub 2023 Mar 7.

Authors

Affiliations

¹ REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium. Renee.Veldkamp@uhasselt.be.
² UMSC, Hasselt-Pelt, Belgium. Renee.Veldkamp@uhasselt.be.
³ REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
⁴ UMSC, Hasselt-Pelt, Belgium.
⁵ National MS Center Melsbroek, Steenokkerzeel, Belgium.
⁶ Kessler Foundation, East Hanover, NJ, USA.
⁷ Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.
⁸ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
⁹ Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern Medical Center, Dallas, TX, USA.
¹⁰ Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, M5R 3B6, Canada.
¹¹ Department NEUROFARBA, Section Neurosciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
¹² IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
¹³ Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149, Genoa, Italy.
¹⁴ AISM Rehabilitation Service, Italian Multiple Sclerosis Society (AISM), Via Operai 30, 16149, Genoa, Italy.
¹⁵ Queen Square MS Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK.
¹⁶ Exercise Biology, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus, Denmark.
¹⁷ Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, IRCCS, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
¹⁸ Vita-Salute San Raffaele University, Milan, Italy.
¹⁹ School of Health Professions, Faculty of Health, University of Plymouth, Devon, UK.
²⁰ Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA.
²¹ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
²² IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
²³ Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA.

PMID: 36881147
DOI: 10.1007/s00415-023-11636-y

Abstract

Background: Performing cognitive-motor dual tasks (DTs) may result in reduced walking speed and cognitive performance. The effect in persons with progressive multiple sclerosis (pwPMS) having cognitive dysfunction is unknown.

Objective: To profile DT-performance during walking in cognitively impaired pwPMS and examine DT-performance by disability level.

Methods: Secondary analyses were conducted on baseline data from the CogEx-study. Participants, enrolled with Symbol Digit Modalities Test 1.282 standard deviations below normative value, performed a cognitive single task ([ST], alternating alphabet), motor ST (walking) and DT (both). Outcomes were number of correct answers on the alternating alphabet task, walking speed, and DT-cost (DTC: decline in performance relative to the ST). Outcomes were compared between EDSS subgroups (≤ 4, 4.5-5.5, ≥ 6). Spearman correlations were conducted between the DTC_motor with clinical measures. Adjusted significance level was 0.01.

Results: Overall, participants (n = 307) walked slower and had fewer correct answers on the DT versus ST (both p < 0.001), with a DTC_motor of 15.8% and DTC_cognitive of 2.7%. All three subgroups walked slower during the DT versus ST, with DTC_motor different from zero (p's < 0.001). Only the EDSS ≥ 6 group had fewer correct answers on the DT versus ST (p < 0.001), but the DTC_cognitive did not differ from zero for any of the groups (p ≥ 0.039).

Conclusion: Dual tasking substantially affects walking performance in cognitively impaired pwPMS, to a similar degree for EDSS subgroups.

Keywords: Cognitive–motor interference; Dual task; Gait; Multiple sclerosis; Progressive.

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References

1. Wajda DA, Sosnoff JJ (2015) Cognitive–motor interference in multiple sclerosis: a systematic review of evidence, correlates, and consequences. Biomed Res Int 2015:720856 - DOI - PMC
1. Postigo-Alonso B et al (2018) Cognitive–motor interference during gait in patients with multiple sclerosis: a mixed methods systematic review. Neurosci Biobehav Rev 94:126–148 - DOI
1. Leone C, Patti F, Feys P (2015) Measuring the cost of cognitive–motor dual tasking during walking in multiple sclerosis. Mult Scler 21(2):123–131 - DOI
1. Learmonth YC, Ensari I, Motl RW (2017) Cognitive motor interference in multiple sclerosis: insights from a systematic quantitative review. Arch Phys Med Rehabil 98(6):1229–1240 - DOI
1. Plummer P, Eskes G (2015) Measuring treatment effects on dual-task performance: a framework for research and clinical practice. Front Hum Neurosci 9:225 - DOI - PMC

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Profiling cognitive-motor interference in a large sample of persons with progressive multiple sclerosis and impaired processing speed: results from the CogEx study

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Profiling cognitive-motor interference in a large sample of persons with progressive multiple sclerosis and impaired processing speed: results from the CogEx study

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