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Upper and Lower Extremity Motor Function and Cognitive Impairment in Multiple Sclerosis

Published online by Cambridge University Press:  13 April 2011

Ralph H.B. Benedict ,
Roee Holtzer ,
Robert W. Motl ,
Frederick W. Foley ,
Sukhmit Kaur ,
David Hojnacki  and
Bianca Weinstock-Guttman
Ralph H.B. Benedict*
Affiliation:
SUNY Buffalo School of Medicine, Department of Neurology, and the Jacobs Neurological Institute, Buffalo, New York
Roee Holtzer
Affiliation:
Ferkauf Graduate School of Psychology and Department of Neurology, at the Albert Einstein College of Medicine, Yeshiva University, New York, New York
Robert W. Motl
Affiliation:
Department of Kinesiology, University of Illinois Urbana-Champaign, Illinois
Frederick W. Foley
Affiliation:
Ferkauf Graduate School of Psychology and Department of Neurology, at the Albert Einstein College of Medicine, Yeshiva University, New York, New York
Sukhmit Kaur
Affiliation:
SUNY Buffalo School of Medicine, Department of Neurology, and the Jacobs Neurological Institute, Buffalo, New York
David Hojnacki
Affiliation:
SUNY Buffalo School of Medicine, Department of Neurology, and the Jacobs Neurological Institute, Buffalo, New York
Bianca Weinstock-Guttman
Affiliation:
SUNY Buffalo School of Medicine, Department of Neurology, and the Jacobs Neurological Institute, Buffalo, New York
*
Correspondence and reprint requests to: Ralph H.B. Benedict, Neurology, D-6, Buffalo General Hospital, 100 High Street, Buffalo, New York 14203. E-mail: benedict@buffalo.edu
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Abstract

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. (JINS, 2011, 17, 643–653)

Keywords

Neurological disorderExecutive functionMemoryPhysical disabilityGaitManual dexterity
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 4 , 21 June 2011 , pp. 643 - 653
Copyright
Copyright © The International Neuropsychological Society 2011

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