Attention-Demanding Cognitive Tasks Worsen Postural Control in Patients With Cervical Dystonia: A Case-Control Study

Viola Baione1, Gina Ferrazzano1, Claudia Celletti2, Matteo De Rosa1, Daniele Belvisi1,3, Giovanni Fabbrini1,3, Manuela Galli4, Filippo Camerota2, Antonella Conte1,3
1Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
2Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Rome, Italy
3Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Neuromed, Pozzilli, Italy
4Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy

Tóm tắt

Background: Patients with cervical dystonia (CD) show impaired postural control, balance, and gait, likely due to abnormal head postures and sensorimotor disturbances. However, until now no study has investigated whether attention-demanding activity worsens postural control and balance in CD patients.Objective: To investigate whether patients with CD show cognitive-motor interference (CMI), a specific kind of dual-task interference that occurs during the simultaneous execution of a cognitive and motor task. This information may be useful to determine whether performing activities of daily living worsens postural control and balance in CD patients.Methods: We performed a pilot case-control study. Twenty-two patients affected by CD and 19 healthy controls were enrolled in order to test CMI. Each subject was evaluated during the execution of a cognitive task while postural stability was assessed through a stabilometric platform.Results: CD patients showed impaired postural control compared to healthy controls, with instability increasing with increasing cognitive task complexity. No relationships were found between stabilometric parameters and clinical characteristics of CD.Conclusions: Our hypothesis is that CMI in CD patients derives from deranged network connectivity when activated simultaneously during the performance of two tasks that interfere with each other and “compete” for the same resources within the cognitive system.

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Tài liệu tham khảo

Jinnah, 2013, The focal dystonias: current views and challenges for future research, Mov Disord., 28, 926, 10.1002/mds.25567

Albanese, 2013, Phenomenology and classification of dystonia: a consensus update, Mov Disord., 28, 863, 10.1002/mds.25475

Barr, 2017, Impairments of balance, stepping reactions and gait in people with cervical dystonia, Gait Posture., 55, 55, 10.1016/j.gaitpost.2017.04.004

Anastasopoulos, 2014, Interactions between voluntary head control and neck proprioceptive reflexes in cervical dystonia, Parkinsonism Relat Disord., 20, 1165, 10.1016/j.parkreldis.2014.08.008

De, 2018, Postural control and the relation with cervical sensorimotor control in patients with idiopathic adult-onset cervical dystonia, Exp Brain Res., 236, 803, 10.1007/s00221-018-5174-x

Moreau, 1999, Static and dynamic balance function in spasmodic torticollis, Mov Disord., 14, 87, 10.1002/1531-8257(199901)14:1<l87::AID-MDS1015>3.0.CO;2-C

Esposito, 2017, Cervical dystonia patients display subclinical gait changes, Parkinsonism Relat Disord., 43, 97, 10.1016/j.parkreldis.2017.07.005

Woollacott, 2002, Attention and the control of posture and gait: a review of an emerging area of research, Gait Posture., 16, 1, 10.1016/S0966-6362(01)00156-4

McIsaac, 2018, Cognitive-motor interference in neurodegenerative disease: a narrative review and implications for clinical management, Front Psychol., 9, 2061, 10.3389/fpsyg.2018.02061

Raffegeau, 2019, A meta-analysis: Parkinson's disease and dual-task walking, Parkinsonism Relat Disord., 62, 28, 10.1016/j.parkreldis.2018.12.012

Rao, 2013, Cognitive motor interference during dual-task gait in essential tremor, Gait Posture., 38, 403, 10.1016/j.gaitpost.2013.01.006

Purcell, 2019, The effects of dual-task cognitive interference and environmental challenges on balance in huntington's disease, Mov Disord Clin Pract., 6, 202, 10.1002/mdc3.12720

Defazio, 2019, Expert recommendations for diagnosing cervical, oromandibular, and limb dystonia, Neurol Sci., 40, 89, 10.1007/s10072-018-3586-9

Comella, 2016, Clinimetric testing of the comprehensive cervical dystonia rating scale, Mov Disord., 31, 563, 10.1002/mds.26534

Stroop, 1935, Studies of interference in serial verbal reactions, J Exp Psychol., 18, 643, 10.1037/h0054651

MacLeod, 1988, Training and Stroop-like interference: evidence for a continuum of automaticity, J Exp Psychol Learn Mem Cogn., 14, 126, 10.1037/0278-7393.14.1.126

Browne, 2000, A quality control procedure for force platforms, Physiol Meas., 21, 515, 10.1088/0967-3334/21/4/308

Lion, 2014, “Postural first” principle when balance is challenged in elderly people, Int J Neurosci, 124, 558, 10.3109/00207454.2013.864288

Tjernström, 2015, Romberg ratio in quiet stance posturography–Test to retest reliability, Gait Post., 42, 27, 10.1016/j.gaitpost.2014.12.007

Holtzer, 2007, The relationship between specific cognitive functions and falls in aging, Neuropsychology., 21, 540, 10.1037/0894-4105.21.5.540

Romano, 2014, Impaired cognitive functions in adult-onset primary cranial cervical dystonia, Parkinsonism Relat Disord., 20, 162, 10.1016/j.parkreldis.2013.10.008

Conte, 2016, Non-motor symptoms in patients with adult-onset focal dystonia: sensory and psychiatric disturbances, Parkinsonism Relat Disord., 22, S111, 10.1016/j.parkreldis.2015.09.001

Mahajan, 2018, Cervical dystonia and executive function: a pilot magnetoencephalography study, Brain Sci., 8, 159, 10.3390/brainsci8090159

Leone, 2017, Cognitive-motor dual-task interference: a systematic review of neural correlates, Neurosci Biobehav Rev., 75, 348, 10.1016/j.neubiorev.2017.01.010

Periáñez, 2020, Construct validity of the stroop color-word test: influence of speed of visual search, verbal fluency, working memory, cognitive flexibility, and conflict monitoring, Arch Clin Neuropsychol., 36, 99, 10.1093/arclin/acaa034

Jinnah, 2017, The anatomical basis for dystonia: the motor network model, Tremor Other Hyperkinet Mov., 7, 506, 10.5334/tohm.383

Conte, 2019, Ten-year reflections on the neurophysiological abnormalities of focal dystonias in humans, Mov Disord., 34, 1616, 10.1002/mds.27859

Conte, 2020, Advances in the pathophysiology of adult-onset focal dystonias: recent neurophysiological and neuroimaging evidence, F1000Res., 9, F1000, 10.12688/f1000research.21029.1

Schirinzi, 2018, Dystonia as a network disorder: a concept in evolution, Curr Opin Neurol., 31, 498, 10.1097/WCO.0000000000000580

Avanzino, 2015, Sensory-motor integration in focal dystonia, Neuropsychologia., 79, 288, 10.1016/j.neuropsychologia.2015.07.008

Conson, 2020, Spatial and egocentric mental rotation in patients with cervical dystonia, J Neurol., 267, 2281, 10.1007/s00415-020-09839-8

Wajda, 2017, Intervention modalities for targeting cognitive-motor interference in individuals with neurodegenerative disease: a systematic review, Exp Rev Neuro., 17, 251, 10.1080/14737175.2016.1227704