Posture-Motor and Posture-Ideomotor Dual-Tasking: A Putative Marker of Psychomotor Retardation and Depressive Rumination in Patients With Major Depressive Disorder

Abstract

Background: Recent studies have demonstrated that the assessment of postural performance may be a potentially reliable and objective marker of the psychomotor retardation (PMR) in the major depressive disorder (MDD). One of the important facets of MDD-related PMR is reflected in disrupted central mechanisms of psychomotor control, heavily influenced by compelling maladaptive depressive rumination. In view of this we designed a research paradigm that included sequential execution of simple single-posture task followed by more challenging divided attention posture tasks, involving concurring motor and ideomotor workloads. Another difficulty dimension assumed executing of all the tasks with eyes open (EO) (easy) and closed (EC) (difficult) conditions. We aimed at investigating the interplay between the severity of MDD, depressive rumination, and efficiency of postural performance.Methods: Compared with 24 age- and body mass index-matched healthy controls (HCs), 26 patients with MDD sequentially executed three experimental tasks: (1) single-posture task of maintaining a quiet stance (ST), (2) actual posture-motor dual task (AMT); and (3) mental/imaginary posture-motor dual task (MMT). All the tasks were performed in the EO and the EC conditions. The primary dependent variable was the amount of kinetic energy (E) expended for the center of pressure deviations (CoPDs), whereas the absolute divided attention cost index showed energy cost to the dual-tasking vs. the single-posture task according to the formula: ΔE = (EDual-task - ESingle-task).Results: The signs of PMR in the MDD group were objectively indexed by deficient posture control in the EC condition along with overall slowness of fine motor and ideomotor activity. Another important and probably more challenging feature of the findings was that the posture deficit manifested in the ST condition was substantially and significantly attenuated in the MMT and AMT performance dual-tasking activity. A multiple linear regression analysis evidenced further that the dual-tasking energy cost (i.e., ΔE) significantly predicted clinical scores of severity of MDD and depressive rumination.Conclusion: The findings allow to suggest that execution of concurrent actual or imaginary fine motor task with closed visual input deallocates attentional resources from compelling maladaptive depressive rumination thereby attenuating severity of absolute dual-tasking energy costs for balance maintenance in patients with MDD.Significance: Quantitative assessment of PMR through measures of the postural performance in dual-tasking may be useful to capture the negative impact of past depressive episodes, optimize the personalized treatment selection, and improve the understanding of the pathophysiological mechanisms underlying MDD.

Psychophysiological Indicators of Postural Control. Contribution of the Russian Scientific School. Part I

“…Despite the well-known interaction between sensory and motor systems in balance maintenance and the possibility of training postural muscles [ 81 ], the process of triggering muscle reactions opposing natural postural instability has not been completely elucidated. Moreover, it is unclear why the performance of a cognitive or psychomotor task does not decrease but even increases postural stability in some groups of healthy subjects [ 82 ] and patients with depression [ 83 ].…”

“…The role of cognitive factors, including distribution of attention in the balance maintenance system, is assessed using the paradigm of dual cognitive-postural tasks [ 83 , 101 , 102 ]. Healthy young people can easily execute the tasks for maintaining balance in combination with other types of activity such as conversation or reading.…”

Movement disorders in psychiatric patients

“…These subjects do have reduced fingertapping speed and defective postural control which, in contrast to PD, improve with dual task activity. 54 It has been theorised that depressive rumination interferes with movement control, and that concentration on Open access a second task may be helping by drawing attentional resources away from it.…”

Dual-tasks is an indicator of cognitive deficit specificity in patients after traumatic brain injury

“…В связи с этим возникает необходимость изучения особенностей работы мозга в условиях сложной интеллектуальной деятельности человека, которая может включать одновременное выполнение когнитивных и моторных задач. Наиболее удачной моделью такой сложной деятельности человека являются так называемые двойные задачи [6][7][8][9][10][11].…”

“…Как правило, пациенты выполняют компоненты двойных задач не одновременно, а последовательно -вначале моторную задачу, как биологически более важную и только после этого -когнитивную [10]. Использование двойных задач может быть полезным диагностическим подходом, позволяющим оценить степень нарушения отдельных функций при различных формах церебральной патологии, в том числе и ЧМТ [11][12][13].…”