Ambulatuar Multipl Skleroz Hastalarında Santral Vestibüler Disfonksiyonun Fiziksel Fonksiyonellik ve Kognitif Fonksiyon Üzerine Etkisinin İncelenmesi

Abstract

This study was conducted to investigate the effect of central vestibular dysfunction on physical functioning and cognitive function in ambulatory Multiple Sclerosis (MS) patients. The study included 52 individuals aged between 18-55 years, with an Expanded Disability Status Scale (EDSS) score of 0-4, no attacks in the last 3 months and no peripheral vestibular involvement. The individuals included in the study were divided into two groups as those with central vestibular involvement (Group-1, n:25) and those without vestibular involvement (Group-2, n:27) using the Videonystagmography test battery. Vertigo Symptom Scale (VSS) and Dizziness Disability Inventory (DHI) were used for subjective evaluation of the vestibular system. Then, physical functionality and cognitive function assessments were performed in all individuals. For the assesment of physical functioning, the Glittre Activities of Daily Living (ADL) Test, the Godin Leisure Time Physcial Activity Scale (GPAS) and the physical score of the Multiple Sclerosis Quality of Life Scale (MSQL-54) were used. The Brief İnternational Cognitive Assessment Batery for MS (BICAMS), Trail Making Test (TMT), Word List Generation Test (WLG) and cognitive score of MSQL-54 were used to assess cognitive function. When the physical functioning comparisons were analyzed, the time to complete the Glittre ADL test was higher in Group-1 compared to Group-2 (p=0.01). There was no significant difference between the groups in the GPAS comparison (p>0.05). There was a significant difference between the groups for the physical part of the MSQL-54 (p<0.05). When the cognitive functions were compared, the mean of Group-1 was lower than Group-2 for the Symbol Digital Modality Test (SDMT) of the BICAMS test battery (p<0.05). The groups were similiar in terms of other tests in the BICAMS battery (p>0.05). A significant difference was found between the groups in terms of TMT-(B-A) (p=0.017). TMT-(A+B) scores of the groups were similar (p>0.05). WLG test and WLG perseveration scores of the groups were similiar (p>0.05). For the cognitive part of the MSQL-54, the mean of Group-1 was lower than that of Group-2 (p=0.012). As a result of our study, it was shown that central vestibular involvement affects both physical functionality and information processing speed, working memory and executive functions subfields of cognitive function in individuals with MS. It should be considered that vestibular dysfunction has negative effects on functionality even in fully ambulatory patients.