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

Viola Baione,Manuela Galli,Giovanni Fabbrini,Antonella Conte,Filippo Camerota,Claudia Celletti,Matteo De Rosa,Gina Ferrazzano,Daniele Belvisi

doi:10.3389/fneur.2021.666438

Abstract

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.

Highlights

Cervical dystonia (CD), considered a network disorder, is the most frequent adultonset focal dystonia [1]
Two-way ANOVA for stabilometric variables during the Stroop test showed that CD patients were less stable than healthy controls (HCs) during the Stroop test, with instability increasing with increasing cognitive task complexity
Data are expressed as mean ± standard deviation (SD) and as the percentage of CD patients

Summary

Introduction

Cervical dystonia (CD), considered a network disorder, is the most frequent adultonset focal dystonia [1]. Previous studies have demonstrated that CD patients have impaired postural control, balance, gait, and stepping reactions that could be secondary to abnormal head postures and sensorimotor disturbances [3,4,5,6] or may be an endophenotypic aspect of the disease [7]. The dual-task paradigm, i.e., the simultaneous performance of motor and cognitive tasks, can assess the extent that cognitive tasks interfere with automatic motor activity, such as balance and gait, i.e., cognitive-motor interference (CMI) [8, 9]. Patients with cervical dystonia (CD) show impaired postural control, balance, and gait, likely due to abnormal head postures and sensorimotor disturbances. Until now no study has investigated whether attention-demanding activity worsens postural control and balance in CD patients

Methods

Results

Discussion

Conclusion