Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-09T22:04:19.311Z Has data issue: false hasContentIssue false
  • English
  • Français

Balancing the Demands of Two Tasks: An Investigation of Cognitive–Motor Dual-Tasking in Relapsing Remitting Multiple Sclerosis

Published online by Cambridge University Press:  22 September 2017

Emma Butchard-MacDonald ,
Lorna Paul  and
Jonathan J. Evans
Emma Butchard-MacDonald
Affiliation:
Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
Lorna Paul
Affiliation:
Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom
Jonathan J. Evans*
Affiliation:
Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
*
Correspondence and reprint requests to: Jonathan J. Evans, Mental Health & Wellbeing, University of Glasgow, Gartnaval Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance. Objectives: This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined. Methods: A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measured via the Modified Fatigue Index Scale. Results: No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p=.007), but not a stable surface (p=.679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho=0.527; p=.001) and depression (rho=0.451; p=.007). Conclusions: RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties. (JINS, 2018, 24, 247–258)

Keywords

AttentionAnxietyBalancePosturalCognitionFalls
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 3 , March 2018 , pp. 247 - 258
Copyright
Copyright © The International Neuropsychological Society 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aydin, Y., Irek, C., Guclu-Gunduz, A., Ozkan, T., Yazici, G., Ozkul, C., & Batur-Caglayan, H. (2015). Assessing the construct validity of the BESTest in people with multiple sclerosis. ECTRIMS Online Library, 115190.Google Scholar
Baddeley, A.D., Della Sala, S., Gray, C., Papagno, C., & Spinnler, H. (1997). Testing central executive functioning with a pencil-and-paper test. In: P. Rabbitt (Ed.), Methodology of frontal and executive functions (pp. 61–80). Hove: Psychology Press.Google Scholar
Biodex. (2015). Biosway portable balance system. Retrieved from http://www.biodex.com/sites/default/files/950460man_10202revd.pdf Google Scholar
Bjelland, I., Dahl, A.A., Haug, T.T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression: An updated literature review. Journal of Psychosomatic Research, 52, 69–77.Google Scholar
Boes, M.K., Sosnoff, J.J., Socie, M.J., Sandroff, B.M., Pula, J.H., & Motl, R.W. (2012). Postural control in multiple sclerosis: Effects of disability status and dual task. Journal of Neurological Sciences, 315, 44–48.Google Scholar
Cameron, M.H., & Lord, S. (2010). Postural control in multiple sclerosis: Implications for fall prevention. Current Neurology and Neuroscience Reports, 10, 407–412.Google Scholar
Castelli, L., De Luca, F., Marchetti, M.R., Sellitto, G., Fanelli, F., & Prosperini, L. (2016). The dual task-cost of standing balance affects quality of life in mildly disabled MS people. Neurological Sciences, 37, 673–679.Google Scholar
Cattaneo, D., De Nuzzo, C., Fascia, T., Macalli, M., Pisoni, I., & Cardini, R. (2002). Risk of falls in subjects with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 83, 864–867.Google Scholar
Cocchini, G., Della Sala, S., Logie, R.H., Pagani, R., Sacco, L., & Spinnler, H. (2004). Dual task effects of walking when talking in Alzheimer’s disease. Revue Neurologique, 160, 74–80.Google Scholar
Denney, D.R., Sworowski, L.A., & Lynch, S.G. (2005). Cognitive impairment in three subtypes of multiple sclerosis. Archives of Clinical Neuropsychology, 20(8), 967–981.Google Scholar
Donker, S.F., Roerdink, M., Greven, A.J., & Beek, P.J. (2007). Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control. Experimental Brain Research, 181, 1–11.Google Scholar
Evans, J.J., Cullen, B., Paul, L., Frei, L., Norrie, J., & O’Leary, C. (2014). Understanding and assessing dual-tasking deficits in people with Multiple Sclerosis (Abstract). Journal of the International Neuropsychological Society, 20(Suppl 2), 84.Google Scholar
Evans, J.J., Greenfield, E., Wilson, B.A., & Bateman, A. (2009). Walking and talking therapy: Improving cognitive–motor dual-tasking in neurological illness. Journal of the International Neuropsychological Society, 15, 112–120.Google Scholar
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.Google Scholar
Field, A., & Hole, G. (2003). How to design and report experiments. London: Sage.Google Scholar
Goretti, B., Niccolai, C., Hakiki, B., Sturchio, A., Falautano, M., Minacapelli, E., & Amato, M.P. (2014). The brief international cognitive assessment for multiple sclerosis (BICAMS): Normative values with gender, age and education corrections in Italian population. BMC Neurology, 14(171), 1–6.Google Scholar
Hamilton, F., Rochester, L., Paul, L., Rafferty, D., O’Leary, C.P., & Evans, J.J. (2009). Walking and talking: An investigation of cognitive-motor dual tasking in multiple sclerosis. Multiple Sclerosis, 15(10), 1215–1227.Google Scholar
Hodges, J.R. (2007). Cognitive assessment for clinicians (2nd ed.). Oxford: Oxford University Press.Google Scholar
Hobart, J., Lamping, D., Fitzpatrick, R., Riazi, A., & Thompson, A. (2001). The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain, 124, 962–973.Google Scholar
Hsieh, S., Schubert, S., Hoon, C., Mioshi, E., & Hodges, J.R. (2013). Validation of the Addenbrooke’s Cognitive Examination III in frontotemporal dementia and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 36(3-4), 242–250.Google Scholar
James, M., Plant, G.T., & Warrington, E.K. (2001). Cortical vision screening test manual. London: Thames Valley Test Company Limited.Google Scholar
Kalron, A., Dvir, Z., & Achiron, A. (2010). Walking while talking – Difficulties incurred during the initial stages of multiple sclerosis disease process. Gait and Posture, 32, 332–335.Google Scholar
Kalron, A., Dvir, Z., & Achiron, A. (2011). Effect of a cognitive task on postural control in patients with a clinically isolated syndrome suggestive of multiple sclerosis. European Journal of Physical and Rehabilitation Medicine, 47, 579–586.Google Scholar
Kos, D., Kerchofs, E., Carrea, I., Verza, R., Ramos, M., & Jansa, J. (2005). Evaluation of the Modified Fatigue Impact Scale in four different European countries. Multiple Sclerosis, 11(1), 76–80.Google Scholar
LaBar, K.S., Gitelman, D.R., Parrish, T.B., & Mesulam, M. (1999). Neuroanatomic overlap of working memory and spatial attention networks: A functional MRI comparison within subjects. Neuroimage, 10, 695–704.Google Scholar
Leone, C., Patti, F., & Feys, P. (2015). Measuring the cost of cognitive-motor dual tasking during walking in multiple sclerosis. Topical Review: Multiple Sclerosis, 21(2), 123–131.Google Scholar
Malouin, F., Richards, C.L., Jackson, P.L., Dumas, F., & Doyon, J. (2003). Brain activation during motor imagery of locomotor-related tasks: A PET study. Human Brain Mapping, 19, 47–62.Google Scholar
Matsuura, Y., Fujino, H., Hashimoto, R., Yasuda, Y., Yamamori, H., Ohi, K., &Imura, O. (2015). Standing postural instability in patients with schizophrenia: Relationships with psychiatric symptoms, anxiety, and the use of neuroleptic medications. Gait & Posture, 41, 847–851.Google Scholar
Multiple Sclerosis Council for Clinical Practice (MSCCP) Guidelines. (1998). Fatigue and multiple sclerosis: Evidence-based management strategies for fatigue in multiple sclerosis. Washington, DC: Paralyzed Veterans of America.Google Scholar
Multiple Sclerosis Trust (MS Trust). (2013). Expanded Disability Status Scale. Retrieved from http://www.mstrust.org.uk/atoz/edss.jsp Google Scholar
Negahban, H., Mofateh, R., Arastoo, A.A., Mazaheri, M., Yazdi, M.J., Salavati, M., & Majdinasab, N. (2011). The effects of cognitive loading on balance control in patients with multiple sclerosis. Gait & Posture, 34, 479–484.Google Scholar
Ozkan, T., Guclu-Gunduz, A., & Irek, C. (2015). Evaluation of the relationship between postural imbalance and ataxia with disability in patients with multiple sclerosis. ECTRIMS Online Library, 115198.Google Scholar
Pearson Education Ltd. (2008). Wechsler Adult Intelligence Scale – Fourth UK Edition. Retrieved from http://www.pearsonclinical.co.uk/Psychology/AdultCognitionNeuropsychologyandLanguage/AdultGeneralAbilities/WechslerAdultIntelligenceScale-FourthUKEdition(WAIS-IVUK)/WechslerAdultIntelligenceScale-FourthUKEdition(WAIS-IVUK).aspx Google Scholar
Pearson Education Ltd. (2010). Test of premorbid function – UK edition. Administration, scoring and technical manual. London: Pearson Education Inc.Google Scholar
Polman, C.H., Reingold, S.C., Banwell, B., Clanet, M., Cohen, J.A., Filippi, M., & Wolinsky, J.S. (2010). Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald Criteria. American Neurological Association, 69, 292–302.Google Scholar
Prosperini, L., Castelli, L., De Luca, F., Fabiano, F., De Giglio, L., Gurreri, F., & Pozzilli, C. (2016). Task-dependent deterioration of balance underpinning cognitive-postural interference in MS. Neurology, 87, 1085–1092.Google Scholar
Prosperini, L., Castelli, L., Sellitto, G., De Luca, F., De Giglio, L., Gurreri, F., & Pozzilli, C. (2015). Investigating the phenomenon of “cognitive-motor interference” in multiple sclerosis by means of dual-task posturography. Gait & Posture, 41, 780–785.Google Scholar
Rogers, J.M., & Panegyres, P.K. (2007). Cognitive impairment in multiple sclerosis: Evidence-based analysis and recommendations. Journal of Clinical Neuroscience, 14, 919–927.Google Scholar
Shumway-Cook, A., & Woolacott, M. (2000). Motor control: Theory and practical applications (2nd ed.). Baltimore: Lippincott, Williams and Wilkins.Google Scholar
Suh, J.H., Han, S.J., Jeon, S.Y., Kim, H.J., Lee, J.E., Yoon, T.S., &Chong, H.J. (2014). Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients. Neurorehabiliation, 34, 193–199.Google Scholar
Wajda, D.A., Motl, R.W., & Sosnoff, J.J. (2014). Correlates of dual task cost of standing balance in individuals with multiple sclerosis. Gait & Posture, 40, 352–356.Google Scholar
Wajda, D.A., & Sosnoff, J.J. (2015). Cognitive-motor interference in Multiple Sclerosis: A systematic review of evidence, correlates, and consequences. Biomed Research International, 2015, 720856.Google Scholar
Wechsler, D. (2011). Test of premorbid functioning – UK Version. Retrieved from http://www.pearsonclinical.co.uk/Psychology/AdultCognitionNeuropsychologyandLanguage/AdultGeneralAbilities/TOPF/TestofPremorbidFunctioning.aspx Google Scholar
Whelan, R., Lonergan, R., Kiiski, H., Nolan, H., Kinsella, K., Hutchison, M., & Reilly, R.B. (2010). Impaired information processing speed and attention allocation in multiple sclerosis patients versus controls: A high-density EEG study. Journal of Neurological Sciences, 293, 45–50.Google Scholar
Wood, B., van der Mei, I.A., Ponsonby, A.L., Pittas, F., Quinn, S., Dwyer, T., & Taylor, B.V. (2012). Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Multiple Sclerosis Journal, 19(2), 217–224.CrossRefGoogle ScholarPubMed
Woollacott, M., & Shumway-Cook, A. (2002). Attention and the control of posture and gait: A review of an emerging area of research. Gait & Posture, 16, 1–14.Google Scholar
Yang, L., Liao, L.R., Lam, F.M.H., He, C.Q., & Pang, M.Y.C. (2015). Psychometric properties of dual-task balance assessments for older adults: A systematic review. Maturitas, 80, 359–369.Google Scholar
Yogev-Seligmann, G., Hausdorff, J.M., & Giladi, N. (2008). The role of executive function and attention in gait. Movement Disorders, 23(3), 329–342.Google Scholar
Zigmond, A.S., & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar