Walking impairs cognitive performance among people with multiple sclerosis but not controls

People with multiple sclerosis (MS) complain of problems completing two tasks simultaneously; sometimes called ‘dual-tasking’ (DT). Previous research in DT among people with MS has focused on how adding a cognitive task interferes with gait and few have measured how adding a motor task could interfere with cognition. We aimed to determine the extent to which walking affects a concurrent working memory task in people with MS compared to healthy controls. We recruited MS participants (n = 13) and controls (n = 10) matched by age (±3 years), education (±3 years) and gender. Participants first completed the cognitive task (subtracting 7’s from the previous number) and then again while walking on an instrumented walkway. Although there were no baseline differences in cognition or walking between MS participants and controls, MS participants demonstrated a 52% decrease in number of correct answers during DT (p < 0.001). Mental Tracking Rate (% correct answers/min) correlated strongly with MS-related disability measured using the Expanded Disability Status Scale (EDSS; r(11) = −0.68, p < 0.01). We propose that compromised mental tracking during walking could be related to limited neural resource capacity and could be a potentially useful outcome measure to detect ecologically valid dual tasking impairments.     

Longitudinal associations between mindfulness and well-being in people with multiple sclerosis

Background/Objective: Depression, anxiety, fatigue, and sleep problems are typical conditions reported in people with multiple sclerosis (MS), often resulting in a reduction of their quality of life (QOL) and well-being. Mindfulness is a multifaceted and complex construct that has been increasingly explored for its correlated to well-being. Despite preliminary evidence, longitudinal data about the impact of mindfulness on QOL in MS remain limited. In addition, Langerian mindfulness, one of the prominent approaches to mindfulness, is yet unexplored in this field. The study aims to examine the longitudinal relationships between two forms of mindfulness (Langerian and contemplative) and QOL, anxiety, depression, fatigue, and sleep. Method: Within a larger randomized controlled trial of an online mindfulness-based stress reduction intervention, a cohort of 156 people with MS was recruited and assessed for both mindfulness constructs, QOL, anxiety, depression, fatigue, and sleep problems. Assessments were repeated after 2 and after another 6 months. Results: Both mindfulness constructs were highly correlated with all investigated outcomes. Both Langerian and contemplative mindfulness predicted higher QOL, lower anxiety, depression, fatigue, and sleep, over time. Conclusions: In both approaches dispositional mindfulness is a protective factor against depression, anxiety, fatigue, and sleep in people with MS.     

The lived experiences of people diagnosed with multiple sclerosis in relation to exercise

The purpose of this study was to examine the lived experiences of people diagnosed with Multiple Sclerosis (MS). Seven active exercisers with MS participated in semi-structured interviews regarding their exercise experiences since diagnosis. Data were analysed using Interpretative Phenomenological Analysis (IPA; Smith?&?Osborn, 2003 Smith, JA and Osborn, M. 2003. “Interpretive phenomenological analysis”. In Qualitative psychology: A practical guide to research methods, Edited by: Smith, JA. 51–80. London: Sage.  [Google Scholar]). Interpretive Phenomenological Analysis. The results and interpretations of narratives revealed a number of functional limitations due to the severity of MS symptoms, which were found to have a major effect on the ability of the participants to exercise. Furthermore, psychological problems and the heightened behavioural adjustments to the progressive disability led to re-appraisal of ability to exercise. Previous, relevant exercise experience made participants more determined to continue to be able to exercise after diagnosis. The wider exercise experience narratives were related to concerns about safety, dependability on others to overcome the challenges, and potential environmental hazards. The loss of spontaneous opportunities to exercise because of these actual and perceived barriers was key to this population. This research highlighted the need to rethink the health and social service arrangements in relation to exercise provision for individuals with MS.     

Upper limb proprioception and fine motor function in young pianists

BackgroundThis study investigated if intensive piano training may be associated with improved motor and somatosensory function. We systematically examined upper limb proprioception, which is known to play an essential role in skill movements, and motor function in young pianists.MethodForty-four typically developing children who either regularly played piano for more than six years (N = 16) or had no experience playing musical instruments (N = 28) participated. Elbow and wrist joint proprioceptive acuity was assessed using a manipulandum. The wrist/elbow was passively flexed to a target with participants actively trying to match the just experienced target position. Motor function was assessed using the Movement Assessment Battery for Children (MABC-2).ResultsFirst, children in the pianist group exhibited significantly lower position sense bias (systematic error) at both the elbow and wrist when compared to controls. Position sense precision (random error) was not different between groups. Second, the piano group exhibited enhanced fine motor function as shown by higher manual dexterity MABC-2 scores. Performance in other motor domains (aiming and catching or balance) was not improved in young pianists. Third, a lower position sense bias was correlated with a higher level of manual dexterity.ConclusionThis study documents that children who regularly play the piano have superior upper limb position sense acuity. Specifically, smaller position sense bias, i.e., less systematic error. Superior upper position sense acuity in young pianists is associated with higher fine motor functions.     

Association between fine motor skills and binocular visual function in children with reading difficulties

Performance of fine motor skills (FMS) assessed by a clinical test battery has been associated with reading achievement in school-age children. However, the nature of this association remains to be established. The aim of this study was to assess FMS in children with reading difficulties using two experimental tasks, and to determine if performance is associated with reduced binocular function. We hypothesized that in comparison to an age- and sex-matched control group, children identified with reading difficulties will perform worse only on a motor task that has been shown to rely on binocular input. To test this hypothesis, motor performance was assessed using two tasks: bead-threading and peg-board in 19 children who were reading below expected grade and age-level. Binocular vision assessment included tests for stereoacuity, fusional vergence, amplitude of accommodation, and accommodative facility. In comparison to the control group, children with reading difficulties performed significantly worse on the bead-threading task. In contrast, performance on the peg-board task was similar in both groups. Accommodative facility was the only measure of binocular function significantly associated with motor performance. Findings from our exploratory study suggest that normal binocular vision may provide an important sensory input for the optimal development of FMS and reading. Given the small sample size tested in the current study, further investigation to assess the contribution of binocular vision to the development and performance of FMS and reading is warranted.     

The first year after diagnosis: psychological impact on people with multiple sclerosis

The impact of multiple sclerosis (MS) diagnosis on newly diagnosed individuals remains so far little explored. Our aim is to outline affective, personality and quality of life (QoL) correlates of MS patients shortly after MS diagnosis. Thirty-eight (22 F and 16 M) newly-diagnosed MS patients (mean interval from diagnosis communication 4.7 ± 3.8 months, range 1–12 months) underwent the Montgomery–Åsberg Depression Rating Scale and a comprehensive psychological evaluation: Beck Depression Inventory-II, State-Trait Anxiety Inventory, Psychophysiological Questionnaire-Revised, Fear Survey Schedule, Maudsley Obsessional-Compulsive Questionnaire, Impact of Event Scale-Revised, Personal Meaning Questionnaire, Problem Solving Inventory and Multiple Sclerosis Quality of Life-54. The Expanded Disability Status Scale was assessed during the neurological examination. Depressive symptomatology, only partially related to disability, was observed in approximately 40% of patients. The prevalent approach to MS diagnosis was one of avoidance in 65.8% of cases. QoL reductions in self-perception and psychological well-being emerged, together with a peculiar perception of change in health that was not related to neurological disability. With regard to personality assessment, depressive personal meaning organization correlates inversely with important QoL measures. Newly-diagnosed patients go through a complex network of psychological changes still in the initial phases immediately after diagnosis. A thorough understanding of these adjusting aspects by the neurologist could be crucial in improving patients’ QoL, participation in relevant disease decisions and adherence to pharmacological therapy.     

Working memory and fine motor skills predict early numeracy performance of children with cerebral palsy

Early numeracy is an important precursor for arithmetic performance, academic proficiency, and work success. Besides their apparent motor difficulties, children with cerebral palsy (CP) often show additional cognitive disturbances. In this study, we examine whether working memory, non-verbal intelligence, linguistic skills, counting and fine motor skills are positively related to the early numeracy performance of 6-year-old children with CP. A total of 56 children (M = 6.0, SD = 0.61, 37 boys) from Dutch special education schools participated in this cross-sectional study. Of the total group, 81% of the children have the spastic type of CP (33% unilateral and 66% bilateral), 9% have been diagnosed as having diskinetic CP, 8% have been diagnosed as having spastic and diskinetic CP and 2% have been diagnosed as having a combination of diskinetic and atactic CP. The children completed standardized tests assessing early numeracy performance, working memory, non-verbal intelligence, sentence understanding and fine motor skills. In addition, an experimental task was administered to examine their basic counting performance. Structural equation modeling showed that working memory and fine motor skills were significantly related to the early numeracy performance of the children (β = .79 and p < .001, β = .41 and p < .001, respectively). Furthermore, counting was a mediating variable between working memory and early numeracy (β = .57, p < .001). Together, these findings highlight the importance of working memory for early numeracy performance in children with CP and they warrant further research into the efficacy of intervention programs aimed at working memory training.     

Experiences with the indirect Clausen Test using NTA as an antigen in multiple sclerosis and other neurologic diseases

The present study based on the indirect Clausen-test using NTA and PHA as antigens contributed to therapy control and possibly prognosis assessment rather than to immunological differential diagnosis.     

The caregiver experience: a South African perspective on caring for people with multiple sclerosis

This study explored the lived experiences of caregivers of people with multiple sclerosis (MS) with regard to their daily challenges, as well as the resources which help them to cope with their caregiving task. Participants were eight South African men (n?=?3) and women (n?=?5) [white?=?6; coloured?=?2] caring for a person with MS. They responded to a qualitative interview on their caregiving experiences. The data were thematically analysed. Findings suggest their daily challenges of managing symptoms, limited social interaction, financial difficulties, and the unpredictability of the future as a result of MS. Resources helpful to coping with caregiving roles include resilience, positive attitude, patience, religion, information, and financial security. Carer support should be tailor-made, because of the unique experiences of each caregiver and the varied presentation of MS.     

Locus of control and perceived alcohol ingestion in performance of a fine motor skill

To investigate the influence of locus of control on a fine motor corrdination task where subjects had ingested or believed that they had ingested alcohol, 60 men who were enrolled in introductory psychology and scored in the upper or lower thirds of the population on Rotter's I-E Scale (30 external and 30 internal scorers) were randomly assigned to one of three treatment conditions: a control group (no alcohol expected/no alcohol received), an alcohol group (alcohol expected/alcohol received), and a placebo group (alcohol expected/no alcohol received). Pretest and posttest measures of performance on the Purdue Pegboard Test were obtained from all subjects. Subjects in the control groups were given three 6-oz. (177.4-ml) glasses of fruit punch over a 35-min. waiting period between pretest and posttest on the Purdue Pegboard. The alcohol groups drank a sufficient number of similar glasses (usually three) to produce a 0.1% measure on a breathalyzer before completing the posttest on the Purdue. Pegboard. The placebo groups were told that they were drinking an alcohol-based drink but were served three glasses of a nonalcoholic, rum-flavored fruit drink. These groups were also told that they measured 0.1% on a breathalyzer. Control groups, both internal and external scorers, showed essentially no change from pre- to posttest on the Purdue Pegboard. The alcohol groups, on the other hand, both internal and external scorers, showed a significant decrement in performance. The internal-placebo group did not differ from the two control groups and showed no decrement in performance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Stiffness as a control variable in motor performance

In the experiments described in this article we investigated the control of stiffness of the effector system in relation to parameters of the movement. If the velocity of a movement is chosen, it appears that at the same time the stiffness of the effector system is set to a preferred value. By changing the instruction given to the subject it is possible to change the relationship between velocity and stiffness without changing the kinematic parameters of the movement.Finally, the changes of stiffness and velocity in a learning process are studied. In conformity with what might be expected on intuitive grounds, it is found that velocity increases spontaneously during learning while stiffness decreases. The results are discussed in connection with the generation of motor programmes.     

Orienting reaction in patients with multiple sclerosis

A polygraphic study of the somatic (EMG), autonomic (finger plethysmogram, galvanic skin reaction, respiration, pulse, and EEG (acoustic-evoked potential and EEG-blocking reaction) components of the orienting reaction elicited by an auditory stimulus was performed in 71 patients with multiple sclerosis and in 74 matched normal subjects (control group). The study showed a significantly less intense orienting reaction in patients with multiple sclerosis than in control normal subjects. The severity of this responsiveness disturbance depended on the patients’ age at symptom onset, major symptom types on admission, and the relapse frequency. The orienting reaction changes found in patients with multiple sclerosis may be ascribed to the diffuse demyelinating lesions in the nervous system of these patients, which generate, apart from the so polymorphous clinical manifestations of this disease, also important responsiveness disturbances.