Oralmotor slowing in multiple sclerosis: Relationship to neuropsychological tasks requiring an oral response

Abstract

Although most neuropsychological batteries used with multiple sclerosis (MS) patients now exclude tests that require significant motor writing or manual manipulation speed, many of the most sensitive commonly used cognitive tests nonetheless require some type of rapid oral motor response. The aim of this study is to examine the extent to which primary oral motor articulation speed problems of individuals with MS contribute to performance and group differences on neuropsychological tasks requiring a rapid spoken response. Fifty MS patients and 50 healthy controls were administered the PASAT, COWAT, Animal Naming, and SDMT tests, in addition to a measure of rudimentary oral motor speed known as the maximum repetition rate of syllables and multisyllabic combinations (MRR) task. Regression analyses revealed that the amount of variance accounted for by the group (MS-Control) variable was reduced the following amounts for the tasks when the MRR was entered before the group variable: SDMT, 10% to 6%; PASAT, 4% to 2%; COWAT, 5% to 2%; Animal Naming, 11% to 7%. Our data suggest that rudimentary oral motor speed is slowed in MS patients and makes an important contribution to group differences in performance on commonly used neuropsychological tasks requiring a rapid spoken response. (JINS, 2008, 14, 454-462.)

Speech and pause characteristics in multiple sclerosis: A preliminary study of speakers with high and low neuropsychological test performance

“…When DDK rate was statistically controlled, cognitive test scores for persons with MS and healthy controls became more similar. Similar findings were reported by Arnett, Smith, Barwick, Benedict, and Ahlstrom (2008). Although these studies seem to suggest that speech motor impairment may contribute to the appearance of cognitive impairment in MS, the use of DDK in this study should be considered carefully (Westbury & Dembowski, 1993).…”

Validity of a computerized version of the Symbol Digit Modalities Test in multiple sclerosis

“…These include a reliance on oral responses, which if impaired can slow performance [36], and good visual acuity, for even mild impairments can also affect the results [37]. Reliance on oral responses may also produce motion artefacts when applied to fMRI studies.…”

Cognitive and neurobehavioral features in multiple sclerosis

“…Many of the MACFIMS tests require a rapid Multisyllabic Combinations (MRRSMC) requires examinees to repeat the phonemes 'pa' 'ta' or 'ka' as quickly as possible in one good breath lasting at least 6 s. The number of syllables per second is the main scoring index. Slowed speech measured by this task has been demonstrated to be associated with performance on several of the tasks in the MACFIMS requiring a rapid spoken response, including the COWAT, Animal Naming, PASAT and Oral Symbol Digit [30]. Finally, screening for fatigue using the Fatigue Impact Scale is a recommended supplement to the MACFIMS.…”

“…In addition, because fluency tasks require the rapid production of information, patients may perform poorly on them because of speeded-processing deficits. Slowed speech, common to MS, may also play a role in performance on such tasks, something that at least two recent studies have demonstrated [29,30]. Approximately 20-25% of patients have substantial problems on verbal fluency tasks [18], although some studies have reported impairment frequencies lower than 15% [5].…”