Association Between Cognitive Impairment and Motor Dysfunction among Patients with Multiple Sclerosis

Abstract

Objectives: 1. To study the association between cognitive impairment (CI) and motor dysfunction (MD) among patients with MS. 2. To examine if muscle weakness, motor incoordination, balance impairment, gait abnormalities, and/or increased fall risk can be adopted as indicator of CI in patients with MS. Methods: Seventy patients with multiple sclerosis were included in this cross-sectional study. They underwent assessment of cognitive impairment using the Montreal Cognitive Assessment Scale (MoCA), muscle strength using the Handheld dynamometer, balance, gait, and fall risk assessment using Tinetti scale. Moreover, motor coordination was assessed for both upper and lower extremities through the Timed Rapid Alternating Movement for Upper Extremity and Timed Alternate Heel-to-Knee Test for lower extremity. Results: A Significant association was found between CI and motor coordination, balance, gait, and risk of fall (p< 0.005) apart from muscle strength. Stepwise multiple linear regression showed that 22.7% of the variance in the MoCA was predictable from the fall risk and the incoordination of upper extremity among MS population. Conclusion: CI is significantly associated with motor incoordination, balance impairment, gait abnormality, and increased fall risk. Furthermore, the risk of fall and upper extremity incoordination appeared as the best indicators of CI among patients with MS.