Cognitive and Central Vestibular Functions Correlate in People With Multiple Sclerosis.
Graham D Cochrane, Jennifer B Christy, Brian M Sandroff and 1 others
PMID 34560828WHAT IT FOUND
In 40 people with MS, worse balance, gait, eye movement, and vertical perception scores were linked to worse cognitive scores.
The link remained after accounting for disability. This is association, not proof that vestibular rehabilitation improves cognition.
Key findings
01People with MS performed worse than controls on all four central vestibular measures and all three cognitive tasks, with common language effect sizes of 0.71 to 0.82.
02Within people with MS, central vestibular measures and cognitive task scores had significant Spearman correlations for most pairs, with coefficients of 0.33 to 0.57.
03A composite central vestibular integration score correlated with the BICAMS z-score (Pearson r = -0.69; Spearman r = -0.53), and the correlation remained significant after controlling for EDSS (partial Pearson r = -0.49).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study measured associations at one time point, so it cannot show that central vestibular problems cause cognitive problems or that vestibular rehabilitation improves cognition. The sample was small and described as pilot: 40 people with MS and 20 controls, and correlations were judged significant using a false positive rate of 0.10 because the study was pilot. The MS group had mostly mild to moderate relapsing-remitting MS (median EDSS 2.5, range 1.0 to 6.5), so results may not apply to severe or progressive MS. Some participants (n=12) were recruited from flyers sent to previous research participants, which may have made the sample more research-experienced or higher socioeconomic status than typical MS populations; socioeconomic status was not controlled. Participants were aged 21 to 55, so the study did not address older adults with possible age-related vestibular degeneration. Depression and anxiety were not measured, although they can affect cognition and may confound the results. Subclinical peripheral vestibular lesions may have been present despite intact VEMP and VOR, which could affect interpretation of central integration results.
Declared interests
The supplied text does not include a conflicts-of-interest statement. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that vestibular rehabilitation improves cognition in MS. The study did not test treatment; it only found correlations between central vestibular, balance, and gait scores and cognitive scores at one time point.