Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
Ear Hear. 2020 Jan/Feb;41(1):3-16. doi: 10.1097/AUD.0000000000000748.
Patients suffering from vestibular disorders (VD) often present with impairments in cognitive domains such as visuospatial ability, memory, executive function, attention, and processing speed. These symptoms can be attributed to extensive vestibular projections throughout the cerebral cortex and subcortex on the one hand, and to increased cognitive-motor interference (CMI) on the other hand. CMI can be assessed by performing cognitive-motor dual-tasks (DTs). The existing literature on this topic is scarce and varies greatly when it comes to test protocol, type and degree of vestibular impairment, and outcome. To develop a reliable and sensitive test protocol for VD patients, an overview of the existing reliability and validity studies on DT paradigms will be given in a variety of populations, such as dementia, multiple sclerosis, Parkinson's disease, stroke, and elderly.
The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An extensive literature search on psychometric properties of cognitive-motor DTs was run on MEDLINE, Embase, and Cochrane Databases. The studies were assessed for eligibility by two independent researchers, and their methodological quality was subsequently evaluated using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN).
Thirty-three studies were included in the current review. Based on the reliability and validity calculations, including a static as well as dynamic motor task seems valuable in a DT protocol for VD patients. To evoke CMI maximally in this population, both motor tasks should be performed while challenging the vestibular cognitive domains. Out of the large amount of cognitive tasks employed in DT studies, a clear selection for each of these domains, except for visuospatial abilities, could be made based on this review. The use of the suggested DTs will give a more accurate and daily life representation of cognitive and motor deficiencies and their interaction in the VD population.
患有前庭障碍（VD）的患者常表现出认知领域的损伤，例如视空间能力、记忆、执行功能、注意力和处理速度。这些症状一方面归因于前庭在大脑皮层和皮层下的广泛投射，另一方面归因于认知运动干扰（CMI）的增加。CMI 可以通过执行认知运动双重任务（DT）来评估。关于这个主题的现有文献很少，在测试方案、前庭损伤的类型和程度以及结果方面差异很大。为了为 VD 患者开发可靠和敏感的测试方案，将在各种人群（如痴呆症、多发性硬化症、帕金森病、中风和老年人）中概述关于 DT 范式的现有可靠性和有效性研究。
系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。对 MEDLINE、Embase 和 Cochrane 数据库中关于认知运动 DT 的心理测量特性进行了广泛的文献搜索。两名独立研究人员对研究进行了资格评估，随后使用共识标准选择健康测量仪器（COSMIN）评估其方法学质量。
本综述共纳入 33 项研究。基于可靠性和有效性的计算，在 VD 患者的 DT 方案中包括静态和动态运动任务似乎是有价值的。为了在该人群中最大程度地诱发 CMI，在挑战前庭认知域的同时应执行两项运动任务。在 DT 研究中使用的大量认知任务中，除了视空间能力外，根据本综述可以对每个认知域进行明确选择。使用建议的 DT 将更准确地反映 VD 人群中认知和运动缺陷及其相互作用，并更贴近日常生活。
