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 DTCmotor 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 DTCmotor of 15.8% and DTCcognitive of 2.7%. All three subgroups walked slower during the DT versus ST, with DTCmotor 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 DTCcognitive 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.
Profiling cognitive–motor interference in a large sample of persons with progressive multiple sclerosis and impaired processing speed: results from the CogEx study / Veldkamp R.; D'hooge M.; Sandroff B.M.; DeLuca J.; Kos D.; Salter A.; Feinstein A.; Amato M.P.; Brichetto G.; Chataway J.; Farrell R.; Chiaravalloti N.D.; Dalgas U.; Filippi M.; Freeman J.; Motl R.W.; Meza C.; Inglese M.; Rocca M.A.; Cutter G.; Feys P.. - In: JOURNAL OF NEUROLOGY. - ISSN 0340-5354. - ELETTRONICO. - (2023), pp. 0-0. [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
Amato M. P.;
2023
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 DTCmotor 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 DTCmotor of 15.8% and DTCcognitive of 2.7%. All three subgroups walked slower during the DT versus ST, with DTCmotor 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 DTCcognitive 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.
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