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MULTİPL SKLEROZ’DA BİLİŞSEL FONKSİYONLAR, POSTÜRAL KONTROL VE YÜRÜYÜŞ: DERLEME

Yıl 2025, Cilt: 8 Sayı: 3, 195 - 208, 31.12.2025
https://doi.org/10.52538/iduhes.1769945

Öz

Bilişsel bozukluk, postüral kontrol ve yürüyüş etkilenimi, bireylerin yaşam kalitesini ve günlük işlevlerini önemli ölçüde etkileyen multipl sklerozun yaygın belirtileri arasında yer almaktadır. Postüral kontrolün sağlanması için duyusal, motor ve bilişsel sistemlerin entegrasyonu gereklidir. Giderek artan miktarda kanıt, postüral kontrolün dikkat kaynaklarını tükettiğini göstermektedir. Santral motor, santral duyusal ve bilişsel bozukluklar, postüral kontrolün planlanmasını ve korunmasını etkileyebilir ve yürüme sırasında problem çözme yeteneklerini azaltabilir. Bu, daha yavaş yürüyüşe, kısalmış tek destek süresine ve gecikmiş salınım fazına neden olabilir. Buna rağmen, bilişsel yükün multipl skleroz hastalarında postüral kontrol ve yürüyüş üzerindeki etkileri hakkında çok az şey bilinmektedir. Bu çalışmanın amacı biliş ve postüral kontrol arasındaki ilişkileri anlamak ve etkili multipl skleroz yönetimi için önemini açıklamaktır. Multipl sklerozda biliş ve denge üzerine yapılacak gelecek araştırmalar, longitudinal çalışmalara öncelik vermeli, hedefli müdahaleler geliştirmeli ve gelişmiş nörogörüntüleme tekniklerinden yararlanmalıdır. Bu yaklaşımlar, hastalığın ilerlemesinin daha iyi anlaşılmasına, daha etkili tedavilerin geliştirilmesine ve multipl skleroz hastalarında rehabilitasyon sonuçlarının daha iyi izlenmesine katkıda bulunacaktır.

Kaynakça

  • Michaličková D, Slanař O, Šíma M. New Insights in the Mechanisms of Impaired Redox Signaling and its Interplay With Inflammation and Immunity in Multiple Sclerosis. Physiological Research 2020; 69(1):1–19. https://doi.org/10.33549/physiolres.934276.
  • Rao SM, Leo GJ, Bernardin L, Unverzagt F. Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology 1991; 41(5):685–691. https://doi.org/10.1212/WNL.41.5.685.
  • Huijbregts SCJ, Kalkers NF, De Sonneville LMJ, De Groot V, Reuling IEW, Polman CH. Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS. Neurology 2004; 63(2):335–339. https://doi.org/10.1212/01.WNL.0000129828.03714.90.
  • Diker S, Has AC, Kurne A, Göçmen R, Oğuz KK, Karabudak R. The association of cognitive impairment with gray matter atrophy and cortical lesion load in clinically isolated syndrome. Multiple Sclerosis and Related Disorders 2016; 10:14–21. https://doi.org/10.1016/j.msard.2016.08.008.
  • Amato MP, Ponziani G, Pracucci G, Bracco L, Siracusa G, Amaducci L. Cognitive Impairment in Early-Onset Multiple Sclerosis: Pattern, Predictors, and Impact on Everyday Life in a 4-year Follow-Up. Archives of Neurology 1995; 52(2):168–172. https://doi.org/10.1001/archneur.1995.00540260072019.
  • Matsuda PN, Shumway-Cook A, Ciol MA, Bombardier CH, Kartin DA. Understanding falls in multiple sclerosis: Association of mobility status, concerns about falling, and accumulated impairments. Physical Therapy 2012; 92(3):407–415. https://doi.org/10.2522/ptj.20100380.
  • Perrochon A, Holtzer R, Laidet M, et al. Postural control is associated with cognition and fear of falling in patients with multiple sclerosis. Journal of Neural Transmission 2017; 124(4):495–500. https://doi.org/10.1007/s00702-016-1668-5.
  • Kalron A. The relationship between static posturography measures and specific cognitive domains in individuals with multiple sclerosis. International Journal of Rehabilitation Research 2016; 39(3):249–254. https://doi.org/10.1097/MRR.0000000000000177.
  • Paul F. Pathology and MRI: exploring cognitive impairment in MS. Acta Neurologica Scandinavica 2016; Suppl 134:24–33.https://doi.org/10.1111/ane.12649.
  • Huber SJ, Bornstein RA, Rammohan KW, Christy JA, Chakeres DW, McGhee RB. Magnetic resonance imaging correlates of neuropsychological impairment in multiple sclerosis. The Journal of neuropsychiatry and clinical neurosciences 1992; 4(2):152–158. https://doi.org/10.1176/jnp.4.2.152.
  • Daams M, Steenwijk MD, Schoonheim MM, et al. Multi-parametric structural magnetic resonance imaging in relation to cognitive dysfunction in long-standing multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England) 2016; 22(5):608–619. https://doi.org/10.1177/1352458515596598.
  • Petracca M, Pontillo G, Moccia M, et al. Neuroimaging Correlates of Cognitive Dysfunction in Adults with Multiple Sclerosis. Brain sciences 2021; 11(3). https://doi.org/10.3390/brainsci11030346.
  • Amato MP, Portaccio E, Goretti B, et al. Cognitive impairment in early stages of multiple sclerosis. Neurological Sciences 2010; 31(SUPPL. 2). https://doi.org/10.1007/s10072-010-0376-4.
  • Miller E, Redlicka J, Miller I, Saluk J, Morel A. Pharmacological and Non-pharmacological Therapies of Cognitive Impairment in Multiple Sclerosis. Current Neuropharmacology 2018; 16(4):475–483. https://doi.org/10.2174/1570159x15666171109132650.
  • Hämäläinen P, Rosti-Otajärvi E. Cognitive impairment in MS: rehabilitation approaches. Acta Neurologica Scandinavica 2016; Suppl 134:8–13. https://doi.org/10.1111/ane.12650.
  • Rao SM. Cognitive Function in Patients with Multiple Sclerosis: Impairment and Treatment. International Journal of MS Care 2004; 6(1):9–22. https://doi.org/10.7224/1537-2073-6.1.9.
  • Benedict RHB, Zivadinov R. Risk factors for and management of cognitive dysfunction in multiple sclerosis. Nature Reviews Neurology 2011; 7(6):332–342. https://doi.org/10.1038/nrneurol.2011.61.
  • Calabrese M, Rinaldi F, Grossi P, Gallo P. Cortical pathology and cognitive impairment in multiple sclerosis. Expert Review of Neurotherapeutics 2011; 11(3):425–432. https://doi.org/10.1586/ern.10.155.
  • Portaccio E, Amato MP. Cognitive Impairment in Multiple Sclerosis: An Update on Assessment and Management. NeuroSci 2022; 3(4):667–676. https://doi.org/10.3390/neurosci3040048.
  • Bobholz JA, Rao SM. Cognitive dysfunction in multiple sclerosis: a review of recent developments. Current Opinion in Neurology 2003; 16(3):283–288. https://doi.org/10.1097/01.wco.0000073928.19076.84.
  • Messinis L, Kosmidis MH, Lyros E, Papathanasopoulos P. Assessment and rehabilitation of cognitive impairment in multiple sclerosis. International Review of Psychiatry 2010; 22(1):22–34. https://doi.org/10.3109/09540261003589372.
  • Sumowski JF, Leavitt VM. Cognitive reserve in multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England) 2013; 19(9):1122–1127. https://doi.org/10.1177/1352458513498834.
  • Deluca J, Sandroff BM, Chiaravalloti ND. Treatment and management of cognitive dysfunction in patients with multiple sclerosis. Nature Reviews Neurology 2020; 16(6):319–332. https://doi.org/10.1038/s41582-020-0355-1.
  • Freund JE, Stetts DM, Vallabhajosula S. Relationships between trunk performance, gait and postural control in persons withmultiple sclerosis. NeuroRehabilitation: An International, Interdisciplinary Journal 2016; 39(2):305–317. https://doi.org/10.3233/nre-161362.
  • Cameron MH, Lord S. Postural Control in Multiple Sclerosis: Implications for Fall Prevention. Current Neurology and Neuroscience Reports 2010; 10(5):407–412. https://doi.org/10.1007/s11910-010-0128-0.
  • Ortiz-Gutiérrez R, Alguacil-Diego I, Palacios-Ceña D, Galán-Del-Río F, Miangolarra-Page J, Cano-De-La-Cuerda R. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study. International Journal of Environmental Research and Public Health 2013; 10(11):5697–5710. https://doi.org/10.3390/ijerph10115697.
  • Fjeldstad C, Pardo G, Frederiksen C, Bemben D, Bemben M. Assessment of Postural Balance in Multiple Sclerosis. International Journal of MS Care 2009; 11(1):1–5. https://doi.org/10.7224/1537-2073-11.1.1.
  • Prosperini L, Castelli L. Spotlight on postural control in patients with multiple sclerosis. Degenerative Neurological and Neuromuscular Disease 2018; 8(4):25–34. https://doi.org/10.2147/dnnd.s135755.
  • Davis LA, Feeney DF, Enoka RM, et al. Force control during submaximal isometric contractions is associated with walking performance in persons with multiple sclerosis. Journal of Neurophysiology 2020; 123(6):2191–2200. https://doi.org/10.1152/jn.00085.2020.
  • Motl R, Benedict B, Goldman G. Walking impairment in patients with multiple sclerosis: exercise training as a treatment option. Neuropsychiatric Disease and Treatment 2010; 6(5):767.https://doi.org/10.2147/ndt.s10480.
  • Martin CL, Phillips BA, Kilpatrick TJ, et al. Gait and balance impairment in early multiple sclerosis\nin the absence of clinical disability. Multiple Sclerosis 2006; 12(5):620–628. https://doi.org/10.1177/1352458506070658.
  • Galea MP, Butzkueven H, Kilpatrick TJ, Cofré Lizama LE. Gait and balance deterioration over a 12-month period in multiple sclerosis patients with EDSS scores ≤ 3.0. NeuroRehabilitation 2017; 40(2):277–284. https://doi.org/10.3233/nre-161413.
  • Fujiwara H, Murai T, Yassin W. Neuroimaging studies of social cognition in schizophrenia. Psychiatry and Clinical Neurosciences 2014; 69(5):259–267. https://doi.org/10.1111/pcn.12258.
  • Sandroff BM, Motl RW. Fitness and cognitive processing speed in persons with multiple sclerosis: A cross-sectional investigation. Journal of Clinical and Experimental Neuropsychology 2012; 34(10):1041–1052. https://doi.org/10.1080/13803395.2012.715144.
  • Benedict RHB, Weinstock-Guttman B, Foley FW, et al. Upper and Lower Extremity Motor Function and Cognitive Impairment in Multiple Sclerosis. Journal of the International Neuropsychological Society 2011; 17(4):643–653. https://doi.org/10.1017/s1355617711000403.
  • Munari D, Battistuzzi E, Picelli A, et al. Effects of robot-assisted gait training combined with virtual reality on motor and cognitive functions in patients with multiple sclerosis: A pilot, single-blind, randomized controlled trial. Restorative Neurology and Neuroscience 2020; 38(2):151–164. https://doi.org/10.3233/rnn-190974.
  • Leone C, Veldkamp R, Feys P, et al. Comparing 16 Different Dual-Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive-Motor Interference. Frontiers in Neurology 2020; 11(Pt 5). https://doi.org/10.3389/fneur.2020.00918.
  • D’Esposito M, Onishi K, Armstrong C, Grossman M, Robinson K, Thompson H. Working memory impairments in multiple sclerosis: Evidence from a dual-task paradigm. Neuropsychology 1996; 10(1):51–56. https://doi.org/10.1037/0894-4105.10.1.51.
  • Fritz NE, Cheek FM, Nichols-Larsen DS. Motor-Cognitive Dual-Task Training in Persons With Neurologic Disorders: A Systematic Review. Journal of neurologic physical therapy : JNPT 2015; 39(3):142–153. https://doi.org/10.1097/NPT.0000000000000090.
  • Beste C, Mückschel M, Paucke M, Ziemssen T. Dual-Tasking in Multiple Sclerosis - Implications for a Cognitive Screening Instrument. Frontiers in human neuroscience 2018; 12:24. https://doi.org/10.3389/fnhum.2018.00024.
  • Pashler H. Dual-task interference in simple tasks: data and theory. Psychological bulletin 1994; 116(2):220–244. https://doi.org/10.1037/0033-2909.116.2.220.
  • Wajda DA, Roeing KL, McAuley E, Motl RW, Sosnoff JJ. The Relationship Between Balance Confidence and Cognitive Motor Interference in Individuals With Multiple Sclerosis. Journal of motor behavior 2016; 48(1):66–71. https://doi.org/10.1080/00222895.2015.1040110.
  • Wajda DA, Sosnoff JJ. Cognitive-motor interference in multiple sclerosis: a systematic review of evidence, correlates, and consequences. BioMed Research International 2015; 2015(4):1–8. https://doi.org/10.1155/2015/720856.
  • Benedict RHB, Cox D, Thompson LL, Foley F, Weinstock-Guttman B, Munschauer F. Reliable screening for neuropsychological impairment in multiple sclerosis. Multiple Sclerosis 2004; 10(6):675–678.https://doi.org/10.1191/1352458504ms1098oa.
  • Kalron A, Dvir Z, Achiron A. Effect of a cognitive task on postural control in patients with a clinically isolated syndrome suggestive of multiple sclerosis. European Journal of Physical and Rehabilitation Medicine 2011; 47(4):579–586. PMID: 21304449.
  • Negahban H, Mofateh R, Arastoo AA, et al. The effects of cognitive loading on balance control in patients with multiple sclerosis. Gait and Posture 2011; 34(4):479–484. https://doi.org/10.1016/j.gaitpost.2011.06.023.
  • Rudick R, Antel J, Confavreux C, et al. Clinical outcomes assessment in multiple sclerosis. Annals of Neurology 1996. https://doi.org/10.1002/ana.410400321.
  • Kalron A. The relationship between specific cognitive domains, fear of falling, and falls in people with multiple sclerosis. BioMed Research International 2014; 2014. https://doi.org/10.1155/2014/281760.
  • Barbarulo AM, Costabile T, Grossi D, et al. Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study. Frontiers in Behavioral Neuroscience 2018; 12(185). https://doi.org/10.3389/fnbeh.2018.00196.
  • Maggio MG, De Luca R, Manuli A, et al. Do patients with multiple sclerosis benefit from semi-immersive virtual reality? A randomized clinical trial on cognitive and motor outcomes. Applied Neuropsychology: Adult 2020; 29(1):59–65. https://doi.org/10.1080/23279095.2019.1708364.

COGNITIVE FUNCTIONS, POSTURAL CONTROL AND GAIT IN MULTIPLE SCLEROSIS: REVİEW

Yıl 2025, Cilt: 8 Sayı: 3, 195 - 208, 31.12.2025
https://doi.org/10.52538/iduhes.1769945

Öz

Cognitive impairment, postural control and gait deficits are common manifestations of multiple sclerosis that significantly impact patients' quality of life and daily functioning. The integration of the sensory, motor and cognitive systems are necessary to ensure postural control. Increasing amounts of evidence suggest that postural control consumes attention sources. Central motor, central sensory and cognitive disorders can affect the planning and preservation of postural control, and reduce the problem-solving abilities during walking. This can result in slower gait, shortened single support time, and delayed swing phase because of postural control impairment. However, much less is known about the effects of cognitive burden on postural control and gait in multiple sclerosis patients. The aim of the study was to understand the relationships between cognition and postural control and to explain their importance for effective multiple sclerosis management. Future research in cognition and balance in multiple sclerosis should prioritize longitudinal studies, develop targeted interventions, and utilize advanced neuroimaging techniques. These approaches will contribute to a better understanding of the disease progression, the development of more effective treatments, and improved monitoring of rehabilitation outcomes in multiple sclerosis patients.

Kaynakça

  • Michaličková D, Slanař O, Šíma M. New Insights in the Mechanisms of Impaired Redox Signaling and its Interplay With Inflammation and Immunity in Multiple Sclerosis. Physiological Research 2020; 69(1):1–19. https://doi.org/10.33549/physiolres.934276.
  • Rao SM, Leo GJ, Bernardin L, Unverzagt F. Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology 1991; 41(5):685–691. https://doi.org/10.1212/WNL.41.5.685.
  • Huijbregts SCJ, Kalkers NF, De Sonneville LMJ, De Groot V, Reuling IEW, Polman CH. Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS. Neurology 2004; 63(2):335–339. https://doi.org/10.1212/01.WNL.0000129828.03714.90.
  • Diker S, Has AC, Kurne A, Göçmen R, Oğuz KK, Karabudak R. The association of cognitive impairment with gray matter atrophy and cortical lesion load in clinically isolated syndrome. Multiple Sclerosis and Related Disorders 2016; 10:14–21. https://doi.org/10.1016/j.msard.2016.08.008.
  • Amato MP, Ponziani G, Pracucci G, Bracco L, Siracusa G, Amaducci L. Cognitive Impairment in Early-Onset Multiple Sclerosis: Pattern, Predictors, and Impact on Everyday Life in a 4-year Follow-Up. Archives of Neurology 1995; 52(2):168–172. https://doi.org/10.1001/archneur.1995.00540260072019.
  • Matsuda PN, Shumway-Cook A, Ciol MA, Bombardier CH, Kartin DA. Understanding falls in multiple sclerosis: Association of mobility status, concerns about falling, and accumulated impairments. Physical Therapy 2012; 92(3):407–415. https://doi.org/10.2522/ptj.20100380.
  • Perrochon A, Holtzer R, Laidet M, et al. Postural control is associated with cognition and fear of falling in patients with multiple sclerosis. Journal of Neural Transmission 2017; 124(4):495–500. https://doi.org/10.1007/s00702-016-1668-5.
  • Kalron A. The relationship between static posturography measures and specific cognitive domains in individuals with multiple sclerosis. International Journal of Rehabilitation Research 2016; 39(3):249–254. https://doi.org/10.1097/MRR.0000000000000177.
  • Paul F. Pathology and MRI: exploring cognitive impairment in MS. Acta Neurologica Scandinavica 2016; Suppl 134:24–33.https://doi.org/10.1111/ane.12649.
  • Huber SJ, Bornstein RA, Rammohan KW, Christy JA, Chakeres DW, McGhee RB. Magnetic resonance imaging correlates of neuropsychological impairment in multiple sclerosis. The Journal of neuropsychiatry and clinical neurosciences 1992; 4(2):152–158. https://doi.org/10.1176/jnp.4.2.152.
  • Daams M, Steenwijk MD, Schoonheim MM, et al. Multi-parametric structural magnetic resonance imaging in relation to cognitive dysfunction in long-standing multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England) 2016; 22(5):608–619. https://doi.org/10.1177/1352458515596598.
  • Petracca M, Pontillo G, Moccia M, et al. Neuroimaging Correlates of Cognitive Dysfunction in Adults with Multiple Sclerosis. Brain sciences 2021; 11(3). https://doi.org/10.3390/brainsci11030346.
  • Amato MP, Portaccio E, Goretti B, et al. Cognitive impairment in early stages of multiple sclerosis. Neurological Sciences 2010; 31(SUPPL. 2). https://doi.org/10.1007/s10072-010-0376-4.
  • Miller E, Redlicka J, Miller I, Saluk J, Morel A. Pharmacological and Non-pharmacological Therapies of Cognitive Impairment in Multiple Sclerosis. Current Neuropharmacology 2018; 16(4):475–483. https://doi.org/10.2174/1570159x15666171109132650.
  • Hämäläinen P, Rosti-Otajärvi E. Cognitive impairment in MS: rehabilitation approaches. Acta Neurologica Scandinavica 2016; Suppl 134:8–13. https://doi.org/10.1111/ane.12650.
  • Rao SM. Cognitive Function in Patients with Multiple Sclerosis: Impairment and Treatment. International Journal of MS Care 2004; 6(1):9–22. https://doi.org/10.7224/1537-2073-6.1.9.
  • Benedict RHB, Zivadinov R. Risk factors for and management of cognitive dysfunction in multiple sclerosis. Nature Reviews Neurology 2011; 7(6):332–342. https://doi.org/10.1038/nrneurol.2011.61.
  • Calabrese M, Rinaldi F, Grossi P, Gallo P. Cortical pathology and cognitive impairment in multiple sclerosis. Expert Review of Neurotherapeutics 2011; 11(3):425–432. https://doi.org/10.1586/ern.10.155.
  • Portaccio E, Amato MP. Cognitive Impairment in Multiple Sclerosis: An Update on Assessment and Management. NeuroSci 2022; 3(4):667–676. https://doi.org/10.3390/neurosci3040048.
  • Bobholz JA, Rao SM. Cognitive dysfunction in multiple sclerosis: a review of recent developments. Current Opinion in Neurology 2003; 16(3):283–288. https://doi.org/10.1097/01.wco.0000073928.19076.84.
  • Messinis L, Kosmidis MH, Lyros E, Papathanasopoulos P. Assessment and rehabilitation of cognitive impairment in multiple sclerosis. International Review of Psychiatry 2010; 22(1):22–34. https://doi.org/10.3109/09540261003589372.
  • Sumowski JF, Leavitt VM. Cognitive reserve in multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England) 2013; 19(9):1122–1127. https://doi.org/10.1177/1352458513498834.
  • Deluca J, Sandroff BM, Chiaravalloti ND. Treatment and management of cognitive dysfunction in patients with multiple sclerosis. Nature Reviews Neurology 2020; 16(6):319–332. https://doi.org/10.1038/s41582-020-0355-1.
  • Freund JE, Stetts DM, Vallabhajosula S. Relationships between trunk performance, gait and postural control in persons withmultiple sclerosis. NeuroRehabilitation: An International, Interdisciplinary Journal 2016; 39(2):305–317. https://doi.org/10.3233/nre-161362.
  • Cameron MH, Lord S. Postural Control in Multiple Sclerosis: Implications for Fall Prevention. Current Neurology and Neuroscience Reports 2010; 10(5):407–412. https://doi.org/10.1007/s11910-010-0128-0.
  • Ortiz-Gutiérrez R, Alguacil-Diego I, Palacios-Ceña D, Galán-Del-Río F, Miangolarra-Page J, Cano-De-La-Cuerda R. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study. International Journal of Environmental Research and Public Health 2013; 10(11):5697–5710. https://doi.org/10.3390/ijerph10115697.
  • Fjeldstad C, Pardo G, Frederiksen C, Bemben D, Bemben M. Assessment of Postural Balance in Multiple Sclerosis. International Journal of MS Care 2009; 11(1):1–5. https://doi.org/10.7224/1537-2073-11.1.1.
  • Prosperini L, Castelli L. Spotlight on postural control in patients with multiple sclerosis. Degenerative Neurological and Neuromuscular Disease 2018; 8(4):25–34. https://doi.org/10.2147/dnnd.s135755.
  • Davis LA, Feeney DF, Enoka RM, et al. Force control during submaximal isometric contractions is associated with walking performance in persons with multiple sclerosis. Journal of Neurophysiology 2020; 123(6):2191–2200. https://doi.org/10.1152/jn.00085.2020.
  • Motl R, Benedict B, Goldman G. Walking impairment in patients with multiple sclerosis: exercise training as a treatment option. Neuropsychiatric Disease and Treatment 2010; 6(5):767.https://doi.org/10.2147/ndt.s10480.
  • Martin CL, Phillips BA, Kilpatrick TJ, et al. Gait and balance impairment in early multiple sclerosis\nin the absence of clinical disability. Multiple Sclerosis 2006; 12(5):620–628. https://doi.org/10.1177/1352458506070658.
  • Galea MP, Butzkueven H, Kilpatrick TJ, Cofré Lizama LE. Gait and balance deterioration over a 12-month period in multiple sclerosis patients with EDSS scores ≤ 3.0. NeuroRehabilitation 2017; 40(2):277–284. https://doi.org/10.3233/nre-161413.
  • Fujiwara H, Murai T, Yassin W. Neuroimaging studies of social cognition in schizophrenia. Psychiatry and Clinical Neurosciences 2014; 69(5):259–267. https://doi.org/10.1111/pcn.12258.
  • Sandroff BM, Motl RW. Fitness and cognitive processing speed in persons with multiple sclerosis: A cross-sectional investigation. Journal of Clinical and Experimental Neuropsychology 2012; 34(10):1041–1052. https://doi.org/10.1080/13803395.2012.715144.
  • Benedict RHB, Weinstock-Guttman B, Foley FW, et al. Upper and Lower Extremity Motor Function and Cognitive Impairment in Multiple Sclerosis. Journal of the International Neuropsychological Society 2011; 17(4):643–653. https://doi.org/10.1017/s1355617711000403.
  • Munari D, Battistuzzi E, Picelli A, et al. Effects of robot-assisted gait training combined with virtual reality on motor and cognitive functions in patients with multiple sclerosis: A pilot, single-blind, randomized controlled trial. Restorative Neurology and Neuroscience 2020; 38(2):151–164. https://doi.org/10.3233/rnn-190974.
  • Leone C, Veldkamp R, Feys P, et al. Comparing 16 Different Dual-Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive-Motor Interference. Frontiers in Neurology 2020; 11(Pt 5). https://doi.org/10.3389/fneur.2020.00918.
  • D’Esposito M, Onishi K, Armstrong C, Grossman M, Robinson K, Thompson H. Working memory impairments in multiple sclerosis: Evidence from a dual-task paradigm. Neuropsychology 1996; 10(1):51–56. https://doi.org/10.1037/0894-4105.10.1.51.
  • Fritz NE, Cheek FM, Nichols-Larsen DS. Motor-Cognitive Dual-Task Training in Persons With Neurologic Disorders: A Systematic Review. Journal of neurologic physical therapy : JNPT 2015; 39(3):142–153. https://doi.org/10.1097/NPT.0000000000000090.
  • Beste C, Mückschel M, Paucke M, Ziemssen T. Dual-Tasking in Multiple Sclerosis - Implications for a Cognitive Screening Instrument. Frontiers in human neuroscience 2018; 12:24. https://doi.org/10.3389/fnhum.2018.00024.
  • Pashler H. Dual-task interference in simple tasks: data and theory. Psychological bulletin 1994; 116(2):220–244. https://doi.org/10.1037/0033-2909.116.2.220.
  • Wajda DA, Roeing KL, McAuley E, Motl RW, Sosnoff JJ. The Relationship Between Balance Confidence and Cognitive Motor Interference in Individuals With Multiple Sclerosis. Journal of motor behavior 2016; 48(1):66–71. https://doi.org/10.1080/00222895.2015.1040110.
  • Wajda DA, Sosnoff JJ. Cognitive-motor interference in multiple sclerosis: a systematic review of evidence, correlates, and consequences. BioMed Research International 2015; 2015(4):1–8. https://doi.org/10.1155/2015/720856.
  • Benedict RHB, Cox D, Thompson LL, Foley F, Weinstock-Guttman B, Munschauer F. Reliable screening for neuropsychological impairment in multiple sclerosis. Multiple Sclerosis 2004; 10(6):675–678.https://doi.org/10.1191/1352458504ms1098oa.
  • Kalron A, Dvir Z, Achiron A. Effect of a cognitive task on postural control in patients with a clinically isolated syndrome suggestive of multiple sclerosis. European Journal of Physical and Rehabilitation Medicine 2011; 47(4):579–586. PMID: 21304449.
  • Negahban H, Mofateh R, Arastoo AA, et al. The effects of cognitive loading on balance control in patients with multiple sclerosis. Gait and Posture 2011; 34(4):479–484. https://doi.org/10.1016/j.gaitpost.2011.06.023.
  • Rudick R, Antel J, Confavreux C, et al. Clinical outcomes assessment in multiple sclerosis. Annals of Neurology 1996. https://doi.org/10.1002/ana.410400321.
  • Kalron A. The relationship between specific cognitive domains, fear of falling, and falls in people with multiple sclerosis. BioMed Research International 2014; 2014. https://doi.org/10.1155/2014/281760.
  • Barbarulo AM, Costabile T, Grossi D, et al. Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study. Frontiers in Behavioral Neuroscience 2018; 12(185). https://doi.org/10.3389/fnbeh.2018.00196.
  • Maggio MG, De Luca R, Manuli A, et al. Do patients with multiple sclerosis benefit from semi-immersive virtual reality? A randomized clinical trial on cognitive and motor outcomes. Applied Neuropsychology: Adult 2020; 29(1):59–65. https://doi.org/10.1080/23279095.2019.1708364.
Toplam 50 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Derleme
Yazarlar

Hatice Ayan 0000-0002-6641-3540

Gönderilme Tarihi 21 Ağustos 2025
Kabul Tarihi 31 Aralık 2025
Yayımlanma Tarihi 31 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 3

Kaynak Göster

APA Ayan, H. (2025). COGNITIVE FUNCTIONS, POSTURAL CONTROL AND GAIT IN MULTIPLE SCLEROSIS: REVİEW. Izmir Democracy University Health Sciences Journal, 8(3), 195-208. https://doi.org/10.52538/iduhes.1769945

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