Department of Neurology, SUNY Buffalo School of Medicine, Buffalo, NY, USA.
J Int Neuropsychol Soc. 2011 Jul;17(4):643-53. doi: 10.1017/S1355617711000403.
Motor impairments and cognitive dysfunction are common in multiple sclerosis (MS). We aimed to delineate the relationship between cognitive capacity and upper and lower motor function in 211 MS patients, and 120 healthy volunteers. Lower and upper motor function were assessed with the Timed 25 Foot Walk (T25FW) and the Nine Hole Peg Test (NHPT) as implemented in the Multiple Sclerosis Functional Composite (MSFC). Subjects also underwent neuropsychological evaluation. Hierarchical linear regression analysis was conducted separately for the MS and healthy groups with the T25FW and NHPT serving as the outcome measures. Cognitive performance indices served as predictors. As expected, healthy subjects performed better than the MS group on all measures. Processing speed and executive function tests were significant predictors of lower and upper motor function in both groups. Correlations were more robust in the MS group, where cognitive tests predicted variability in motor function after controlling for disease duration and physical disability. In conclusion, we find evidence of higher order cognitive control of motor function that appears to be particularly salient in this large and representative MS sample. The findings may have implications for risk assessment and treatment of mobility dysfunction in MS.
运动障碍和认知功能障碍在多发性硬化症（MS）中很常见。我们旨在描述 211 名 MS 患者和 120 名健康志愿者的认知能力与上下运动功能之间的关系。下运动和上运动功能分别采用改良的 Timed 25 英尺步行测试（T25FW）和 9 孔钉测试（NHPT）进行评估，这些测试被纳入多发性硬化症功能综合评分（MSFC）中。参与者还接受了神经心理学评估。分别对 MS 组和健康组进行层次线性回归分析，T25FW 和 NHPT 作为结果测量指标。认知表现指数作为预测因子。正如预期的那样，健康组在所有测试中均优于 MS 组。在两个组中，处理速度和执行功能测试都是上下运动功能的重要预测因子。在 MS 组中，相关性更为稳健，在控制疾病持续时间和身体残疾后，认知测试可以预测运动功能的变化。总之，我们发现了高级认知控制运动功能的证据，这在这个大型且具有代表性的 MS 样本中尤为明显。这些发现可能对 MS 患者的移动功能障碍的风险评估和治疗具有重要意义。
