Contributions
Abstract: P521
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Although factors associated with improved functional recovery through rehabilitation in multiple sclerosis (MS) are largely unknown, premorbid physically and intellectually enriching lifestyles have increasingly been recognized as able to mitigate the risk of disease-related disability. Our work hypothesis is that premorbid physical activity, cognitive reserve and trait personality may also contribute to rehabilitation outcome in people with MS.
Methods: We sought to identify each of the 36 patients from the 24-week, randomized, crossover pilot trial investigating the effect of home-based video game training on balance impairment due to MS (Prosperini L et al. Neurorehabil Neural Repair 2013). We achieved 94% ascertainment (34/36). In early 2018, identified patients underwent the following assessments: premorbid Historical Leisure Activity Questionnaire (HLAQ), Cognitive Reserve Index (CRI) and Temperament and Character Inventory (TCI). Non-parametric correlations and ordinal regression analysis were estimated to test association of premorbid HLAQ, CRI and TCI with training effect, expressed as percentage improvement in balance control (static posturography).
Results: No association between baseline patients' characteristics (sex, age, disease duration, disability level) and premorbid HLAQ and CRI and TCI was found. Larger training effect was associated with higher HLAQ values (rho=0.386, p=0.029), but not with CRI or TCI. This finding remained unaltered even after controlling for the aforementioned baseline variables (rho=0.456, p=0.018).
Ordinal regression model confirmed larger training effect as associated with higher HLAQ values (odds ratio [OR]=2.26, p=0.006), and also showed greater benefit in patients with higher score in persistence temperament (OR=3.30, p=0.034) and in those with lower score in self-transcendence character (OR=0.60, p=0.015). The model was significant (Chi-squared=37.85, p=0.001) and explained 45% of the variance in training effect (McFadden pseudo R-squared=0.448).
Discussion: Our study suggests that the rehabilitation outcome in MS is modulated by premorbid level of physical activity, as well as by specific temperament and character. These findings have a two-fold implication: (i) physical activity should be promoted in children by health authorities, in order to strengthen motor reserve; (ii) assessment of patients' character traits and temperaments may help neurologists to tailor rehabilitation strategies.
Disclosure: LC: consulting fees from Almirall.
AT: nothing to disclose.
SH: consulting fees, speaker honoraria and travel grants from Biogen, Genzyme, Teva, CSL Behrig, Zambon and research grants from Italian Minister of Foreign Affairs.
SR: speaking honoraria from Merck Serono and Teva.
LP: consulting fees from Biogen, Novartis and Roche; speaker honoraria from Almirall, Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme.
Abstract: P521
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Although factors associated with improved functional recovery through rehabilitation in multiple sclerosis (MS) are largely unknown, premorbid physically and intellectually enriching lifestyles have increasingly been recognized as able to mitigate the risk of disease-related disability. Our work hypothesis is that premorbid physical activity, cognitive reserve and trait personality may also contribute to rehabilitation outcome in people with MS.
Methods: We sought to identify each of the 36 patients from the 24-week, randomized, crossover pilot trial investigating the effect of home-based video game training on balance impairment due to MS (Prosperini L et al. Neurorehabil Neural Repair 2013). We achieved 94% ascertainment (34/36). In early 2018, identified patients underwent the following assessments: premorbid Historical Leisure Activity Questionnaire (HLAQ), Cognitive Reserve Index (CRI) and Temperament and Character Inventory (TCI). Non-parametric correlations and ordinal regression analysis were estimated to test association of premorbid HLAQ, CRI and TCI with training effect, expressed as percentage improvement in balance control (static posturography).
Results: No association between baseline patients' characteristics (sex, age, disease duration, disability level) and premorbid HLAQ and CRI and TCI was found. Larger training effect was associated with higher HLAQ values (rho=0.386, p=0.029), but not with CRI or TCI. This finding remained unaltered even after controlling for the aforementioned baseline variables (rho=0.456, p=0.018).
Ordinal regression model confirmed larger training effect as associated with higher HLAQ values (odds ratio [OR]=2.26, p=0.006), and also showed greater benefit in patients with higher score in persistence temperament (OR=3.30, p=0.034) and in those with lower score in self-transcendence character (OR=0.60, p=0.015). The model was significant (Chi-squared=37.85, p=0.001) and explained 45% of the variance in training effect (McFadden pseudo R-squared=0.448).
Discussion: Our study suggests that the rehabilitation outcome in MS is modulated by premorbid level of physical activity, as well as by specific temperament and character. These findings have a two-fold implication: (i) physical activity should be promoted in children by health authorities, in order to strengthen motor reserve; (ii) assessment of patients' character traits and temperaments may help neurologists to tailor rehabilitation strategies.
Disclosure: LC: consulting fees from Almirall.
AT: nothing to disclose.
SH: consulting fees, speaker honoraria and travel grants from Biogen, Genzyme, Teva, CSL Behrig, Zambon and research grants from Italian Minister of Foreign Affairs.
SR: speaking honoraria from Merck Serono and Teva.
LP: consulting fees from Biogen, Novartis and Roche; speaker honoraria from Almirall, Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme.