An Insight into Cognition and Posture in Multiple Sclerosis

Abstract

   The Lexico Dictionary of Oxford defines cognition as the mental activity or process of learning and comprehending through senses, experience, and thought. Progressive cognitive deficits are considered to be the most devastating disorder in MS as they cause serious economic and social problems. Although MS can affect any cognitive domain, episodic memory and information processing speed are the most commonly affected. There is a physiological relationship between cognition and balance. These functions are respectively controlled by specific cortical areas and the cerebellum, which are linked by a neuronal network. Cognitive domains are necessary for postural control. Consequently, combined investigation of the higher cognitive function and balance control sheds light on the practical implications in MS patients who experience cognitive and balance disorders. The ability to integrate physical and cognitive tasks is compromised in people with MS. In comparison to single task performance alone, simultaneous execution of motor and cognitive tasks in MS patients results in a significant decrease in gait speed, alterations to gait kinematic characteristics, and an increase in postural sway. Stronger evidence exists on cognitive training in patients with MS. Restorative approaches rely on repetitive training for targeted cognitive functions (e.g., processing speed and working memory). This can be done at home via telerehabilitation or in clinic settings using computerized activities (also known as computer-assisted cognitive rehabilitation intervention).