TY - JOUR
T1 - Prevalence and Associated Clinical Characteristics of Walking-Related Motor, Cognitive, and Fatigability in Progressive Multiple Sclerosis
T2 - Baseline Results From the CogEx Study
AU - Ramari, Cintia
AU - D’hooge, Mieke
AU - Dalgas, Ulrik
AU - Feinstein, Anthony
AU - Amato, Maria Pia
AU - Brichetto, Giampaolo
AU - Chataway, Jeremy
AU - Chiaravalloti, Nancy D.
AU - Cutter, Gary R.
AU - DeLuca, John
AU - Farrell, Rachel
AU - Filippi, Massimo
AU - Freeman, Jennifer
AU - Inglese, Matilde
AU - Meza, Cecilia
AU - Motl, Robert W.
AU - Rocca, Maria A.
AU - Sandroff, Brian M.
AU - Salter, Amber
AU - Kos, Daphne
AU - Feys, Peter
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/5
Y1 - 2024/5
N2 - Background: People with progressive multiple sclerosis (PMS) present motor (eg, walking) and cognitive impairments, and report fatigue. Fatigue encompasses fatigability which is objectively measured by the capacity to sustain a motor or cognitive task. Objective: To investigate the prevalence of walking and cognitive fatigability (CF) and the associated clinical characteristics in a large sample of PMS patients. Methods: PMS patients (25-65 years old) were included from 11 sites (Europe and North America), having cognitive impairment (1.28 standard deviation below normative data for the symbol digit modality test [SDMT]). Walking fatigability (WF) was assessed using the distance walk index (DWI) and CF using the SDMT (scores from the last 30 seconds compared to the first 30 seconds). Additional measures were: cognitive assessment—Brief International Cognitive Assessment for multiple sclerosis (MS), cardiorespiratory fitness, 6-minute walk, physical activity, depressive symptoms, perceived fatigue—Modified Fatigue Impact Scale (MFIS), MS impact—MSIS-29, and walking ability. Results: Of 298 participants, 153 (51%) presented WF (DWI = −28.9 ± 22.1%) and 196 (66%) presented CF (−29.7 ± 15%). Clinical characteristics (EDSS, disease duration, and use of assistive device) were worse in patients with versus without WF. They also presented worse scores on MSIS-29 physical, MFIS total and physical and reduced physical capacity. CF patients scored better in the MSIS-29 physical and MFIS psychosocial, compared to non-CF group. Magnitude of CF and WF were not related. Conclusions: Half of the cognitively-impaired PMS population presented WF which was associated with higher disability, physical functions, and fatigue. There was a high prevalence of CF but without strong associations with clinical, cognitive, and physical functions. Trial Registration Number: The “CogEx-study,” www.clinicaltrial.gov identifier number: NCT03679468.
AB - Background: People with progressive multiple sclerosis (PMS) present motor (eg, walking) and cognitive impairments, and report fatigue. Fatigue encompasses fatigability which is objectively measured by the capacity to sustain a motor or cognitive task. Objective: To investigate the prevalence of walking and cognitive fatigability (CF) and the associated clinical characteristics in a large sample of PMS patients. Methods: PMS patients (25-65 years old) were included from 11 sites (Europe and North America), having cognitive impairment (1.28 standard deviation below normative data for the symbol digit modality test [SDMT]). Walking fatigability (WF) was assessed using the distance walk index (DWI) and CF using the SDMT (scores from the last 30 seconds compared to the first 30 seconds). Additional measures were: cognitive assessment—Brief International Cognitive Assessment for multiple sclerosis (MS), cardiorespiratory fitness, 6-minute walk, physical activity, depressive symptoms, perceived fatigue—Modified Fatigue Impact Scale (MFIS), MS impact—MSIS-29, and walking ability. Results: Of 298 participants, 153 (51%) presented WF (DWI = −28.9 ± 22.1%) and 196 (66%) presented CF (−29.7 ± 15%). Clinical characteristics (EDSS, disease duration, and use of assistive device) were worse in patients with versus without WF. They also presented worse scores on MSIS-29 physical, MFIS total and physical and reduced physical capacity. CF patients scored better in the MSIS-29 physical and MFIS psychosocial, compared to non-CF group. Magnitude of CF and WF were not related. Conclusions: Half of the cognitively-impaired PMS population presented WF which was associated with higher disability, physical functions, and fatigue. There was a high prevalence of CF but without strong associations with clinical, cognitive, and physical functions. Trial Registration Number: The “CogEx-study,” www.clinicaltrial.gov identifier number: NCT03679468.
KW - cognition
KW - fatigue
KW - multiple sclerosis
KW - progressive
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=85186625007&partnerID=8YFLogxK
U2 - 10.1177/15459683241236161
DO - 10.1177/15459683241236161
M3 - Article
C2 - 38426484
AN - SCOPUS:85186625007
SN - 1545-9683
VL - 38
SP - 327
EP - 338
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 5
ER -