Abstract
Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease affecting various neurological domains, such as postural control, cognition, fear of falling, depression-anxiety, and fatigue. This study examined the associations of cognitive functions, fear of falling, depression-anxiety, and fatigue with postural control in patients with MS. Postural control (sway velocity) of 63 patients with MS (age 39.0 ± 8.9 years; %female 57%; Expanded Disability Status Scale score median (interquartile range) 2.0 (1.5)) was recorded on two platforms at stable and unstable conditions. Cognition, fear of falling, depression-anxiety, and fatigue were evaluated by a comprehensive neuropsychological assessment. The associations between these domains and postural control have been measured by multivariable linear regression (adjusted for age, gender, disability, and education). In stable condition, only working memory was associated with postural control (p < 0.05). In unstable condition, working memory, executive functions, attention/processing speed, and fear of falling were associated with postural control (p < 0.05). Specific cognitive domains and fear of falling were associated with postural control in MS patients, particularly in unstable condition. These findings highlight the association of cognitive functions and fear of falling with postural control in MS.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Allali G, Laidet M, Assal F et al (2014) Dual-task assessment in natalizumab-treated multiple sclerosis patients. Eur Neurol 71(5):247–251. doi:10.1159/000357217
Barre A, Armand S (2014) Biomechanical ToolKit: open-source framework to visualize and process biomechanical data. Comput Methods Programs Biomed 114(1):80–87. doi:10.1016/j.cmpb.2014.01.012
Behrens JR, Mertens S, Krüger T et al (2016) Validity of visual perceptive computing for static posturography in patients with multiple sclerosis. Mult Scler 22(12):1596–1606. doi:10.1177/1352458515625807
Bennett DA, Schneider JA, Buchman AS et al (2005) The Rush Memory and Aging Project: study design and baseline characteristics of the study cohort. Neuroepidemiology 25(4):163–175. doi:10.1159/000087446
Cattaneo D, Jonsdottir J (2009) Sensory impairments in quiet standing in subjects with multiple sclerosis. Mult Scler 15(1):59–67. doi:10.1177/1352458508096874
Fjeldstad C, Pardo G, Bemben D, Bemben M (2011) Decreased postural balance in multiple sclerosis patients with low disability. Int J Rehabil Res 34(1):53–58. doi:10.1097/MRR.0b013e32833d6ccb
Gunn HJ, Newell P, Haas B et al (2013) Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis. Phys Ther 93(4):504–513. doi:10.2522/ptj.20120231
Hebert JR, Corboy JR (2013) The association between multiple sclerosis-related fatigue and balance as a function of central sensory integration. Gait Posture 38(1):37–42. doi:10.1016/j.gaitpost.2012.10.015
Hoang PD, Cameron MH, Gandevia SC, Lord SR (2014) Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study. Arch Phys Med Rehabil 95(3):480–486. doi:10.1016/j.apmr.2013.09.017
Kalron A (2014) The relationship between specific cognitive domains, fear of falling, and falls in people with multiple sclerosis. BioMed Res Int 2014:1–10. doi:10.1155/2014/281760
Kalron A (2016) The relationship between static posturography measures and specific cognitive domains in individuals with multiple sclerosis. Int J Rehabil Res Int Z Rehabil Rev Int Rech Readaptation 39(3):249–254. doi:10.1097/MRR.0000000000000177
Kalron A, Achiron A (2013) Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids. J Neurol Sci 335(1):186–190. doi:10.1016/j.jns.2013.09.029
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. Eur J Phys Rehabil Med 47(4):579–586
Karst GM, Venema DM, Roehrs TG, Tyler AE (2005) Center of pressure measures during standing tasks in minimally impaired persons with multiple sclerosis. J Neurol Phys Ther 29(4):170–180
Kelly VE, Johnson CO, McGough EL et al (2015) Association of cognitive domains with postural instability/gait disturbance in Parkinson’s disease. Parkinsonism Relat Disord 21(7):692–697. doi:10.1016/j.parkreldis.2015.04.002
Mazumder R, Lambert WE, Nguyen T et al (2015) Fear of falling is associated with recurrent falls in people with multiple sclerosis: a longitudinal cohort study. Int J MS Care 17(4):164–170. doi:10.7224/1537-2073.2014-042
McIlroy WE, Maki BE (1997) Preferred placement of the feet during quiet stance: development of a standardized foot placement for balance testing. Clin Biomech Bristol Avon 12(1):66–70
Negahban H, Sanjari MA, Mofateh R, Parnianpour M (2013) Nonlinear dynamical structure of sway path during standing in patients with multiple sclerosis and in healthy controls is affected by changes in sensory input and cognitive load. Neurosci Lett 553:126–131. doi:10.1016/j.neulet.2013.08.024
Paul F (2016) Pathology and MRI: exploring cognitive impairment in MS. Acta Neurol Scand 134:24–33. doi:10.1111/ane.12649
Peterson EW, Cho CC, Finlayson ML (2007) Fear of falling and associated activity curtailment among middle aged and older adults with multiple sclerosis. Mult Scler Houndmills Basingstoke Engl 13(9):1168–1175. doi:10.1177/1352458507079260
Polman CH, Reingold SC, Edan G et al (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol 58(6):840–846. doi:10.1002/ana.20703
Prosperini L, Pozzilli C (2013) The clinical relevance of force platform measures in multiple sclerosis: a review. Mult Scler Int 2013:1–9. doi:10.1155/2013/756564
Ruano L, Portaccio E, Goretti B, et al (2016) Age and disability drive cognitive impairment in multiple sclerosis across disease subtypes. Mult Scler. doi:10.1177/1352458516674367
Simpson S, Tan H, Otahal P et al (2016) Anxiety, depression and fatigue at 5-year review following CNS demyelination. Acta Neurol Scand 134(6):403–413. doi:10.1111/ane.12554
Tangen GG, Engedal K, Bergland A et al (2014) Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and alzheimer disease. Phys Ther 94(8):1123–1134. doi:10.2522/ptj.20130298
Wajda DA, Sosnoff JJ (2015) Cognitive-motor interference in multiple sclerosis: a systematic review of evidence, correlates, and consequences. Biomed Res Int 2015:1–8. doi:10.1155/2015/720856
Wieder L, Gäde G, Pech LM et al (2013) Low contrast visual acuity testing is associated with cognitive performance in multiple sclerosis: a cross-sectional pilot study. BMC Neurol 13:167. doi:10.1186/1471-2377-13-167
Wilson RS, Barnes LL, Krueger KR et al (2005) Early and late life cognitive activity and cognitive systems in old age. J Int Neuropsychol Soc JINS 11(4):400–407
Acknowledgements
We are grateful to the patients for their participations to the study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
PH. Lalive is on the scientific advisory board and received travel funding and/or speaker honoraria from Biogen-Idec, Merck-Serono, Novartis, Roche, Sanofi-Genzyme, and Teva. The other authors report no conflict of interest.
Fundings
This project was supported by a grant from the Swiss National Science Foundation (Grant Number: 164809) and the Swiss Multiple Sclerosis Society. Gilles Allali was supported by a grant from the Baasch-Medicus Foundation.
Rights and permissions
About this article
Cite this article
Perrochon, A., Holtzer, R., Laidet, M. et al. Postural control is associated with cognition and fear of falling in patients with multiple sclerosis. J Neural Transm 124, 495–500 (2017). https://doi.org/10.1007/s00702-016-1668-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-016-1668-5