The Role of Central Vestibular Dysfunction in Cognitive and Physical Impairment in Ambulatory Multiple Sclerosis

ABSTRACT Background: The aim of this study was to investigate the effects of central vestibular dysfunction on physical functionality and cognitive function in individuals with multiple sclerosis (MS). Methods: Fifty-two fully ambulatory individuals with MS (Expanded Disability Status Scale [EDSS] ≤ 4) were included and divided into two groups: those with central vestibular involvement (Group 1; n = 25) and those without (Group 2; n = 27). Central vestibular involvement was assessed using videonystagmography. Physical and cognitive functions were evaluated in all participants using the Glittre Activities of Daily Living (ADL) test, Godin Leisure-Time Exercise Questionnaire (GLTEQ), and the physical dimension of the MSQoL-54 for physical functionality, and the BICAMS, Trail Making Test (TMT), Word List Generation test and the cognitive dimension of the MSQoL-54 for cognitive function. Results: According to the physical functionality assessment results, the time required to complete the Glittre ADL test was longer in group 1 than in group 2 ( p = 0.01). The score for the physical dimension of the MSQoL-54 was lower in group 1 ( p = 0.045). In the BICAMS Symbol Digit Modalities Test, Group 1 scored lower than Group 2 ( p = 0.013). A significant difference between the groups was also observed in the time taken to complete the TMT ( p = 0.017). Additionally, Group 1 exhibited lower scores on the cognitive dimension of the MSQoL-54 ( p = 0.012). Conclusion: Physical functionality and specific cognitive domains differed between MS participants with and without central vestibular involvement. It should be considered that vestibular dysfunction may adversely impact cognitive and physical functionality, even in low-moderate disability level.