Upper and Lower Extremity Motor Function and Cognitive Impairment in Multiple Sclerosis

Abstract

Motor impairments and cognitive dysfunction are common in multiple sclerosis (MS). We aimed to delineate the relationship between cognitive capacity and upper and lower motor function in 211 MS patients, and 120 healthy volunteers. Lower and upper motor function were assessed with the Timed 25 Foot Walk (T25FW) and the Nine Hole Peg Test (NHPT) as implemented in the Multiple Sclerosis Functional Composite (MSFC). Subjects also underwent neuropsychological evaluation. Hierarchical linear regression analysis was conducted separately for the MS and healthy groups with the T25FW and NHPT serving as the outcome measures. Cognitive performance indices served as predictors. As expected, healthy subjects performed better than the MS group on all measures. Processing speed and executive function tests were significant predictors of lower and upper motor function in both groups. Correlations were more robust in the MS group, where cognitive tests predicted variability in motor function after controlling for disease duration and physical disability. In conclusion, we find evidence of higher order cognitive control of motor function that appears to be particularly salient in this large and representative MS sample. The findings may have implications for risk assessment and treatment of mobility dysfunction in MS.

Correlation of the VEMP score, ambulation and upper extremity function in clinically isolated syndrome

“…It has been shown that processing speed and executive function tests were significant predictors of lower and upper motor function in MS; where cognitive tests predicted variability in motor function after controlling for disease duration and physical disability. (20) We found a modest correlation between PASAT and T25FW, however, this effect was reduced to non-significant after controlling for age and EDSS.…”

The Relationship Between Balance Confidence and Cognitive Motor Interference in Individuals With Multiple Sclerosis

“…Given that there is evidence of coupling between cognitive and motor function in MS (Benedict et al, 2011) and in other clinical populations (Verghese et al, 2002) this was an unexpected observation. A potential explanation of this lack of association is that there may be distinct underlying mechanisms.…”

Cognitive and motor functioning in patients with multiple sclerosis: Neuropsychological predictors of walking speed and falls

“…A dual task paradigm was also used to show that patients with MS had greater decrements in walking speed than healthy controls, and that the degree of the decrement was related to fatigue, measures of general cognitive function and self-reported cognitive errors rather than measures of overall disability [27]. Processing speed and EF were also found to be significant predictors of lower and upper motor function in patients with MS [28].…”