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Rich TJ, Alexander A, Dobryakova E, Chiaravalloti ND, DeLuca J, Costa SL. Effect of methylphenidate on oculomotor function in individuals with multiple sclerosis: a pilot randomized placebo-controlled trial. Front Neurol 2024; 15:1393877. [PMID: 38846035 PMCID: PMC11153819 DOI: 10.3389/fneur.2024.1393877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/29/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Individuals with multiple sclerosis (MS) frequently experience visual and oculomotor symptoms that may impact and confound neuropsychological assessments of information processing speed (IPS). In this study, we examined the effect of the psychostimulant methylphenidate on oculomotor function and the association between change in oculomotor speed and change in information processing speed. Methods We used a repeated measures crossover design in which a sample of 11 participants with MS were randomly assigned to one of two treatment arms: one that received methylphenidate for 4 weeks and another that received a placebo for 4 weeks. After a 7-day washout period, the treatments were crossed over. The King Devick test, the Symbol Digit Modalities Test, and the Paced Auditory Serial Addition Test were administered at baseline and after each of the two study arms. Results We found a significant improvement in oculomotor speed in the methylphenidate condition as compared to placebo. This improvement was significantly correlated with improvement on a visuomotor assessment of IPS (Symbol Digit Modalities Test), but no such association was found for an auditory-verbal assessment of IPS (Paced Auditory Serial Addition Test). Discussion These findings suggest that individuals with MS experience improved oculomotor speed while taking methylphenidate, which may, in turn, improve performance on assessments of IPS with visuomotor demands.
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Affiliation(s)
- Timothy J. Rich
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Aubree Alexander
- Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
| | - Ekaterina Dobryakova
- Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, United States
| | - Nancy D. Chiaravalloti
- Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, United States
| | - John DeLuca
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, NJ, United States
- Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
- Center for Multiple Sclerosis Research, Kessler Foundation, West Orange, NJ, United States
| | - Silvana L Costa
- Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
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Chen MH, Chiaravalloti ND, Genova HM, Costa SL. Visual and motor confounds on the symbol digit modalities test. Mult Scler Relat Disord 2020; 45:102436. [PMID: 32750607 DOI: 10.1016/j.msard.2020.102436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Slowed information processing speed is the most prevalent cognitive symptom in persons with multiple sclerosis (MS). The most commonly used instrument to measure information processing speed in MS is the Symbol Digit Modalities Test (SDMT). However, visual, oculomotor, and oralmotor deficits are frequently observed in persons with MS, and performance on the SDMT relies on these visual and motor functions, in addition to cognition. METHODS The current study examined the relationship between the SDMT and the King-Devick Test (KDT). The KDT encompasses similar oculomotor and oralmotor demands as the SDMT but requires a smaller attentional load. One hundred and thirty participants with MS completed the oral version of the SDMT and the KDT. Ordinary nonparametric bootstrapped regression models were performed with 1000 bootstrapped samples. Bootstrapped confidence intervals (CIs) were bias-corrected. RESULTS KDT performance explained 31% (bootstrapped CI: 18 - 43%) of the variance of SDMT performance (moderate correlation), much more than demographic and disease-related variables (0.7% and 10%, respectively). CONCLUSIONS Visual, oralmotor, and oculomotor functions contributed significantly to SDMT performance. Therefore, these sensory and motor functions must be taken into account when interpreting SDMT scores.
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Affiliation(s)
- Michelle H Chen
- Kessler Foundation, East Hanover, NJ, USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Nancy D Chiaravalloti
- Kessler Foundation, East Hanover, NJ, USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Helen M Genova
- Kessler Foundation, East Hanover, NJ, USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Silvana L Costa
- Kessler Foundation, East Hanover, NJ, USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
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