Author Of 1 Presentation
P1102 - Manual Dexterity Improves with Cognitive Remediation in Relapsing but not in Progressive Multiple Sclerosis (ID 1928)
Abstract
Background
There is increasing evidence that upper extremity (UE) motor functioning, measured by speeded pegboard completion, correlates with cognitive functioning in multiple sclerosis (MS). To date, studies have characterized this correlation with single assessment points in cross-sectional studies. However, to be validated as a behavioral biomarker of cognition, pegboard completion should also reflect change in cognitive functioning over time.
Objectives
To characterize changing of pegboard completion and cognitive functioning at baseline and following cognitive remediation program.
Methods
In this large RCT of n=135, n=74 participants with MS (EDSS 0-8, relapsing-remitting and progressive subtypes) completed an adaptive cognitive remediation program (60 hours x 12 weeks) that led to a significant improvement in cognitive functioning compared to a control condition (n=61). Cognitive functioning was assessed by a composite score from a comprehensive battery of neuropsychological measures, while UE functioning was assessed by the 9-Hole Peg Test (9-HPT). Study outcomes were evaluated at baseline and treatment end.
Results
Participants in the active condition (median EDSS 3.5, age 48 ± 13 years, 67.5% female; 69% relapsing-remitting) significantly improved in cognitive functioning (composite neuropsychological z-score: -0.77 vs. -0.68, p<0.001) and in the 9-HPT completion for the dominant hand (9-HPT z-score: -4.1 vs -3.3, p=0.013). Within the active condition group, only those with relapsing-remitting subtype were found to have a significant improvement in the completion time of 9-HPT (dominant hand 9-HPT z-score: -3.4 vs. -2.4, p<0.001; non-dominant hand 9-HPT z-score: -3.0 vs. -2.5, p=0.04). In the control condition, where no significant improvement in cognitive functioning was found, there was not an improvement in the 9-HPT completion.
Conclusions
Routine pegboard completion is a quick and efficient measure of both cognitive and fine motor involvement in MS at one point in time and in response to change in cognitive functioning. However, this relation is specific to those with relapsing-remitting subtype, likely due to higher motor impairment in those with progressive disease.