Working memory impairments in multiple sclerosis: Evidence from a dual-task paradigm.

Abstract

The aim of this study was to investigate working memory in multiple sclerosis (MS) patients. To test the hypothesis that the central executive system (CES) of working memory is impaired, 36 MS patients were administered a dual-task paradigm in which a judgment of line orientation measure was performed concurrently with finger tapping, humming a melody, or reciting the alphabet. MS patients exhibited a significantly greater decrement in performance than controls during the more demanding dual-task conditions (concurrent humming or alphabet recitation) as compared with the single-task condition. Dual-task performance in MS patients correlated with performance on the Paced Auditory Serial Addition Test but not with other cognitive or clinical measures. The authors conclude that MS patients have a working memory deficit reflecting an impaired central executive system. Moreover, impairments in speed of information processing in MS patients are associated with this CES deficit. Memory dysfunction is the most common cognitive impairment observed in patients with multiple sclerosis (MS). A long-term memory deficit in these patients is well documented (Grafman, Rao, & Litvan, 1990), but most early studies of MS patients have concluded that short-term memory (STM) is intact. Support for this claim was derived from the observation of a normal digit span, as well as an intact recency effect on supraspan list learning, measures commonly used to assess STM (Caine, Bamford, Schiffer, Shoulson, & Levy, 1986; Rao, Hammeke, McQuillen, Khatri, & Lloyd, 1984). Although most studies continue to focus on the long-term memory impairments in MS patients (Rao, Leo, & Aubin-Faubert, 1989), evidence is accumulating that STM deficits may also exist (Grigsby, Ayarbe, Kravcism, & Busenbark, 1994; Rao et al., 1993). However, the nature of these deficits remain unclear. The purpose of this study was to further investigate STM processing in MS patients. Several experimental tasks have been useful for identifying impairment in various aspects of STM in MS patients. One experimental measure, the Brown-Peterson task (Peterson & Peterson, 1959), measures consolidation of information in STM and the effect of interference on temporarily stored information. With this task, two groups of investigators (Beatty, Goodkin, Monson, Beatty, & Hertsgaard, 1988; Grant,