Contributions
Abstract: P346
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Gait and cognitive impairments are two relevant clinical features of Multiple Sclerosis (MS). The separate assessment of both is important to address therapeutic approaches, but taking into account the interaction of them (cognitive-motor interference-CMI) could allow to compute the real disabling impact of the pathology. CMI correlates have been widely investigated in MS with sometimes different results due to neuroimaging methods, CMI procedures, and the involvement of different samples (Leone,2014). Cerebellum has recently shown to play an important role not only in balance control and coordination of voluntary movements but also in cognitive functions (Jacobi, 2015).
Goal: Aim of this study is to clarify the characteristics of CMI in MS and the role of cerebellar lobules into this interfering process.
Method: 20 MS and 18 matched controls (HC) underwent clinical assessments, Dual-Task procedure (DTp) and 3T-MRI. For each participant, a high-resolution T1-weighted magnetisation prepared rapid gradient echo sequence was acquired. DTp was composed by three 2-minutes trials in which subjects were asked to walk fast along a route. In trial-N subjects only had to walk, in trial-C they should add a backward counting task, in trial-W they should add a semantic Word List Generation task. Meters covered (Mt) and correct scores (CS) were collected for all subjects.
Results: Both groups evidenced a decreased motor performance in both interfering conditions (trial-C and -W) but the effect of Trial-W in MS was significantly greater since involved the cognitive task too (p=.039). MS were then divided into high- and low-performers (HP>1SD; LP< 1SD) by using the HC"s z-score of trial-W"s CS. An ANOVA between HP, LP and HC"s grey matter volumes of all cerebellar lobules corrected for total volume showed a significant difference in Vermis lobules VIIIA (p=.015) and IX (p=.034). In particular HP showed a significant increased GM volume compared to HC for both lobules (p=.016; p=.034).
Conclusions: The influence of a cognitive task on walking performance also exists in HC, but is significantly more evident in MS. Trial-W has showed to be the most suitable interfering DTp to detect CMI. We can speculate the existence of an initial cerebellar compensatory mechanism consequent to higher control request of supra-tentorial circuits in MS patients who maintain high cognitive performance. Then cerebellar GM loss leads to a more evident expression of motor CMI symptoms.
Disclosure:
U. Nocentini has participated in an advisory board for Biogen.
M. Bozzali took part in advisory boards for Roche and Lilly Pharmaceuticals. He is also involved in Clinical trials for TEVA Pharmaceutical.
C. Caltagirone took part in an advisory board for Epitech.
O. Argento, B. Spanò, C. Incerti and V. Pisani have nothing to disclose.
Abstract: P346
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Gait and cognitive impairments are two relevant clinical features of Multiple Sclerosis (MS). The separate assessment of both is important to address therapeutic approaches, but taking into account the interaction of them (cognitive-motor interference-CMI) could allow to compute the real disabling impact of the pathology. CMI correlates have been widely investigated in MS with sometimes different results due to neuroimaging methods, CMI procedures, and the involvement of different samples (Leone,2014). Cerebellum has recently shown to play an important role not only in balance control and coordination of voluntary movements but also in cognitive functions (Jacobi, 2015).
Goal: Aim of this study is to clarify the characteristics of CMI in MS and the role of cerebellar lobules into this interfering process.
Method: 20 MS and 18 matched controls (HC) underwent clinical assessments, Dual-Task procedure (DTp) and 3T-MRI. For each participant, a high-resolution T1-weighted magnetisation prepared rapid gradient echo sequence was acquired. DTp was composed by three 2-minutes trials in which subjects were asked to walk fast along a route. In trial-N subjects only had to walk, in trial-C they should add a backward counting task, in trial-W they should add a semantic Word List Generation task. Meters covered (Mt) and correct scores (CS) were collected for all subjects.
Results: Both groups evidenced a decreased motor performance in both interfering conditions (trial-C and -W) but the effect of Trial-W in MS was significantly greater since involved the cognitive task too (p=.039). MS were then divided into high- and low-performers (HP>1SD; LP< 1SD) by using the HC"s z-score of trial-W"s CS. An ANOVA between HP, LP and HC"s grey matter volumes of all cerebellar lobules corrected for total volume showed a significant difference in Vermis lobules VIIIA (p=.015) and IX (p=.034). In particular HP showed a significant increased GM volume compared to HC for both lobules (p=.016; p=.034).
Conclusions: The influence of a cognitive task on walking performance also exists in HC, but is significantly more evident in MS. Trial-W has showed to be the most suitable interfering DTp to detect CMI. We can speculate the existence of an initial cerebellar compensatory mechanism consequent to higher control request of supra-tentorial circuits in MS patients who maintain high cognitive performance. Then cerebellar GM loss leads to a more evident expression of motor CMI symptoms.
Disclosure:
U. Nocentini has participated in an advisory board for Biogen.
M. Bozzali took part in advisory boards for Roche and Lilly Pharmaceuticals. He is also involved in Clinical trials for TEVA Pharmaceutical.
C. Caltagirone took part in an advisory board for Epitech.
O. Argento, B. Spanò, C. Incerti and V. Pisani have nothing to disclose.