Effect of vestibular training on cognitive functions in people with multiple sclerosis: A randomized controlled trial

Abstract

Background: Cognitive dysfunction is prevalent but inadequately treated in people with multiple sclerosis (PwMS). Central vestibular functions are associated with multiple cognitive domains in PwMS, even when controlling for disability status. To our knowledge, the effectiveness of vestibular training on cognition in PwMS has never been explored. The study's purpose was to determine the effect of vestibular training on PwMS's cognitive functions.

Methods: Forty PwMS with relapsing-remitting MS, primarily fatigued, were randomly divided into two equal groups. The control group (GI) was treated with aerobic endurance exercises using stationary bicycle training. The study group (GII) was treated with aerobic endurance exercises as GI in addition to a designed vestibular training program. Outcome measures of cognition were assessed pre- and post-treatment using the Arabic version of Brief International Cognitive Assessment for MS (BICAMS-A) and serum Brain-derived neurotrophic factor (BDNF).

Results: Post-treatment, there was a significant increase of oral Symbol Digit Modalities Test (SDMT), California Verbal Learning Test II (CVLT-II), revised Brief Visuospatial retention Test (BVRT-R) of BICAMS-A and serum BDNF in both study and control groups. There was a significant increase in CVLT-II, BVRT-R of BICAMS-A and serum BDNF in the study group compared to the control group (P < 0.05).

Conclusion: Vestibular training is an effective and innovative approach for improving cognitive functions in PwMS.

Trial registration: PACTR202311670782148.

Keywords: Cognitive functions; Multiple sclerosis; Vestibular system; Vestibular training.