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Abstract Details

Postural facilitation can occur during dual-task performance in people with progressive multiple sclerosis and is related to upper extremity function.
Multiple Sclerosis
MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)
039

To determine the pattern of cognitive-postural interference adopted by people with progressive multiple sclerosis (PMS) during dual-task performance, and its clinical implications.

Cognitive impairment and balance impairment are common in PMS. Cognitive and postural control processes share attentional resources – the interaction between these two modalities (i.e. cognitive-postural interference) may be quantified by comparing performance during single- and dual-task conditions.

We recruited 73 people with PMS (age 18-65 years, EDSS score 3.5-6.0). Participants performed single-task posturography (stood quietly on force platform with eyes open), single-task N-Back cognitive test (performed while sitting down – instructed to click mouse when two consecutive letters e.g. “A”, “A” appeared on the screen), and dual-task (simultaneous posturography and N-Back cognitive test). Participants also completed a battery of clinical outcome measures.
While 73 participants performed the single-tasks, only 44 (60.3%) were able to stand long enough to perform the dual-task: of this cohort, mean age was 51.5 years (SD 9.0), mean disease duration 12.8 years (SD 10.1). Twenty-six (59%) participants were cognitively impaired [Symbol Digit Modalities Test (SDMT) z-score ≤ 1.5]. During the dual-task, Mediolateral Displacement decreased (i.e. improved) by median 38.9% (p=0.014) from single-task; meanwhile there was no statistically significant change in the N-Back cognitive score. Subgroup analyses between participants with clinically meaningfully improved (n=19, 43.2%) and clinically meaningfully worsened (n=6, 13.6%) postural control showed significant differences in upper extremity function (9 Hole Peg Test, median 29.8 vs 41.9 seconds, p=0.02) but no significant differences in EDSS, lower extremity weakness, cognition, depression, or fatigue.

Postural facilitation can occur during dual-task performance in people with PMS, perhaps because of increased automaticity of postural control with an external cognitive focus, with implications for rehabilitative training. If validated, measures of cognitive-postural interference have a potential role as a biomarker of upper extremity function in people with PMS.

Authors/Disclosures
Siew Mei Yap, MBBS (National Hospital for Neurology and Neurosurgery)
PRESENTER 		Dr. Yap has received research support from Novartis.
No disclosure on file
No disclosure on file
Maria Gaughan, MBBS (St Vincent'S Hospital) Dr. Gaughan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Dr. Gaughan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Gaughan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Dr. Gaughan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck.
Hugh Kearney, MD, PhD Dr. Kearney has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
Niall Tubridy, MD (St Vincent's University Hospital) Dr. Tubridy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis .
Richard Reilly, PhD (Trinity College Dublin, The Univeristy of Dublin) Dr. Reilly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for La Caixa Foundation. Dr. Reilly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for La Caixa Foundation, Barcelona, Spain. The institution of Dr. Reilly has received research support from Enterprise Ireland. The institution of Dr. Reilly has received research support from Science Foundation Ireland. The institution of Dr. Reilly has received research support from Health Research Board.
Christopher McGuigan, MD (Department of Neurology, St. Vincent's University Hospital) An immediate family member of Prof. McGuigan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Prof. McGuigan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Prof. McGuigan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. The institution of Prof. McGuigan has received research support from Novartis.