The relationship between cognitive function and functional capacity, and cognitive reserve and reaction time in patients with multiple sclerosis

Candiri, Busra; Ramazanoglu, Engin; Talu, Burcu; Tecellioglu, Mehmet

doi:10.1055/s-0044-1788273

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Original Article • Arq. Neuro-Psiquiatr. 82 (09) • 2024 • https://doi.org/10.1055/s-0044-1788273 copy

The relationship between cognitive function and functional capacity, and cognitive reserve and reaction time in patients with multiple sclerosis

A relação entre função cognitiva e capacidade funcional, reserva cognitiva e tempo de reação em pacientes com esclerose múltipla

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

Cognitive dysfunction is frequently seen in multiple sclerosis (MS). However, there are conflicting findings regarding the factors it is associated with.

Objective

To investigate the relationship between aerobic capacity, strength, disability, depression, fatigue, and cognitive reserve and function.

Methods

The mobile applications Trail Making Test (TMT A-B), Digit Span Test (DST), Visuospatial Memory Test (VSMT), and Tap Fast were used in the cognitive function evaluation. Functional performance was assessed with the 6-minute walk test (6MWT), 5-Time Sit-to-Sand (5STS) test, and grip strength. Cognitive Reserve Index (CRI), Beck Depression Inventory, Fatigue Severity Scale (FSS), and Nottingham Health Profile were also used.

Results

A significant difference was found between the MS and control groups only in the 6MWT, STS-5, grip strength, TMT, VSMT, and Tap Fast. Good correlation was found between the TMT-A and 6MWT and physical mobility. A fair correlation was shown between grip strength, energy, and pain status. A good correlation was found between TMT-B and 6MWT, and a fair relationship with disability, cognitive reserve, and pain. Good correlation was observed between the DST and 6MWT, left grip strength, pain, and energy status; fair correlations were found between right grip strength, cognitive reserve, and physical mobility. Good correlation was found between the VSMT and energy. A fair relationship between disability, cognitive reserve, and pain was demonstrated. Good correlation was observed between the Tap Fast score and disability, 5STS, FSS, energy, and physical mobility. A fair relationship was found between pain and social isolation.

Conclusion

It has been shown that cognitive performance in MS is related to disability, functional performance, cognitive reserve, fatigue, and general health.

Trial registration

NCT06084182.

Keywords
Multiple Sclerosis; Cognition; Cognitive Reserve; Mobile Applications; Muscle Strength; Physical Functional Performance

	MS (n = 42)	Control (n = 34)	p
Mean age (years)	35.69 ± 9.15	37.91 ± 11.99	0.363^a a Independent samples t-test (mean ± standard deviation).
Mean BMI (kg/m²)	23.35 ± 3.94	25.31 ± 4.76	0.054^a a Independent samples t-test (mean ± standard deviation).
Gender (F/M)	33/9	20/14	0.062^b b Chi-squared test.
Mean EDSS score	3.04 ± 0.97	–	–

	MS (n = 42)	Control (n = 34)	p
6MWT (m)	2.86 ± 0.57	3.45 ± 0.39	0.000^b b Independent samples t-test.
STS-5 (s)	13.05 ± 2.87	11.08 ± 2.27	0.001^b b Independent samples t-test.
Handgrip R (kg)	22.94 ± 8.27	28.07 ± 9.93	0.016^b b Independent samples t-test.
Handgrip L (kg)	22.28 ± 7.53	28.54 ± 10.33	0.004^a a Mann-Whitney U test.
TMT-A (s)	86.61 ± 39.44	71.62 ± 41.33	0.014^a a Mann-Whitney U test.
TMT-B (s)	116.47 ± 45.50	80.87 ± 24.76	0.000^a a Mann-Whitney U test.
Digit Span Test	5.50 ± 1.46	6.44 ± 1.50	0.011^a a Mann-Whitney U test.
Visuospatial Memory Test	4.28 ± 1.46	4.76 ± 1.12	0.063^a a Mann-Whitney U test.
Tap Fast	18.76 ± 5.74	23.35 ± 4.04	0.000^b b Independent samples t-test.

		TMT-A^a a Spearman correlation test.	TMT-B^a a Spearman correlation test.	Digit Span Test^a a Spearman correlation test.	Visuospatial Memory Test^a a Spearman correlation test.	Tap Fast
BMI (kg/m²)	r	0.105	0.106	−0.093	−0.303	−0.132
BMI (kg/m²)	p	0.507	0.505	0.558	0.051	0.405^b b Pearson correlation test.
EDSS score	r	0.220	0.352 ^* * p < 0.05.	−0.292	−0.354^* * p < 0.05.	−0.421^ p < 0.01.
EDSS score	p	0.162	0.022	0.061	0.021	0.005 ^a a Spearman correlation test.
6MWT (m)	r	−0.455^ p < 0.01.	−0.401^ p < 0.01.	0.446 ^ p < 0.01.	−0.273	0.188
6MWT (m)	p	0.002	0.009	0.003	0.081	0.233^b b Pearson correlation test.
STS-5 (s)	r	0.179	0.225	−0.261	0.232	−0.412^ p < 0.01.
STS-5 (s)	p	0.256	0.152	0.095	0.140	0.007 ^b b Pearson correlation test.
Handgrip R (kg)	r	−0.306^* * p < 0.05.	−0.198	0.375	0.226	0.257
Handgrip R (kg)	p	0.049	0.210	0.014	0.151	0.101^b b Pearson correlation test.
Handgrip L (kg)	r	−0.308^* * p < 0.05.	−0.205	0.432 ^ p < 0.01.	0.236	0.172
Handgrip L (kg)	p	0.048	0.193	0.004	0.132	0.277^a a Spearman correlation test.
CRI	r	−0.212	−0.327^* * p < 0.05.	0.358 ^* * p < 0.05.	0.376 ^* * p < 0.05.	0.181
CRI	p	0.177	0.034	0.020	0.014	0.252^b b Pearson correlation test.
BDI	r	0.161	0.141	−0.270	−0.248	−0.141
BDI	p	0.307	0.373	0.084	0.114	0.372^a a Spearman correlation test.
FSS	r	0.282	0.198	−0.270	−0.184	−0.441^ p < 0.01.
FSS	p	0.070	0.209	0.084	0.244	0.003 ^b b Pearson correlation test.
Nottingham Health Profile
Energy	r	0.323 ^* * p < 0.05.	0.245	−0.425^ p < 0.01.	−0.427^ p < 0.01.	−0.415^ p < 0.01.
Energy	p	0.037	0.118	0.005	0.005	0.006 ^a a Spearman correlation test.
Pain	r	0.312 ^* * p < 0.05.	0.308 ^* * p < 0.05.	−0.401^ p < 0.01.	−0.389^* * p < 0.05.	−0.307^* * p < 0.05.
Pain	p	0.044	0.047	0.009	0.011	0.048 ^a a Spearman correlation test.
Emotional reactions	r	0.213	0.127	−0.290	−0.178	−0.154
Emotional reactions	p	0.176	0.423	0.062	0.259	0.330^a a Spearman correlation test.
Sleep	r	0.102	0.225	−0.192	−0.073	−0.239
Sleep	p	0.519	0.152	0.223	0.646	0.128^a a Spearman correlation test.
Social isolation	r	0.207	0.150	−0.229	−0.084	−0.323^* * p < 0.05.
Social isolation	p	0.187	0.343	0.145	0.598	0.037 ^a a Spearman correlation test.
Physical mobility	r	0.426 ^ p < 0.01.	0.264	−0.341^* * p < 0.05.	−0.283	−0.442^ p < 0.01.
Physical mobility	p	0.005	0.091	0.027	0.069	0.003 ^a a Spearman correlation test.

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[1] Address for correspondence
Mehmet Tecellioglu (email: mehmettecelli@hotmail.com).