ABSTRACT
The cognitive-motor interference (CMI) produced by simultaneous performance of a cognitive and a motor task has been proposed as a marker of real-life impairment of people with Multiple Sclerosis (pwMS), yet there is no consensus on the dual task (DT) procedure. This study aimed to compare DT performance of pwMS and healthy controls (HC) under different instructions and to examine its association with neuropsychological and clinical variables. PwMS (N = 23; relapsing-remitting course) and HC (N = 24) completed the cognitive (Verbal Fluency) and motor (walking) tasks under three conditions: independently or as single task (ST), both tasks simultaneously at best capacity or double prioritization (DT-DP), and only the cognitive task at best capacity while walking at preferred speed or cognitive prioritization (DT-CP). Compared to HC, pwMS walked significantly slower and produced less correct words under all conditions. The distance walked by pwMS and HC significantly differed between conditions (DT-CP< DT-DP< ST). PwMS produced more words during ST respective to DT-DP and DT-CP, with no difference between both DT conditions. HC showed no differences in cognitive performance between conditions. Motor and cognitive dual-task costs (DTC) were similar between groups. Only in pwMS, the cognitive DTC of DT-DP was different from zero. CMI measures correlated with neuropsychological, symptomatic, physiological (cognitive event-related potentials) and clinical variables. These results suggest that cognitive performance while walking is impaired in pwMS, but not in HC. CMI over cognitive performance might be a potential early marker of cognitive decline in pwMS, which may be enhanced by the instruction to prioritize both tasks in DT.
Subject(s)
Multiple Sclerosis, Relapsing-Remitting/physiopathology , Adult , Cognition , Female , Humans , Male , Middle Aged , Multiple Sclerosis, Relapsing-Remitting/psychology , Psychomotor Performance , Task Performance and AnalysisABSTRACT
Fundamento y objetivo: los programas de rehabilitación cognitiva están rindiendo resultados esperanzadores en la recuperación del deterioro cognitivo en pacientes con esclerosis múltiple (EM). En el presente proyecto de investigación se pretende analizar si un programa adaptado en nuestra unidad hospitalaria permite mejorar la atención visual de los pacientes con EM. Material y método: un total de 20 pacientes con EM fueron distribuidos en dos grupos: a) grupo tratamiento (participaron en un programa de rehabilitación durante 3 meses) y b) grupo control patológico (no participaron el programa). Se completó el estudio con un grupo de control sano con variables sociodemográficassimilares. El programa de rehabilitación fue una adaptación del Attention Process Training (APT). Los beneficiosde la aplicación del programa se evaluaron empleando un test de atención selectiva computarizado. Resultados: los pacientes del grupo de tratamiento mostraron mejoras en los tiempos de reacción tras la aplicación del programa; en cambio, los pacientes del grupo de control patológico o los controles sanos no. El beneficio del programa de rehabilitación se mantuvo hasta 4 meses después del cese de su aplicación. Conclusiones: el programa de rehabilitación produce mejoras en la capacidad de atención selectiva de los pacientes con EM que se mantienen incluso meses después de la aplicación del programa (AU)
Background and objective: Cognitive rehabilitation programs are producing hopeful results in the recovery of the cognitive impairment in multiple sclerosis patients (MS). The main aim in the present research project is to analyze if a rehabilitation program customized in our clinical unit allows improving attention system in MS patients. Materials and method: 20 patients with MS were distributed in two groups: a) Treatment (these patients received a rehabilitation program for three months), and b) Pathological (no program was applied). A third healthy control group was included with similar sociodemographical parameters. Cognitive rehabilitation program was adapted from the Attention Program Training (APT). Benefits from the application of the program were assessed by a computerized selective attention test. Results: Patients from treatment group experienced a benefit in reaction time after the application of the rehabilitation program. This benefit lasted four months after the completion of the rehabilitation program. Conclusions: Cognitive rehabilitation program induces benefits in the selective attention in multiple sclerosis patients and persist even months after the end of the treatment (AU)
