Aging, Gait Disorders, Neurologic, Multiple Sclerosis, Neuro-Degenerative Disease
Conditions
Keywords
functional near infrared spectrometry, gait, physical activity, cognition, brain activity
Brief summary
Every-day life means being part of a complex environment and performing complex tasks that usually involve a combination of motor and cognitive skills. However, the process of aging or the sequelae of neurological diseases such as Multiple Sclerosis (MS) compromises motor-cognitive interaction necessary for an independent lifestyle. While motor-cognitive performance has been identified as an important goal for sustained health across different clinical populations, little is known about underlying brain function leading to these difficulties and how to best target these motor-cognitive difficulties in the context of rehabilitation and exercise interventions. The challenge of improving treatments of motor-cognitive difficulties (such as dual-tasking and navigation) is daunting, and an important step is arriving at a method that accurately portrays these impairments in an ecological valid state. The investigators aim therefore to explore brain function during complex walking in MS (in comparison with people with Parkinson's disease and healthy controls) by investigating the effects of neurological disease on motor-cognitive performance and its neural correlates during three conditions of complex walking (dual-task walking, navigation and a combination of both) using non-invasive measures of brain activity (functional near infrared spectrometry, fNIRS) and advanced gait analysis in real time in people with MS (in comparison with people with Parkinson's disease and healthy adults).
Interventions
OTHERNo intervention
Assessment of brain activity with fNIRS and behavioural assessments (motor, motor-cognitive and cognitive) during three complex walking conditions. 1. Dual-task walking with the auditory stroop task. 2. Navigational walking - a course consisting of a distribution of 45 and 90 degrees turns to the left and right 3. Navigational and dual-task walking (condition 1 and 2 together)
Sponsors
Karolinska University Hospital
Karolinska Institutet
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years or older * with an MS diagnosis according to McDonald criteria * with the ability to walk without a mobility device for ≥5 minutes continuously.
Exclusion criteria
* Disease or condition that affects cognition, gait or balance. * MS relapse or change of disease-modifying treatment within the past eight weeks.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional near infrared spectrometry (fNIRS) | During the test session during all three conditions | The measurement of changes in concentration of HbO and HHb in the prefrontal cortex will be assessed using a NIRSPORT 2 (NIRx Medizintechnik, Berlin, Germany) device. |
| Gait performance during all conditions | During the test session during all three conditions | Gait variables such as stride time and/or velocity will be analyzed with the APDM mobility system. |
| Dual-task performance-reaction time | During the test session during complex walking condition 1 and 3 | Cognitive performance of the dual task will be assessed as errors in the response to the Auditory stroop task. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive function - Episodic memory | During the test session, takes about 30 minutes | Episodic memory will be assessed with the Ray Auditory Verbal Learning Test (RAVLT). |
| Cognitive function - Cognitive processing speed | During the test session, takes about 3 minutes | Cognitive processing speed will be assessed with the Symbol Digit Modalities Test (SDMT) |
| Cognitive function - Inhibition & task-set switching | During the test session, takes about 5 minutes | Inhibition & task-set switching with the The Color-Word Interference Test (CWIT) from D-KEFS (Delis-Kaplan Executive Function System). |
| Self-reported level of physical activity | Will be answered before the test session in the patients home or during the test session | Assessed with the Frändin-Grimby Scale (score 1-6, higher score=better) |
| Physical activity level and intensity | For one week after the test session | Assessed with accelerometers (Actigraph GT3X+) |
| Overall MS-disability | During the test session | Assessed with the Expanded Disability Status Scale (EDSS). Higher scores=worse/more severe disability |
| Cognitive function- composite score | During the test session, takes about 50 minutes | The cognitive test battery comprised the following tests: The Color-Word Interference Test (CWIT), Verbal Fluency, Trail Making Test (TMT) and Ray Auditory Verbal Learning Test (RAVLT) and Symbol Digit Modalities Test (SDMT). Cognitive function will be assessed as a composite measure of these test together. |
| Anxiety and depression | Will be answered before the test session in the patients home or during the test session | Assessed with Hospital Anxiety and Depression Scale (HADS), 0-24 on the depression and anxiety part respectively. Lower score=better |
| Walking ability | Will be answered before the test session in the patients home or at the test session | Self-assessed walking ability with the WALK-12G. |
| Dual-task performance -errors | During the test session during dual task conditions | Cognitive performance of the dual task will be assessed as the reaction time to respond during Auditory stroop |
| Disability | Will be answered before the test session in the patients home or during the test session | WHO Disability Assessment Schedule (WHODAS) version 2.0, 12 self-assessed questions (12 to 60) more points=worse |
| Impact of Fatigue | Will be answered before the test session in the patients home or during the test session | Self-assessed impact of fatigue on physical, cognitive, and psychosocial functioning, with the Modified Fatigue Impact Scale (MFIS). 21 items, scored from 0 to 4. Higher scores indicate a larger impact of fatigue. |
| Impact of MS on health | Will be answered before the test session in the patients home or during the test session | Self-assessed physical and psychological impact of MS on health. 29 items, rated from 1 to 5. Higher score indicates perceived worse physical or psychological impacts of MS, respectively, on health. |
| Balance performance | During the test session | Assessed with the Mini-BESTest (Balance Evaluation Systems test), 0-28p. |
| Cognitive function - verbal fluency | During the test session, takes about 12 minutes | Verbal function, initiation & task-set switching with the Verbal Fluency test from D-KEFS (Delis-Kaplan Executive Function System). |
| Cognitive function - Attention and psychomotor processing speed | During the test session, takes about 3 minutes | Attention and psychomotor processing speed will be assessed with the Trail Making Test (TMT) from D-KEFS (Delis-Kaplan Executive Function System). |
Countries
Sweden
Outcome results
None listed